title: Molecular detection and quantification of pertussis and correlation with clinical outcomes in children.
abstract: Pertussis is an under-recognized serious infection. Conventional cultures are insensitive and of limited utility after antibiotic exposure. We corroborated the utility of real-time polymerase chain reaction (PCR) as a diagnostic tool in pertussis and investigated its role as a prognostic tool by evaluating its benefit in the quantification of pertussis bacterial load. All pertussis-positive PCR tests (n = 104) submitted over 5 years were collected for retrospective study. PCR cycle threshold was compared to quantitative culture in 43. Compared to PCR, the sensitivity of culture was 41%. Our PCR assay reliably quantified bacterial load and was quantitatively reproducible. Higher bacterial load correlated with longer duration of hospitalization (P = 0.0003), and multivariate logistic regression models demonstrated this association to be independent. The study confirmed PCR as a superior diagnostic tool in pertussis. PCR quantification of bacterial load at initial diagnosis predicts later clinical disease severity, suggesting a potential benefit of PCR as a prognostic tool in pertussis.
authors.affiliation: Memphis University School, Memphis, TN 38119, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: DeVincenzo
authors.forename: Cliff
authors.initials: C
authors.lastname: Guyton
authors.forename: Harrison
authors.initials: H
authors.lastname: Rea
authors.forename: Evan
authors.initials: E
authors.lastname: Elmore
authors.forename: Shivam
authors.initials: S
authors.lastname: Patel
authors.forename: Luke
authors.initials: L
authors.lastname: Wynn
authors.forename: Lisa
authors.initials: L
authors.lastname: Harrison
authors.forename: Chadi M
authors.initials: CM
authors.lastname: El Saleeby
authors.forename: Bindiya
authors.initials: B
authors.lastname: Bagga
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D058491:Bacterial Load; D001886:Bordetella pertussis / Q000187:drug effects / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014917:Whooping Cough / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents