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Kim AR, Sette A, da Silva Antunes R. Adaptive immune response to bordetella pertussis during vaccination and infection: emerging perspectives and unanswered questions. Expert Rev Vaccines 2024; 23:705-714. [PMID: 39037200 PMCID: PMC11306532 DOI: 10.1080/14760584.2024.2383745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/17/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Whooping cough, also known as pertussis, remains a significant challenge as a vaccine-preventable disease worldwide. Since the switch from the whole-cell Pertussis (wP) vaccine to the acellular Pertussis vaccine (aP), cases of whooping cough have increased in countries using the aP vaccine. Understanding the immune system's response to pertussis vaccines and infection is crucial for improving current vaccine efficacy. AREAS COVERED This review of the literature using PubMed records offers an overview of the qualitative differences in antibody and T cell responses to B. pertussis (BP) in vaccination and infection, and their potential association with decreased efficacy of the aP vaccine in preventing infection and subclinical colonization. We further discuss how asymptomatic infections and carriage are widespread among vaccinated human populations, and explore methodologies that can be employed for their detection, to better understand their impact on adaptive immune responses and identify key features necessary for protection against the disease. EXPERT OPINION An underappreciated human BP reservoir, stemming from the decreased capacity of the aP vaccine to prevent subclinical infection, offers an alternative explanation for the increased incidence of clinical disease and recurrent outbreaks.
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Affiliation(s)
- A-Reum Kim
- Center for Vaccine Innovation, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Alessandro Sette
- Center for Vaccine Innovation, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
- Department of Medicine, Division of Infectious Disease and Global Public Health, University of California San Diego (UCSD), La Jolla, CA, 92037, USA
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Juscamayta-López E, Valdivia F, Soto MP, Nureña B, Horna H. A pangenome approach-based loop-mediated isothermal amplification assay for the specific and early detection of Bordetella pertussis. Sci Rep 2023; 13:4356. [PMID: 36928221 PMCID: PMC10018623 DOI: 10.1038/s41598-023-29773-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/10/2023] [Indexed: 03/18/2023] Open
Abstract
Despite widespread vaccination, Bordetella pertussis continues to cause pertussis infections worldwide, leaving infants at the highest risk of severe illness and death, while people around them are likely the main sources of infection and rapidly spread the disease. Rapid and less complex molecular testing for the specific and timely diagnosis of pertussis remains a challenge that could help to prevent the disease from worsening and prevent its transmission. We aimed to develop and validate a colorimetric loop-mediated isothermal amplification (LAMP) assay using a new target uvrD_2 informed by the pangenome for the specific and early detection of B. pertussis. Compared to that of multitarget quantitative polymerase chain reaction (multitarget qPCR) using a large clinical DNA specimen (n = 600), the diagnostic sensitivity and specificity of the uvrD_2 LAMP assay were 100.0% and 98.6%, respectively, with a 99.7% degree of agreement between the two assays. The novel colorimetric uvrD_2 LAMP assay is highly sensitive and specific for detecting B. pertussis DNA in nasopharyngeal swabs and showed similar diagnostic accuracy to complex and high-cost multitarget qPCR, but it is faster, simpler, and inexpensive, which makes it very helpful for the reliable and timely diagnosis of pertussis in primary health care and resource-limited settings.
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Affiliation(s)
- Eduardo Juscamayta-López
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Perú.
- Facultad de Salud Pública y Administración (GA, AGL), Universidad Peruana Cayetano Heredia, Lima, Perú.
