title: Evaluation of PCR for diagnosis of Bordetella pertussis and Bordetella parapertussis infections.
abstract: PCR, using primers Plp1 and Plp2, was evaluated for the detection of DNA from Bordetella pertussis in bacterial strains and in nasopharyngeal samples from patients with a cough lasting at least 7 days. The assay could detect DNA from 6 CFU of B. pertussis/10 microl of sample. Results of the PCR assay were compared with those of cultures, a determination of serum antibodies against pertussis toxin and filamentous hemagglutinin, and a clinical evaluation of 2,442 coughing episodes. The overall sensitivity of PCR was 65% (623 of 956), which was higher than the sensitivity of cultures (58%) (P < 0.001). Factors influencing the sensitivity of PCR were the interval between the onset of symptoms and sampling and the vaccination status of the patient. The specificity of PCR was 98% (1,451 of 1,486). The positive and negative predictive values were 95 and 81%, respectively. Parapertussis PCR, using primers BPPA and BPPZ, was positive in 11 of 18 culture-positive cases and was confirmed by serology in another 4 cases. In conclusion, PCR is a valuable complement to cultures and can probably replace cultures for diagnosis of B. pertussis and Bordetella parapertussis infections.
authors.affiliation: Department of Clinical Bacteriology, Göteborg University, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Lind-Brandberg
authors.forename: C
authors.initials: C
authors.lastname: Welinder-Olsson
authors.forename: T
authors.initials: T
authors.lastname: Lagergård
authors.forename: J
authors.initials: J
authors.lastname: Taranger
authors.forename: B
authors.initials: B
authors.lastname: Trollfors
authors.forename: G
authors.initials: G
authors.lastname: Zackrisson
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood; D001884:Bordetella / Q000235:genetics / Q000302:isolation & purification*; D001885:Bordetella Infections / Q000175:diagnosis* / Q000517:prevention & control; D001886:Bordetella pertussis / Q000235:genetics / Q000302:isolation & purification*; D017931:DNA Primers; D004269:DNA, Bacterial / Q000032:analysis*; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D006801:Humans; D007223:Infant; D009305:Nasopharynx / Q000382:microbiology; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014121:Toxoids / Q000276:immunology; D014917:Whooping Cough / Q000175:diagnosis* / Q000517:prevention & control
chemical_list: D000907:Antibodies, Bacterial; D017931:DNA Primers; D004269:DNA, Bacterial; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D014121:Toxoids; C051093:pertussis toxoid