[Laboratory diagnosis of pertussis. Role of serology].
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.
Sanz Moreno
Juan Carlos
JC
Laboratorio Regional de Salud Pública, Dirección General de Salud Pública, Consejería de Sanidad Comunidad de Madrid, Spain. jcsanzl@teleline.es
De Ory Manchón
Fernando
F
González Alonso
Julia
J
de La Torre
José Luis
JL
Salmerón
Francisco
F
Limia
Aurora
A
Tello
Odorina
O
Pachón
Isabel
I
Amela
Carmen
C
Vázquez
Julio
J
de Ory
Fernando
F
Sanz
Juan Carlos
JC
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
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