| | - Faviola Valdivia
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Perú
| | - María Pía Soto
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Perú
| | - Brenda Nureña
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Perú
| | - Helen Horna
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Perú
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Gill CJ, Gunning CE, MacLeod WB, Mwananyanda L, Thea DM, Pieciak RC, Kwenda G, Mupila Z, Rohani P. Asymptomatic Bordetella pertussis infections in a longitudinal cohort of young African infants and their mothers. eLife 2021; 10:65663. [PMID: 34097599 PMCID: PMC8184211 DOI: 10.7554/elife.65663] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/26/2021] [Indexed: 12/17/2022] Open
Abstract
Recent pertussis resurgence in numerous countries may be driven by asymptomatic infections. Most pertussis surveillance studies are cross-sectional and cannot distinguish asymptomatic from pre-symptomatic infections. Longitudinal surveillance could overcome this barrier, providing more information about the true burden of pertussis at the population level. Here we analyze 17,442 nasopharyngeal samples from a longitudinal cohort of 1320 Zambian mother/infant pairs. Our analysis has two elements. First, we demonstrate that the full range of IS481 qPCR CT values provides insight into pertussis epidemiology, showing concordance of low and high CT results over time, within mother/infant pairs, and in relation to symptomatology. Second, we exploit these full-range qPCR data to demonstrate a high incidence of asymptomatic pertussis, including among infants. Our results demonstrate a wider burden of pertussis infection than we anticipated in this population, and expose key limitations of threshold-based interpretation of qPCR results in infectious disease surveillance.
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Affiliation(s)
- Christopher J Gill
- Boston University School of Public Health, Department of Global Health, Boston, United States
| | | | - William B MacLeod
- Boston University School of Public Health, Department of Global Health, Boston, United States
| | - Lawrence Mwananyanda
- Boston University School of Public Health, Department of Global Health, Boston, United States.,Right to Care, Lusaka, Zambia
| | - Donald M Thea
- Boston University School of Public Health, Department of Global Health, Boston, United States
| | - Rachel C Pieciak
- Boston University School of Public Health, Department of Global Health, Boston, United States
| | - Geoffrey Kwenda
- University of Zambia, School of Health Sciences, Department of Biomedical Science, Lusaka, Zambia
| | | | - Pejman Rohani
- University of Georgia, Odum School of Ecology, Athens, Georgia.,University of Georgia, Center for the Ecology of Infectious Diseases, Athens, Georgia.,University of Georgia, Department of Infectious Diseases, Athens, Georgia
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Gill CJ, Gunning CE, MacLeod W, Mwananyanda L, Thea D, Pieciak R, Kwenda G, Mupila Z, Rohani P. Asymptomatic Bordetella pertussis infections in young African infants and their mothers identified within a longitudinal cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.11.18.20231423. [PMID: 33236026 PMCID: PMC7685339 DOI: 10.1101/2020.11.18.20231423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Despite long-standing vaccination programs, pertussis incidence has increased in numerous countries; transmission by asymptomatic individuals is a suspected driver of this resurgence. However, unequivocal evidence documenting asymptomatic infections in adults and children is lacking due, in part, to the cross-sectional nature of most pertussis surveillance studies. In addition, modern pertussis surveillance relies on quantitative PCR (qPCR) using fixed diagnostic thresholds to identify cases. To address this gap, we present a longitudinal analysis of 17,442 nasopharyngeal samples collected from a cohort of 1,320 Zambian mother/infant pairs. Using full-range cycle threshold (CT) values from IS481 qPCR assays, we document widespread asymptomatic infections among mothers and also, surprisingly, among young infants. From an initial group of eight symptomatic infants who tested positive by qPCR, we identify frequent contemporaneous subclinical infections in mothers. Within the full cohort, we observe strong temporal correlation between low- and high-intensity qPCR signals. We compute a single time-averaged score for each individual summarizing the evidence for pertussis infection (EFI), and show that EFI strongly clusters within mother/infant pairs, and is strongly associated with clinical symptomatology and antibiotic use. Overall, the burden of pertussis here is substantially underestimated when restricting diagnostic criteria to IS481 CT≤35. Rather, we find that full-range CT values provide valuable insights into pertussis epidemiology in this population, and illuminate the infection arc within individuals. These findings have significant implications for quantifying asymptomatic pertussis prevalence and its contribution to overall transmission. Our results also expose limitations of threshold-based interpretations of qPCR assays in infectious disease surveillance.
