Distribution and Co-detection of Bacterial Respiratory Pathogens Using Pertussis-Positive Specimens from Children and Adolescents in Busan,  Korea

Mi-Jung Park

doi:10.4167/jbv.2026.56.1.035

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2026 Vol.56, Issue 1 Preview Page Next Page

Original Article

Distribution and Co-detection of Bacterial Respiratory Pathogens Using Pertussis-Positive Specimens from Children and Adolescents in Busan, Korea

31 March 2026. pp. 35-43

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Abstract

Following the COVID-19 pandemic, the epidemiology of respiratory infectious diseases has changed substantially, with a marked resurgence of pertussis among children and adolescents in Korea in 2024. Although current molecular diagnostic methods for pertussis, based on detection of IS481, provides high sensitivity, they have limitations in differentiating closely related Bordetella species and in identifying concomitant bacterial respiratory pathogens. Moreover, region-specific surveillance data for bacterial respiratory infections remain limited compared with those for viral respiratory infections. From July–December 2024, in total, 607 respiratory specimens were collected from pertussis-positive patients under aged < 19 years at private medical institutions in Busan. These comprised 602 nasopharyngeal swabs and five sputum samples. Using nucleic acid amplification methods, six major bacterial respiratory pathogens, along with the pertussis-related species B. holmesii, were investigated. Age group–specific distributions, pathogen detection patterns, and co-detection profiles were evaluated. Among the 607 specimens, at least one bacterial respiratory pathogen was detected in 366 cases (60.3%). B. pertussis was the most frequently detected pathogen (205 cases), followed by Haemophilus influenzae (119 cases), B. holmesii (79 cases), Streptococcus pneumoniae (73 cases), and Mycoplasma pneumoniae (55 cases). Pathogen detection was most prominent in school-aged children and adolescents. Co-detection of two or more bacterial pathogens was identified in 142 cases (38.8%), including dual detections in 115 cases, triple co-detections in 25 cases, and quadruple co-detections in two cases. Notably, co-detections involving B. pertussis and M. pneumoniae was relatively common. This study provides a comprehensive characterization of the distribution and co-detection patterns of bacterial respiratory pathogens in pertussis-positive specimens from children and adolescents during the 2024 pertussis resurgence in Busan. These findings underscore the importance of considering concomitant bacterial infections in patients with pertussis-like symptoms and may serve as baseline data for strengthening region-specific surveillance and the development of multi-pathogen–oriented diagnostic and treatment strategies for bacterial respiratory infections.

Keywords

Pertussis

Bacterial respiratory detection

Co-detection

Children and adolescents

Multiplex PCR

References

Jeong SY, Lee GH, Park SJ, Jeon HI, Kim EY, Park CM, et al. Results of the national respiratory infectious disease surveillance, 2020. Public Health Weekly Rep. 2021;14(18):1139-1149.

Cho K, Choi M, Yu D, Kang U. 2021 Incidences of infectious disease and respiratory infectious disease, and deaths of infectious disease, the Republic of Korea. Public Health Weekly Rep. 2022;15(27):1923-1934.

Kim HJ, Park YJ, Kim D, Lee J, Kim YK, Seo S, et al. Pertussis surveillance and occurrence report in the Republic of Korea: from 2024 to the first half of 2025. Public Health Weekly Rep. 2025;18(43):1631-1651.

Kim CH, Yi SJ, Cho SI. Recent increase in pertussis incidence in South Korea: an age-period-cohort analysis. Epidemiol Health. 2021;43:e2021053.

10.4178/epih.e202105334412447PMC8666685

Lee SY, Han SB, Kang JH, Kim JS. Pertussis prevalence in Korean adolescents and adults with persistent cough. J Korean Med Sci. 2015;30:988–990.

10.3346/jkms.2015.30.7.98826130965PMC4479956

Cherry JD. Epidemic pertussis in 2012—the resurgence of a vaccine-preventable disease. N Engl J Med. 2012; 367(9):785–787.

