Characteristics of Bordetella pertussis infection among infantsand children admitted to paediatric intensive care units in Greece: A multicentre, 11‐year study

Aim To describe children with pertussis who required intensive care. Methods This is a retrospective analysis of pertussis admissions to all (six) national intensive care units in Greece from 2003 to 2013. Results A total of 31 children were included, 28 of whom were younger than 12 months old. Cough was the most prominent symptom, being present in 27 of 31 (87%) patients, and on admission, only 7 (22.6%) satisfied the case definition. Mechanical ventilation was initiated in 13 (42%) patients. Six patients died because of respiratory failure (two) or multi-organ system failure (four). The patients who died had significantly higher white blood cell counts (WBC) (77 800–31 600, P = 0.031) and neutrophils (29 016–12 795, P = 0021) than those who survived and lower minimum values of serum sodium (125–133, P = 0002). They also had a longer duration of hospitalisation prior to their paediatric intensive care unit admission (6–1 days, P = 0022). Three patients were diagnosed with pulmonary hypertension, and only one of them survived. Age, gender and immunisation status did not differ between survivors and non-survivors. Two patients received exchange blood transfusion, and survival benefit was not apparent. Conclusion Young infants are at risk of severe pertussis, resulting in serious complications or death. Elevated WBC and low serum sodium are associated with higher mortality. Despite advances in life support and treatment of organ failure in childhood critical illness, pertussis still has substantial mortality.