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Affiliation(s)
- C J Gill
- Boston University School of Public Health, Deptartment of Global Health
| | - C E Gunning
- University of Georgia, Odum School of Ecology
| | - W MacLeod
- Boston University School of Public Health, Deptartment of Global Health
| | - L Mwananyanda
- Boston University School of Public Health, Deptartment of Global Health
- Right to Care - Zambia
| | - D Thea
- Boston University School of Public Health, Deptartment of Global Health
| | - R Pieciak
- Boston University School of Public Health, Deptartment of Global Health
| | - G Kwenda
- University of Zambia, School of Health Sciences, Department of Biomedical Science
| | | | - P Rohani
- University of Georgia, Odum School of Ecology
- University of Georgia, Center for the Ecology of Infectious Diseases
- University of Georgia, Department of Infectious Diseases
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Zhang RQ, Li Z, Li GX, Tie YQ, Li XN, Gao Y, Duan QX, Wang L, Zhao L, Fan GH, Bai XD, Wang RH, Chen ZW, Wang JR, Wu Y, Zhao MC, Feng ZS, Wang J, Ma XJ. A highly sensitive one-tube nested quantitative real-time PCR assay for specific detection of Bordetella pertussis using the LNA technique. Int J Infect Dis 2020; 93:224-230. [PMID: 32045697 DOI: 10.1016/j.ijid.2020.01.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Bordetella pertussis is a highly contagious respiratory agent and is the causative pathogen of pertussis, which primarily affects children. Current diagnostic techniques for this pathogen have a variety of limitations including a long culture time, low bacterial load, and lack of specificity. METHODS This article reports the development of a one-tube nested quantitative real-time PCR assay using the locked nucleic acid (LNA) technique (LNA-OTN-q-PCR), targeting the BP485 gene and using a simple inexpensive extraction method. A total of 130 clinical samples from patients with clinically suspected pertussis, collected from the Children's Hospital of Hebei, China, were tested by LNA-OTN-q-PCR assay. RT-PCR and two-step semi-nested PCR assays were performed in parallel for comparison. RESULTS Only strains of B. pertussis were identified as positive, whereas all of the remaining strains were appropriately identified as negative by the LNA-OTN-q-PCR assay. A single copy per reaction can be detected by the LNA-OTN-q-PCR assay. Additionally, the sensitivity of this method was 100 times that of the RT-PCR assay (100 copies per reaction). Sixty-three of the 130 clinical samples were detected positive by LNA-OTN-q-PCR assay; in contrast, RT-PCR was able to detect only 41 positive samples. Following this, all 63 samples were positively identified by two-step semi-nested PCR. Compared with the two-step semi-nested PCR assay, both the specificity and sensitivity of the LNA-OTN-q-PCR assay using purified DNA and crude extract were 100%. CONCLUSIONS This assay was able to detect B. pertussis infection with high sensitivity and specificity. This test shows great potential as a promising technique to detect B. pertussis in both clinical laboratories and public health settings.
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Affiliation(s)
- Rui-Qing Zhang
- Hebei Medical University, Shijiazhuang, 050031, Hebei, China; NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing 102206, China; Hebei General Hospital, Shijiazhuang, 050051, Hebei, China.
| | - Zheng Li
- Hebei General Hospital, Shijiazhuang, 050051, Hebei, China.
| | - Gui-Xia Li
- Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei, China.
| | - Yan-Qing Tie
- Hebei General Hospital, Shijiazhuang, 050051, Hebei, China.
| | - Xin-Na Li
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing 102206, China.
| | - Yuan Gao
- Hebei Medical University, Shijiazhuang, 050031, Hebei, China; NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing 102206, China.
| | - Qing-Xia Duan
- Hebei Medical University, Shijiazhuang, 050031, Hebei, China; NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing 102206, China.
| | - Le Wang
- Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei, China.
| | - Li Zhao
- Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei, China.
| | - Guo-Hao Fan
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing 102206, China.
| | - Xue-Ding Bai
- Tangshan Gongren Hospital, Tangshan, 063000, China.
| | - Rui-Huan Wang
- Hunan Provincial Center for Disease Control and Prevention, Hunan, 410005, China.
| | - Zi-Wei Chen
- The Third Xiangya Hospital of Central South University, Hunan, 410013, China.
| | - Jin-Rong Wang
- Hebei Medical University, Shijiazhuang, 050031, Hebei, China; NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing 102206, China.
| | - Yong Wu
- Health Gene Technologies, Ningbo, 315040, China.
| | - Meng-Chuan Zhao
- Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei, China.
| | - Zhi-Shan Feng
- Hebei Medical University, Shijiazhuang, 050031, Hebei, China; Hebei General Hospital, Shijiazhuang, 050051, Hebei, China.
| | - Ji Wang
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing 102206, China.
| | - Xue-Jun Ma
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing 102206, China.
