Epidemiology of pertussis-related paediatric intensive care unit (ICU) admissions in Australia, 1997-2013: an observational study.

Abstract:

OBJECTIVE:To review the epidemiology of pertussis-related intensive care unit (ICU) admissions across Australia, over a 17-year period. DESIGN:Retrospective descriptive study. SETTING:Australian ICUs contributing data to the Australian and New Zealand Paediatric Intensive Care (ANZPIC) Registry. The number of contributing ICUs increased over the study period, from 8 specialist paediatric ICUs in 1997 to 8 specialist paediatric and 13 general ICUs in 2013. PARTICIPANTS:All paediatric (<16 years) ICU admissions, coded as pertussis-related, between 1 January 1997 and 31 December 2013. RESULTS:A total of 373 pertussis-coded ICU admissions were identified in the ANZPIC Registry over the study period. Of these cases, 52.8% occurred during the 4 years of the recent Australian epidemic (2009-2012). ICU admissions were most likely to occur in infants aged younger than 6 weeks (41.8%, n=156) and aged 6 weeks to 4 months (42.9%, n=160). The median length of stay for pertussis-related ICU admissions was 3.6 days, with 77.5% of cases staying in ICU for <7 days. Approximately half of all admissions (54.8%) required some form of respiratory support, with 32.7% requiring invasive respiratory support. Over the study period, 23 deaths were recorded (6.2% of pertussis-related ICU admissions), of which 20 (87.0%) were infants <4 months old. CONCLUSIONS:Pertussis-related ICU admissions occur primarily in infants too young to be fully protected from active immunisation. More needs to be done to protect these high-risk infants, such as maternal immunisation.

journal_name

BMJ Open

journal_title

BMJ open

authors

Kaczmarek MC,Ware RS,McEniery JA,Coulthard MG,Lambert SB

doi

10.1136/bmjopen-2015-010386

subject

Has Abstract

pub_date

2016-04-06 00:00:00

pages

e010386

issue

4

issn

2044-6055

pii

bmjopen-2015-010386

journal_volume

6

pub_type

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