title: [Laboratory diagnosis of pertussis. Role of serology].
abstract: Culture is the reference method for the diagnosis of infection by Bordetella pertussis. Nevertheless, delayed sample collection and previous antibiotic treatment can limit culture sensitivity. In principle, direct immunofluorescence provides immediate diagnosis. It is, however, a subjective procedure that shows low sensitivity and specificity. PCR techniques increase culture sensitivity while maintaining high specificity, but their performance decreases along the evolution of the disease. Serologic methods are the main alternative for cases in which diagnosis is delayed. Current recommendations center on ELISA techniques that include purified antigens, such as filamentous hemaglutinin, and particularly, pertussis toxin. Traditionally, serological diagnosis requires confirmation by demonstrated seroconversion, but now the possibility of diagnosis based on titration of a single serum sample is being evaluated.
authors: Laboratorio Regional de Salud Pública, Dirección General de Salud Pública, Consejería de Sanidad Comunidad de Madrid, Spain. jcsanzl@teleline.es
authors: Juan Carlos
authors: JC
authors: Sanz Moreno
authors: Fernando
authors: F
authors: De Ory Manchón
authors: Julia
authors: J
authors: González Alonso
authors: José Luis
authors: JL
authors: de La Torre
authors: Francisco
authors: F
authors: Salmerón
authors: Aurora
authors: A
authors: Limia
authors: Odorina
authors: O
authors: Tello
authors: Isabel
authors: I
authors: Pachón
authors: Carmen
authors: C
authors: Amela
authors: Julio
authors: J
authors: Vázquez
authors: Fernando
authors: F
authors: de Ory
authors: Juan Carlos
authors: JC
authors: Sanz
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology; D001431:Bacteriological Techniques; D001886:Bordetella pertussis / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D003470:Culture Media; D004269:DNA, Bacterial / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005188:False Negative Reactions; D005189:False Positive Reactions; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D010567:Pertussis Vaccine / Q000276:immunology; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D014611:Vaccination; D014917:Whooping Cough / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D003470:Culture Media; D004269:DNA, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D010567:Pertussis Vaccine