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Martini H, Detemmerman L, Soetens O, Yusuf E, Piérard D. Improving specificity of Bordetella pertussis detection using a four target real-time PCR. PLoS One 2017; 12:e0175587. [PMID: 28403204 PMCID: PMC5389834 DOI: 10.1371/journal.pone.0175587] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 03/28/2017] [Indexed: 11/21/2022] Open
Abstract
The incidence of whooping cough, a contagious respiratory disease caused by Bordetella pertussis, is on the rise despite existing vaccination programmes. Similar, though usually milder, respiratory symptoms may be caused by other members of the Bordetella genus: B. parapertussis, B. holmesii, and B. bronchiseptica. Pertussis diagnosis is mostly done using PCR, but the use of multiple targets is necessary in order to differentiate the different Bordetella spp. with sufficient sensitivity and specificity. In this study we evaluate a multiplex PCR assay for the differentiation of B. pertussis from other Bordetella spp., using the targets IS481, IS1001, IS1002, and recA. Moreover, we retrospectively explore the epidemiology of Bordetella spp. infections in Belgium, using the aforementioned assay over a three-year period, from 2013 until 2015.
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Affiliation(s)
- Helena Martini
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Microbiology and Infection Control and Belgian National Reference Centre for Bordetella Pertussis, Brussels, Belgium
- * E-mail:
| | - Liselot Detemmerman
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Microbiology and Infection Control and Belgian National Reference Centre for Bordetella Pertussis, Brussels, Belgium
| | - Oriane Soetens
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Microbiology and Infection Control and Belgian National Reference Centre for Bordetella Pertussis, Brussels, Belgium
| | - Erlangga Yusuf
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Microbiology and Infection Control and Belgian National Reference Centre for Bordetella Pertussis, Brussels, Belgium
| | - Denis Piérard
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Microbiology and Infection Control and Belgian National Reference Centre for Bordetella Pertussis, Brussels, Belgium
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7
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Using Nucleic Acid Amplification Techniques in a Syndrome-Oriented Approach: Detection of Respiratory Agents. Mol Microbiol 2016. [DOI: 10.1128/9781555819071.ch25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Abstract
The introduction of vaccination in the 1950s significantly reduced the morbidity and mortality of pertussis. However, since the 1990s, a resurgence of pertussis has been observed in vaccinated populations, and a number of causes have been proposed for this phenomenon, including improved diagnostics, increased awareness, waning immunity, and pathogen adaptation. The resurgence of pertussis highlights the importance of standardized, sensitive, and specific laboratory diagnoses, the lack of which is responsible for the large differences in pertussis notifications between countries. Accurate laboratory diagnosis is also important for distinguishing between the several etiologic agents of pertussis-like diseases, which involve both viruses and bacteria. If pertussis is diagnosed in a timely manner, antibiotic treatment of the patient can mitigate the symptoms and prevent transmission. During an outbreak, timely diagnosis of pertussis allows prophylactic treatment of infants too young to be (fully) vaccinated, for whom pertussis is a severe, sometimes fatal disease. Finally, reliable diagnosis of pertussis is required to reveal trends in the (age-specific) disease incidence, which may point to changes in vaccine efficacy, waning immunity, and the emergence of vaccine-adapted strains. Here we review current approaches to the diagnosis of pertussis and discuss their limitations and strengths. In particular, we emphasize that the optimal diagnostic procedure depends on the stage of the disease, the age of the patient, and the vaccination status of the patient.