10.1056/NEJMp1209051

Tan T, Dalby T, Forsyth K, Halperin SA, Heininger U, Hozbor D, et al. Pertussis across the globe: Recent epidemiologic trends from 2000 to 2013. Pediatr Infect Dis J. 2015;34(9):e222-e232.

10.1097/INF.0000000000000795

Jung SO, Moon YM, Sung HY, Kang YH, Yu JY. Discriminative PCR of Bordetella pertussis from closely related Bordetella species using 16S rDNA gene. Infect Chemother. 2008;40(1):24-31.

10.3947/ic.2008.40.1.24

Loeffelholz M. Toward improved accuracy in Bordetella pertussis nucleic acid amplification tests. J Clin Microbiol. 2012;50(7):2182-2190.

10.1128/JCM.00612-1222442315PMC3405598

Kim JW, Seo HK, Yoo EG, Park SJ, Yoon SH, Jung HY, et al. Mycoplasma pneumoniae pneumonia in Korean children, from 1979 to 2006: a meta-analysis. Korean J Pediatr. 2009;52(3):315-323.

10.3345/kjp.2009.52.3.315

Kim HS. Macrolide-resistant Mycoplasma pneumoniae: where we come from, where we are, and where do we go from here? Allergy Asthma Respir Dis. 2023;11(4):165-166.

10.4168/aard.2023.11.4.165

Jung SO, Kim SH. Analysis of antimicrobial resistance of bacterial respiratory pathogens isolated from patients shown respiratory infections in South Korea. Public Health Weekly Rep. 2014;7(24):513-518.

Kim NR, Choi BH, Sung HS. Analysis of macrolide resistance-associated genes in Mycoplasma pneumoniae isolated in 2015 [abstract]. Korean Society of Microbiological Laboratory Science Fall Meeting; 2015.

Principi N, Esposito S. Macrolide-resistant Mycoplasma pneumoniae: Its role in respiratory infection. J Antimicrob Chemother. 2013;68(3):506-511.

10.1093/jac/dks457

Lee J, Kim YB, Jang JH, Kim J, Yoo J. Serotype distribution of Streptococcus pneumoniae from respiratory specimens of children with pneumonia in the Republic of Korea, 2018–2022. Public Health Weekly Rep. 2023;16(11):305-320.

Lee ET, Park SR, Kim MN, Lee JN. Trend of antibiotic susceptibility of Haemophilus influenzae isolated from children, 2014–2019. Pediatr Infect Vaccine. 2020;27(3):147-157.

10.14776/piv.2020.27.e25

Park JW, Kim JK, Rheem IS, Kim JW. Evaluation of Seeplex™ Pneumobacter multiplex PCR kit for the detection of respiratory bacterial pathogens in pediatric patients. Korean J Lab Med. 2009;29(4):307-313.

10.3343/kjlm.2009.29.4.307

Clinical and Laboratory Standards Institute. Evaluation of transport systems for clinical specimens; approved guideline M40-A2. Wayne (PA): CLSI, 2014.

Pittet LF, Emonet S, François P, Bonetti EJ, Schrenzel J, Hug M, et al. Diagnosis of Whooping Cough in Switzerland: Differentiating Bordetella pertussis from Bordetella holmesii by PCR. PLoS One. 2014;9(2):e88936.

10.1371/journal.pone.008893624586447PMC3929760

Martini H, Detemmerman L, Soetens O, Yusuf E, Piérard D. Improving specificity of Bordetella pertussis detection using a four-target real-time PCR. PLoS One. 2017;12(4):e0175587.

10.1371/journal.pone.017558728403204PMC5389834

Information

Publisher :The Korean Society for Microbiology and The Korean Society of Virology
Publisher(Ko) :대한미생물학회‧대한바이러스학회
Journal Title :JOURNAL OF BACTERIOLOGY AND VIROLOGY
Volume : 56
No :1
Pages :35-43
Received Date : 2026-01-06
Revised Date : 2026-03-23
Accepted Date : 2026-03-26
DOI :https://doi.org/10.4167/jbv.2026.56.1.035

JOURNAL OF BACTERIOLOGY AND VIROLOGY ISSN:1598-2467(Print) 2093-0429(Online)

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