{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:07:41Z","timestamp":1788934061015,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Despite high DTaP coverage, pertussis resurgence persists. Infants under 2 months of age face severe outcomes due to vaccine ineligibility and rising macrolide-resistant\n                      <jats:italic>B. pertussis<\/jats:italic>\n                      (MRBP), yet treatment options remain limited.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyze epidemiology, clinical profiles, and antimicrobial management of hospitalized pertussis infants under 2 months of age, identifying risk factors for severity and evaluating real-world SMZ-TMP use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective study of PCR\/culture-confirmed pertussis infants hospitalized at Shenzhen Children's Hospital (2015\u20132024). Data included transmission sources, clinical severity, and antimicrobial regimens. Logistic regression analysis was performed to analyze the risk factors for severe pertussis, and a\n                      <jats:italic>P<\/jats:italic>\n                      -value &amp;lt; 0.05 was considered statistically significant. The predictive value for severe pertussis was evaluated using the receiver operating characteristic (ROC) curve.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 321 infants with a history of exposure, parents constituted the primary infection source (46.1%, 148\/321). 25 infants with\n                      <jats:italic>Bordetella pertussis<\/jats:italic>\n                      infection (aged 24\u201359 days) received off-label SMZ-TMP without bilirubin encephalopathy or renal dysfunction. Leukocytosis, and an elevated neutrophil-lymphocyte ratio were predictors of severe disease. Exposure history, apnea, decreased oxygen saturation, tachypnea, tachycardia, elevated white blood cell count, and an increased neutrophil-to-lymphocyte ratio were identified as significant risk factors for severe pertussis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In infants under 2 months of age with pertussis, parents are the primary source of infection. In infants under 2 months of age with macrolide-resistant pertussis, treatment with SMZ-TMP was effective and no severe adverse reactions were observed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1815371","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:59:52Z","timestamp":1788933592000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Parent-driven transmission, off-label SMZ-TMP, and severe pertussis prediction in infants under 2 months: a real-world observational cohort of 527 cases"],"prefix":"10.3389","volume":"14","author":[{"given":"Jieqi","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Emergency, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jikui","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyun","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shufeng","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"102610","DOI":"10.1016\/j.jiph.2024.102610","article-title":"Pertussis clinical profile shift, 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