Comparison of molecular detection methods for pertussis in children during a state-wide outbreak.
A state-wide pertussis outbreak occurred in Washington during the winter-spring months of 2012, concurrent with respiratory viral season. We compared performance characteristics of a laboratory-developed pertussis PCR (LD-PCR for Bordetella pertussis, Bordetella parapertussis, and Bordetella holmesii) and rapid multiplex PCR (RM-PCR) for respiratory viruses (FilmArray™, BioFire, B. pertussis data unblinded following FDA approval post outbreak). We analyzed three cohorts of patients using physician testing orders as a proxy for clinical suspicion for pertussis or respiratory viruses: Cohort 1, tested by LD-PCR for pertussis pathogens only by nasopharyngeal swab; Cohort 2, by RM-PCR for respiratory viruses only by mid-nasal turbinate swab; and Cohort 3, by both methods. B. pertussis was detected in a total of 25 of the 490 patients in Cohort 3 in which LD-PCR detected 20/25 (80 %) cases and the RM-PCR detected 24/25 (96 %; p = 0.2). Pertussis pathogens were detected in 21/584 (3.6 %) of samples from Cohort 1 where clinicians had a relatively strong suspicion for pertussis. In contrast, B. pertussis was detected in only 4/3071 (0.1 %) specimens from Cohort 2 where suspicion for pertussis was lower (p < 0.001 for comparison with Cohort 1). In summary, the two laboratory methods were comparable for the detection of B. pertussis.
Microbiology Laboratory, Seattle Children's Hospital, Seattle, WA, USA. xuan.qin@seattlechildrens.org.
X
X
Qin
Division of Pediatric Infectious Diseases, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
D M
DM
Zerr
Division of Pediatric Infectious Diseases, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
M P
MP
Kronman
Division of Pediatric Infectious Diseases, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
A L
AL
Adler
Microbiology Laboratory, Seattle Children's Hospital, Seattle, WA, USA.
J E
JE
Berry
Microbiology Laboratory, Seattle Children's Hospital, Seattle, WA, USA.
S
S
Rich
Microbiology Laboratory, Seattle Children's Hospital, Seattle, WA, USA.
A M
AM
Buccat
Microbiology Laboratory, Seattle Children's Hospital, Seattle, WA, USA.|Department of Laboratory Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
M
M
Xu
Division of Pediatric Infectious Diseases, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
J A
JA
Englund
D000293:Adolescent; D042483:Bordetella parapertussis / Q000235:genetics / Q000302:isolation & purification*; D001886:Bordetella pertussis / Q000235:genetics / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D009305:Nasopharynx / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014917:Whooping Cough / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*
D004269:DNA, Bacterial
Bordetella pertussis; Rapid diagnosis; Respiratory viruses