Cross-sectional observation of two antibodies against Bordetella pertussis in patients receiving maintenance dialysis therapies at a single dialysis center

Abstract

【Background】 Pertussis (whooping cough), caused by Bordetella pertussis, has been recognized as a common infectious disease in the general population, not restricted to children. Maintenance hemodialysis (HD) patients are supposed to be vulnerable to such infectious diseases, because they are immunocompromised hosts and receive dialysis therapy along with other patients in a closed unit. However, reports of Bordetella pertussis infection among maintenance hemodialysis patients have been limited, and there are no surveillance reports describing antibody levels against Bordetella pertussis in dialysis patients. 【Methods】 All 141 ambulatory patients receiving dialysis therapies at Toride Kyodo General Hospital were enrolled in this study after informed consent was obtained from each patient. The patients comprised 109 of hemodialysis (M/F : 56/53, 63.9±11.4 years old) and 32 of peritoneal dialysis (M/F : 20/12, 65.3±9.9 years old). Two antibodies against Bodetella pertussis (Touhama and Yamaguchi) were applied to detecting the level of antibodies in the serum obtained from patients using the established agglutinin method. 【Results】 Positive levels (≥×10) of antibodies were identified in 78 patients (61 of HD and 17 of PD). Within two groups, there were no significant differences in patient characteristics about age and sex. The incidence of positive levels of antibodies was not related to dialysis modalities or the past history of vaccination against pertussis, but rather related to the position of the bed in which patients received hemodialysis therapy during each dialysis session. 【Conclusion】 Since pertussis may spread from one patient to another during hemodialysis sessions in a closed dialysis unit, appropriate prophylaxis, diagnosis, and treatment of pertussis should be established in maintenance dialysis units.