{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T12:47:21Z","timestamp":1784119641392,"version":"3.55.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ital J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>In recent months, <jats:italic>Bordetella pertussis<\/jats:italic> has reappeared after maintaining a low rate for many years. Although pertussis is usually characterized by a favorable course, several factors can contribute to the severity of the disease, such as mixed respiratory infections. In this study, we evaluate <jats:italic>B.pertussis<\/jats:italic> cases observed in the pediatric population followed at the Bambino Ges\u00f9 Children's Hospital and analyzed the potential impact of co-infections in relation to disease severity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>From January to May 2024, a total of 1,151 children and adolescents (both inpatients and outpatients) were screened for the presence of respiratory pathogens, including <jats:italic>B.pertussis,<\/jats:italic> with clinically relevant respiratory symptoms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among the 1,151 patients screened, 66 tested positive for <jats:italic>B.pertussis<\/jats:italic>. Fourteen patients had respiratory failure, and six of them required intensive care unit (ICU) admission, while 52 had mild infection. 23.3% of patients had <jats:italic>B.pertussis<\/jats:italic> alone, while 76.7% had co-infections (including 5 patients admitted to the ICU). A higher co-infection rate was observed in patients with respiratory failure than in those without failure (92.9% vs. 69.0%, <jats:italic>p<\/jats:italic>-value:0.041). Rhinovirus, Metapneumovirus and Parainfluenza-virus were the most prevalent in our pediatric population. Co-infections of human bocavirus with <jats:italic>B.pertussis<\/jats:italic> were observed exclusively in patients with respiratory failure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Our results highlighted an increase in <jats:italic>B.pertussis<\/jats:italic> cases from January to May 2024, reaching a peak of cases in the month of May. This study shows a high rate of <jats:italic>B.pertussis<\/jats:italic> co-infection, and a trend toward association between <jats:italic>B.pertussis<\/jats:italic> and specific viruses, that might play a role in increasing disease severity.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13052-025-01865-4","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T01:44:15Z","timestamp":1737423855000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["A new epidemic wave of Bordetella pertussis in paediatric population: impact and role of co-infections in pertussis disease"],"prefix":"10.1186","volume":"51","author":[{"given":"Rossana","family":"Scutari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Linardos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Ranno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Pisani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Chiara","family":"Vittucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Coltella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luna","family":"Colagrossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Velia Chiara","family":"Di Maio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Sisto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia","family":"Mancinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Landi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Cristaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Raponi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Bernaschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Villani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Russo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0825-5388","authenticated-orcid":false,"given":"Carlo Federico","family":"Perno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"issue":"3","key":"1865_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/microbiolspec.EI10-0008-2015","volume":"4","author":"DJ Nieves","year":"2016","unstructured":"Nieves DJ, Heininger U. Bordetella pertussis. Microbiol Spectr. 2016;4(3):1\u201324.","journal-title":"Microbiol Spectr"},{"issue":"1","key":"1865_CR2","doi-asserted-by":"publisher","first-page":"2608","DOI":"10.1080\/21505594.2021.1980987","volume":"12","author":"T Belcher","year":"2021","unstructured":"Belcher T, Dubois V, Rivera-Millot A, Locht C, Jacob-Dubuisson F. Pathogenicity and virulence of Bordetella pertussis and its adaptation to its strictly human host. Virulence. 