title: Latent class analysis of diagnostic tests for adenovirus, Bordetella pertussis and influenza virus infections in German adults with longer lasting coughs.
abstract: Laboratory tests in adult outpatients with longer lasting coughs to identify a potential causal pathogen are rarely performed, and there is no gold standard for these diagnostic tests. While the diagnostic validity of serological tests for pertussis is well established their potential contribution for diagnosing adenovirus and influenza virus A and B infections is unclear. A sentinel study into the population-based incidence of longer lasting coughs in adults was done in Rostock (former East Germany) and Krefeld (former West Germany). A total of 971 outpatients who consulted general practitioners or internists were included. Inclusion criteria were coughing for ⩾1 week and no chronic respiratory diseases. We evaluated the performance of polymerase chain reaction (PCR) as well as IgG and IgA serology, applying a latent class model for diagnosing infections with adenovirus, B. pertussis, and influenza virus A and B. The adult outpatients first sought medical attention when they had been coughing for a median of 3 weeks. In this situation, direct detection of infectious agents by PCR had a low sensitivity. Modelling showed that additional serological tests equally improved sensitivity and specificity for diagnosis for adenovirus, B. pertussis and influenza virus A and B infections. The combination of serology and PCR may improve the overall performance of diagnostic tests for B. pertussis and also for adenovirus, and influenza virus A and B infections.
authors.affiliation: Institut für Soziale Pädiatrie und Jugendmedizin,Ludwig-Maximilians-Universität,München,Germany.
authors.forename: C
authors.initials: C
authors.lastname: Sobotzki
authors.affiliation: Labor: Medizin Krefeld MVZ GmbH,Krefeld,Germany.
authors.forename: M
authors.initials: M
authors.lastname: Riffelmann
authors.affiliation: Institut für Hygiene und Labormedizin,HELIOS Klinikum Krefeld,Germany.
authors.forename: N
authors.initials: N
authors.lastname: Kennerknecht
authors.affiliation: Landesamt für Gesundheit und Soziales des Landes Mecklenburg Vorpommern,Rostock,Germany.
authors.forename: C
authors.initials: C
authors.lastname: Hülsse
authors.affiliation: Landesamt für Gesundheit und Soziales des Landes Mecklenburg Vorpommern,Rostock,Germany.
authors.forename: M
authors.initials: M
authors.lastname: Littmann
authors.affiliation: Trinity College Dublin,School of Computer Science and Statistics,Dublin,Ireland.
authors.forename: A
authors.initials: A
authors.lastname: White
authors.affiliation: Institut für Soziale Pädiatrie und Jugendmedizin,Ludwig-Maximilians-Universität,München,Germany.
authors.forename: R
authors.initials: R
authors.lastname: Von Kries
authors.affiliation: Labor: Medizin Krefeld MVZ GmbH,Krefeld,Germany.
authors.forename: C H
authors.initials: CH
authors.lastname: Wirsing VON König
mesh_terms: D000256:Adenoviridae / Q000302:isolation & purification; D000257:Adenoviridae Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001886:Bordetella pertussis / Q000302:isolation & purification; D003371:Cough / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000821:virology; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D029521:Alphainfluenzavirus / Q000302:isolation & purification; D029524:Betainfluenzavirus / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D014917:Whooping Cough / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G
keywords: Adenovirus; adults; cough; influenza virus; latent class analysis; pertussis