ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : -9 مورد

Comparison of laboratory tests for the detection of Bordetella pertussis

Comparison of laboratory tests for the detection of Bordetella pertussis
Laboratory method Reported sensitivity* Reported specificity* Comments
Culture of nasopharyngeal secretions 20 to 80%
(decreases with increasing duration of cough)		 100%
  • Traditional reference standard for diagnosis.
  • Sensitivity depends on duration of symptoms and decreases after two weeks of illness; prior vaccination or antibiotic exposure also decrease sensitivity.
  • Permits antibiotic susceptibility testing and strain serotyping (helpful in outbreak setting).
  • Results available in three to seven days.
  • Not available in all laboratories.
  • In an outbreak setting, confirmation is recommended for at least one case of suspected pertussis.
Polymerase chain reaction of nasopharyngeal secretions 61 to 94% 88 to 98%
  • Rapidly available results.
  • More sensitive than culture, but sensitivity decreases after three weeks of illness.
  • No standard methodology.
  • Subject to contamination, especially during outbreaks.
  • May also be positive in Bordetella holmesii and Bordetella bronchiseptica.
  • May detect nonviable Bordetella pertussis organisms.
Serology (ELISA) blood 60 to 95% Δ
  • A CDC/FDA-developed assay has been useful in outbreak settings; the accuracy of commercially available assays is not known.
  • In general, serology is most useful for diagnosis two to eight weeks after cough onset. A single high antibody titer above a designated threshold may be sufficient and obviate the need for acute/convalescent titers; this cutoff is often laboratory specific.

CDC: Centers for Disease Control and Prevention; ELISA: enzyme-linked immunosorbent assay; FDA: US Food and Drug Administration.

* Reported sensitivities and specificities taken from clinical or epidemiologic studies or vaccine trials.

¶ Compared with clinical case definitions+serology in most studies.

Δ Not readily available from epidemiologic studies. An investigation in German adults found a specificity of 84% using a clinician's clinical diagnosis as a gold standard (Schmitt-Grohé S, Cherry JD, Heininger U, et al. Pertussis in German adults. Clin Infect Dis 1995; 21:860).
References:
  1. Laboratory testing for pertussis. Centers for Disease Control and Prevention. https://www.cdc.gov/pertussis/php/laboratories/ (Accessed on August 28, 2023).
  2. Best practices for use of polymerase chain reaction (PCR) for diagnosing pertussis. Centers for Disease Control and Prevention. https://www.cdc.gov/pertussis/php/pcr-bestpractices/ (Accessed on June 28, 2018).
  3. Cherry JD, Tan T, Wirsing von König CH, et al. Clinical definitions of pertussis: Summary of a Global Pertussis Initiative roundtable meeting, February 2011. Clin Infect Dis 2012; 54:1756.
  4. Güris D, Strebel PM, Bardenheier B, et al. Changing epidemiology of pertussis in the United States: Increasing reported incidence among adolescents and adults, 1990-1996. Clin Infect Dis 1999; 28:1230.
  5. Heininger U, Schmidt-Schläpfer G, Cherry JD, Stehr K. Clinical validation of a polymerase chain reaction assay for the diagnosis of pertussis by comparison with serology, culture, and symptoms during a large pertussis vaccine efficacy trial. Pediatrics 2000; 105:E31.
  6. Kerr JR, Matthews RC. Bordetella pertussis infection: Pathogenesis, diagnosis, management, and the role of protective immunity. Eur J Clin Micribiol Infect Dis 2000; 19:77.
  7. Kösters K, Riffelmann M, Dohrn B, von König CH. Comparison of five commercial enzyme-linked immunosorbent assays for detection of antibodies to Bordetella pertussis. Clin Diagn Lab Immunol 2000;7:422.
  8. Lind-Brandberg L, Welinder-Olsson C, Lagergård T, Taranger J, Trollfors B, Zackrisson G. Evaluation of PCR for diagnosis of Bordetella pertussis and Bordetella parapertussis infections. J Clin Microbiol 1998; 36:679.
  9. Loeffelholz MJ, Thompson CJ, Long KS, Gilchrist MJ. Comparison of PCR, culture, and direct fluorescent-antibody testing for detection of Bordetella pertussis. J Clin Microbiol 1999; 37:2872.
Graphic 78189 Version 9.0