2021;12(1):2608.","journal-title":"Virulence."},{"issue":"Suppl 1","key":"1865_CR3","doi-asserted-by":"publisher","first-page":"S119","DOI":"10.1016\/j.jinf.2013.09.022","volume":"68","author":"N Guiso","year":"2014","unstructured":"Guiso N. Bordetella pertussis: why is it still circulating? J Infect. 2014;68(Suppl 1):S119\u201324. https:\/\/doi.org\/10.1016\/j.jinf.2013.09.022. Epub 2013 Oct 5 PMID: 24103807.","journal-title":"J Infect"},{"issue":"1","key":"1865_CR4","doi-asserted-by":"publisher","first-page":"16412","DOI":"10.1038\/s41598-020-73462-w","volume":"10","author":"R Muloiwa","year":"2020","unstructured":"Muloiwa R, Dube FS, Nicol MP, Hussey GD, Zar HJ. Co-detection of Bordetella pertussis and other respiratory organisms in children hospitalised with lower respiratory tract infection. Sci Rep. 2020;10(1):16412.","journal-title":"Sci Rep"},{"issue":"1","key":"1865_CR5","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1186\/s12879-017-2567-6","volume":"17","author":"A Frassanito","year":"2017","unstructured":"Frassanito A, Nenna R, Nicolai A, Pierangeli A, Tozzi AE, Stefanelli P, et al. Infants hospitalized for Bordetella pertussis infection commonly have respiratory viral coinfections. BMC Infect Dis. 2017;17(1):492.","journal-title":"BMC Infect Dis"},{"issue":"3","key":"1865_CR6","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1128\/CMR.00083-15","volume":"29","author":"PE Kilgore","year":"2016","unstructured":"Kilgore PE, Salim AM, Zervos MJ, Schmitt HJ. Pertussis: Microbiology, Disease, Treatment, and Prevention. Clin Microbiol Rev. 2016;29(3):449.","journal-title":"Clin Microbiol Rev."},{"issue":"1","key":"1865_CR7","doi-asserted-by":"publisher","first-page":"2352606","DOI":"10.1080\/07853890.2024.2352606","volume":"56","author":"S Guo","year":"2024","unstructured":"Guo S, Zhu Y, Guo Q, Wan C. Severe pertussis in infants: a scoping review. Ann Med. 2024;56(1):2352606.","journal-title":"Ann Med"},{"issue":"5","key":"1865_CR8","doi-asserted-by":"publisher","first-page":"464","DOI":"10.3390\/antibiotics13050464","volume":"13","author":"G Linardos","year":"2024","unstructured":"Linardos G, Coltella L, Ranno S, Di Maio VC, Colagrossi L, Pandolfi E, et al. Whooping Cough Cases Increase in Central Italy after COVID-19 Pandemic. Antibiotics (Basel). 2024;13(5):464.","journal-title":"Antibiotics (Basel)"},{"issue":"7","key":"1865_CR9","doi-asserted-by":"publisher","first-page":"ftw087","DOI":"10.1093\/femspd\/ftw087","volume":"74","author":"NH Carbonetti","year":"2016","unstructured":"Carbonetti NH. Pertussis leukocytosis: mechanisms, clinical relevance and treatment. Pathogens and disease. 2016;74(7):ftw087.","journal-title":"Pathogens and disease."},{"issue":"1","key":"1865_CR10","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/s12887-021-02507-4","volume":"21","author":"C Wang","year":"2021","unstructured":"Wang C, Zhang H, Zhang Y, Xu L, Miao M, Yang H, et al. Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study. BMC Pediatr. 2021;21(1):65.","journal-title":"BMC Pediatr"},{"issue":"9","key":"1865_CR11","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.3390\/vaccines12091030","volume":"12","author":"N Principi","year":"2024","unstructured":"Principi N, Bianchini S, Esposito S. Pertussis Epidemiology in Children: The Role of Maternal Immunization. Vaccines (Basel). 2024;12(9):1030.","journal-title":"Vaccines (Basel)"},{"issue":"4","key":"1865_CR12","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1016\/j.jinf.2016.01.013","volume":"72","author":"P Brotons","year":"2016","unstructured":"Brotons P, de Paz HD, Toledo D, Villanova M, Plans P, Jordan I, et al. Differences in Bordetella pertussis DNA load according to clinical and epidemiological characteristics of patients with whooping cough. J Infect. 2016;72(4):460.","journal-title":"J Infect."},{"issue":"5","key":"1865_CR13","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1097\/INF.0000000000003471","volume":"41","author":"DT Thuy Nga","year":"2022","unstructured":"Thuy Nga DT, Thi Bich Thuy P, Ainai A, Takayama I, Huong DT, Saitoh A, et al. Association Between Real-time Polymerase Chain Reaction Cycle Threshold Value and Clinical Severity in Neonates and Infants Infected With Bordetella pertussis. Pediatr Infect Dis J. 2022;41(5):388.","journal-title":"Pediatr Infect Dis J."