• BMJ open · Apr 2016

    Observational Study

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

    • Marlena C Kaczmarek, Robert S Ware, Julie A McEniery, Mark G Coulthard, and Stephen B Lambert.
    • UQ Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
    • BMJ Open. 2016 Apr 6; 6 (4): e010386.

    ObjectiveTo review the epidemiology of pertussis-related intensive care unit (ICU) admissions across Australia, over a 17-year period.DesignRetrospective descriptive study.SettingAustralian 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.ParticipantsAll paediatric (<16 years) ICU admissions, coded as pertussis-related, between 1 January 1997 and 31 December 2013.ResultsA 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.ConclusionsPertussis-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.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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