百日咳是由百日咳鲍特菌感染引起的急性呼吸道传染病，本病历史悠久，任何年龄段的人群均可感染发病。百日咳再现已成为引起高度关注的全球性问题，包括我国在内。2022年起至今，我国报告百日咳病例数上升迅猛。当前百日咳鲍特菌流行株的主要抗原（百日咳毒素）的基因型已发生改变，相应抗原与疫苗株不同而产生免疫逃逸，是当前百日咳再现的重要原因之一。百日咳鲍特菌目前普遍对大环内酯类抗生素耐药是临床治疗失败的重要原因，因此不再推荐其作为百日咳抗感染治疗的首选用药。2月龄以上无磺胺禁忌症的患儿，百日咳卡他期和痉咳期推荐复方磺胺甲噁唑口服作为首选抗感染方案；对2月龄以下或症状危重的患儿，推荐哌拉西林或头孢哌酮-舒巴坦静滴治疗。改良或研发与流行株抗原一致的新一代百日咳疫苗将是提升易感人群免疫保护力、控制本病流行的长远策略。

Pertussis is an acute respiratory infectious disease caused by Bordetella pertussis, which has a long history and can affect people of all ages. The re-emergence of pertussis has become a global issue of great concern, including in China. Since 2022, the number of whooping cough cases reported in China has increased rapidly. The genotype of the main antigen (pertussis toxin) of the current Bordetella pertussis epidemic strain has changed, and the corresponding antigen is different from the vaccine strain, resulting in immune escape, which is one of the important reasons for the recurrence of pertussis. At present, the resistance of Bordetella pertussis to macrolide antibiotics is an important reason for clinical treatment failure, so it is no longer recommended as the first choice for anti-infection treatment of pertussis. For children over 2 months of age with no contraindications to sulfanilamide, trimethoprim-sulfamethoxazole oral administration is recommended as the preferred anti-infection regimen for pertussis catarrhal stage and spasmodic cough stage. Piperacillin or cefoperazone-sulbactam are recommended for children under 2 months of age or with critical symptoms. The improvement or development of a new generation of pertussis vaccine with the same antigen as the prevalent strain will be a long-term strategy to enhance the immune protection of the susceptible population and control the epidemic of the disease.