},{"issue":"3","key":"1865_CR14","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1111\/j.1469-0691.2010.03255.x","volume":"17","author":"Y Nakamura","year":"2011","unstructured":"Nakamura Y, Kamachi K, Toyoizumi-Ajisaka H, Otsuka N, Saito R, Tsuruoka J, et al. Marked difference between adults and children in Bordetella pertussis DNA load in nasopharyngeal swabs. Clin Microbiol Infect. 2011;17(3):365.","journal-title":"Clin Microbiol Infect."},{"issue":"1","key":"1865_CR15","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1186\/s12879-016-1710-0","volume":"16","author":"AC Vittucci","year":"2016","unstructured":"Vittucci AC, Spuri Vennarucci V, Grandin A, Russo C, Lancella L, Tozzi AE, et al. Pertussis in infants: an underestimated disease. BMC Infect Dis. 2016;16(1):414.","journal-title":"BMC Infect Dis"},{"issue":"5","key":"1865_CR16","doi-asserted-by":"publisher","first-page":"750","DOI":"10.3390\/v16050750","volume":"16","author":"VC Di Maio","year":"2024","unstructured":"Di Maio VC, Scutari R, Forqu\u00e9 L, Colagrossi L, Coltella L, Ranno S, et al. Presence and Significance of Multiple Respiratory Viral Infections in Children Admitted to a Tertiary Pediatric Hospital in Italy. Viruses. 2024;16(5):750.","journal-title":"Viruses"},{"issue":"2","key":"1865_CR17","first-page":"131","volume":"58","author":"FG Versteegh","year":"2006","unstructured":"Versteegh FG, Mooi-Kokenberg EA, Schellekens JF, Roord JJ. Bordetella pertussis and mixed infections. Minerva Pediatr. 2006;58(2):131\u20137.","journal-title":"Minerva Pediatr"},{"issue":"6","key":"1865_CR18","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1097\/INF.0000000000000596","volume":"34","author":"PA Piedra","year":"2015","unstructured":"Piedra PA, Mansbach JM, Jewell AM, Thakar SD, Grant CC, Sullivan AF, et al. Bordetella pertussis is an uncommon pathogen in children hospitalized with bronchiolitis during the winter season. Pediatr Infect Dis J. 2015;34(6):566.","journal-title":"Pediatr Infect Dis J."},{"issue":"8","key":"1865_CR19","doi-asserted-by":"publisher","first-page":"736.e9","DOI":"10.1016\/j.cmi.2016.05.022","volume":"22","author":"JG Wildenbeest","year":"2016","unstructured":"Wildenbeest JG, van der Schee MP, Hashimoto S, Benschop KSM, Minnaar RP, Sprikkelman AB, et al. Prevalence of rhinoviruses in young children of an unselected birth cohort from the Netherlands. Clin Microbiol Infect. 2016;22(8):736.e9.","journal-title":"Clin Microbiol Infect."},{"issue":"4","key":"1865_CR20","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1097\/INF.0000000000000577","volume":"34","author":"H Marshall","year":"2015","unstructured":"Marshall H, Clarke M, Rasiah K, Richmond P, Buttery J, Reynolds G, et al. Predictors of disease severity in children hospitalized for pertussis during an epidemic. Pediatr Infect Dis J. 2015;34(4):339.","journal-title":"Pediatr Infect Dis J."},{"issue":"4","key":"1865_CR21","first-page":"1","volume":"1","author":"GB Lengerova","year":"2020","unstructured":"Lengerova GB, Murdjeva MA, Radeva NB, Kalchev YI, Petrov MM, Komitova RT, et al. Pertussis associated with viral infections in infants. Clin Case Rep J. 2020;1(4):1\u20134.","journal-title":"Clin Case Rep J"}],"container-title":["Italian Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13052-025-01865-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13052-025-01865-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13052-025-01865-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T01:44:17Z","timestamp":1737423857000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijponline.biomedcentral.com\/articles\/10.1186\/s13052-025-01865-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,21]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1865"],"URL":"https:\/\/doi.org\/10.1186\/s13052-025-01865-4","relation":{},"ISSN":["1824-7288"],"issn-type":[{"value":"1824-7288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,21]]},"assertion":[{"value":"12 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No ethical approval was required because this is a retrospective observational study and the results are collected in a completely anonymous and aggregated form.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"7"}}