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 to...

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Published in:	Diagnostic microbiology and infectious disease Vol. 76; no. 1; pp. 10 - 15
Main Authors:	DeVincenzo, J.P, Guyton, Cliff, Rea, Harrison, Elmore, Evan, Patel, Shivam, Wynn, Luke, Harrison, Lisa, El Saleeby, Chadi M, Bagga, Bindiya
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-05-2013
Subjects:	Anti-Bacterial Agents - therapeutic use Bacterial Load Bordetella pertussis - drug effects Bordetella pertussis - isolation & purification Child Child, Preschool Female Hospitalization Humans Infant Infectious Disease Internal Medicine Logistic Models Male Multivariate Analysis PCR Pertussis Prognosis Real-Time Polymerase Chain Reaction Retrospective Studies Semi-quantitative PCR Sensitivity and Specificity Whooping Cough - diagnosis Whooping Cough - drug therapy Whooping Cough - microbiology Pertussis Bacterial load PCR Semi-quantitative PCR
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0732-8893 1879-0070
DOI:	10.1016/j.diagmicrobio.2012.12.015