Challenges and clinical relevance of molecular detection of Bordetella pertussis in South Africa

Details

• Alternative Title:
  BMC Infect Dis
• Personal Author:
  Moosa, Fahima ; du Plessis, Mignon ; Wolter, Nicole ; Carrim, Maimuna ; Cohen, Cheryl ; von Mollendorf, Claire ; Walaza, Sibongile ; Tempia, Stefano ; Dawood, Halima ; Variava, Ebrahim ; von Gottberg, Anne
• Description:
  Background
  
  We assessed the utility of a multi-target, real-time PCR assay for Bordetella pertussis detection and diagnosis in patients with severe respiratory illness (SRI), influenza-like illness (ILI), and asymptomatic controls.
  
  Methods
  
  Real-time PCR detection of IS481, pIS1001, hIS1001 and ptxS1 was performed on nasopharyngeal specimens (SRI, ILI and controls) and induced sputum (SRI) collected from June 2012 to May 2016 through respiratory illness surveillance. Using PCR cycle threshold (Ct) value cut-offs, IS481 positive cases were classified as confirmed (Ct < 35) or possible (Ct 35–39) pertussis disease.
  
  Results
  
  Among 12,922 samples, 146 (1.1%) were IS481 positive of which 62% (90/146) were classified as confirmed. The attributable fraction (AF) was 92.2% (95% CI, 65.6 to 98.2%) and 90.5% (95% CI, 57.5 to 97.9%) amongst SRI and ILI PCR-confirmed pertussis cases, respectively. Amongst possible pertussis cases, AF was 36.9% (95% CI, − 142.3 to 83.6%) and 67.5% (95% CI, − 30.6 to 91.9%) in the SRI and ILI groups, respectively.
  
  Conclusion
  
  All IS481 positive specimens could be considered as B. pertussis infection, and potentially pertussis disease with supportive clinical information.
  
  Electronic supplementary material
  
  The online version of this article (10.1186/s12879-019-3869-7) contains supplementary material, which is available to authorized users.
  
  
• Subjects:
  Diagnosis, Differential Humans Molecular Typing Real-Time Polymerase Chain Reaction Respiratory Tract Infections Whooping Cough
• Source:
  BMC Infect Dis. 19
• Pubmed ID:
  30898099
• Pubmed Central ID:
  PMC6429695
• Document Type:
  Journal Article
• Funding:
  U01 IP001048/IP/NCIRD CDC HHS/United States ; U51 IP000155/IP/NCIRD CDC HHS/United States ; 94343/National Institute for Communicable Diseases/
• Place as Subject:
  South Africa
• Volume:
  19
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:4e3eb8c707035fccaa2201a5c6caca98ee1b88c02534e96b571ffe75b2876d2f
• Download URL:
  https://stacks.cdc.gov/view/cdc/95522/cdc_95522_DS1.pdf
• File Type:
  [PDF - 995.17 KB ]