Clinical and Epidemiological Insights into Bordetella Pertussis Infection in Children: A Comprehensive Study

Bordetella pertussis infection is a leading cause of respiratory illness in pediatric patients globally, especially in areas with lower vaccination coverage. This study aims to investigate the clinical characteristics, coinfections, treatment regimens, and outcomes in pediatric patients with B. per-tussis infection in Southeast Romania. A retrospective clinical study was conducted on 38 pediatric patients, most up to 3 years old (81.58%). They were hospitalized with B. pertussis infection in the Pediatric Departments of Constanta County Clinical Emergency Hospital "St. Apostle Andrew" between January 1, 2024, and September 30, 2024. Data on demographics, clinical manifestations, coinfections, antimicrobial treatments, and hospital outcomes were extensively analyzed. Although pertussis is recognized as a vaccine-preventable disease, our findings show that only 7/38 pediatric patients (18.42%) received the B. pertussis vaccine; moreover, none benefitted from maternal im-munization. Therefore, the highest incidence of whooping cough was recorded in infants < 1 year (17/38, 44.74%). Among the 38 children, 18.42% required intensive care, with macrolides being the most commonly administered antibiotics (68.42%). Codetection of respiratory pathogens was common, with Streptococcus pneumoniae, Enterovirus, and Human Rhinovirus identified frequently. Severe cases were characterized by elevated white blood cell counts, with hyperleukocytosis iden-tified as a significant risk factor for complications, including heart failure. This study emphasizes the importance of early recognition and management of coinfections and hyperleukocytosis in pediatric pertussis patients. Macrolides remain a cornerstone of treatment, but further research into leuko-reduction therapies could improve outcomes in severe cases. Despite vaccination campaigns, Bor-detella pertussis remains a public health challenge due to waning immunity and diagnostic limita-tions. Ongoing research and targeted public health initiatives are essential to reduce the disease burden and ensure sustained protection against pertussis.