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Affiliation(s)
- Anneke van der Zee
- Molecular Diagnostics Unit, Maasstad Hospital, Rotterdam, The Netherlands
| | | | - Frits R Mooi
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud University Medical Centre, Nijmegen, The Netherlands
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Torkaman MRA, Kamachi K, Nikbin VS, Lotfi MN, Shahcheraghi F. Comparison of loop-mediated isothermal amplification and real-time PCR for detecting Bordetella pertussis. J Med Microbiol 2015; 64:463-465. [PMID: 25596118 DOI: 10.1099/jmm.0.000021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Affiliation(s)
| | - Kazunari Kamachi
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Vajihe Sadat Nikbin
- Department of Microbiology, MIC Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Masoumeh Nakhost Lotfi
- Department of Microbiology, MIC Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Fereshteh Shahcheraghi
- Department of Microbiology, MIC Research Center, Pasteur Institute of Iran, Tehran, Iran
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Evaluation of amplification targets for the specific detection of Bordetella pertussis using real-time polymerase chain reaction. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2014; 25:217-21. [PMID: 25285127 PMCID: PMC4173943 DOI: 10.1155/2014/763128] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Bordetella pertussis infections continue to be a major public health challenge in Canada. Polymerase chain reaction (PCR) assays to detect B pertussis are typically based on the multicopy insertion sequence IS481, which offers high sensitivity but lacks species specificity. METHODS A novel B pertussis real-time PCR assay based on the porin gene was tested in parallel with several previously published assays that target genes such as IS481, ptx-promoter, pertactin and a putative thialase. The assays were evaluated using a reference panel of common respiratory bacteria including different Bordetella species and 107 clinical nasopharyngeal specimens. Discrepant results were confirmed by sequencing the PCR products. RESULTS Analytical sensitivity was highest for the assay targeting the IS481 element; however, the assay lacked specificity for B pertussis in the reference panel and in the clinical samples. False-positive results were also observed with assays targeting the ptx-promoter and pertactin genes. A PCR assay based on the thialase gene was highly specific but failed to detect all reference strains of B pertussis. However, a novel assay targeting the porin gene demonstrated high specificity for B pertussis both in the reference panel and in clinical samples and, based on sequence-confirmed results, correctly predicted all B pertussis-positive cases in clinical samples. According to Probit regression analysis, the 95% detection limit of the new assay was 4 colony forming units/reaction. CONCLUSION A novel porin assay for B pertussis demonstrated superior performance and may be useful for improved molecular detection of B pertussis in clinical specimens.
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12
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Abstract
BACKGROUND United States national surveillance data show that the use of culture for pertussis diagnostics has sharply declined, whereas polymerase chain reaction (PCR) is now the most common testing method. PCR testing for pertussis is rapid and sensitive, but the lack of standardization and variable specificity is concerning. METHODS A web-based survey containing 12 questions was sent to public health, commercial and hospital-based US laboratories performing clinical diagnostics to determine the pertussis diagnostics used. An extensive real-time PCR (RT-PCR) questionnaire accompanied a proficiency panel assessing the types of extraction methods, RT-PCR methods and current quality control in place at the laboratories. The proficiency panel of 12 specimens containing Bordetella pertussis at various concentrations and negative controls was created to detect cross-contamination and assess the lower limit of detection. RESULTS One hundred twenty-three (35%) of 355 respondents from the web-based survey performed diagnostic tests for the presence of B. pertussis. Eighty-three (71%) labs reported performing culture, whereas 67 (54%) labs used PCR. All 41 laboratories that consented to participate in the proficiency exercise used the IS481 RT-PCR target; however, a variety of extraction and RT-PCR methods were employed. The laboratories correctly identified 92% of the B. pertussis specimens, and 5% of the laboratories (1.8% of the panel specimens) reported at least 1 false-positive. CONCLUSIONS The small percentage of false-positives suggests that adequate procedures are in place to prevent cross-contamination. Differing extraction and PCR methods as well as variable analytic sensitivity emphasize the necessity for an external well-defined quality control program and interlaboratory pertussis PCR harmonization.
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13
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Towards improved accuracy of Bordetella pertussis nucleic acid amplification tests. J Clin Microbiol 2012; 50:2186-90. [PMID: 22442315 DOI: 10.1128/jcm.00612-12] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In many clinical microbiology laboratories, nucleic acid amplification tests such as PCR have become the routine methods for the diagnosis of pertussis. While PCR has greatly increased the ability of laboratories to detect Bordetella pertussis infections, it has also been associated with false-positive results that can, given the tendency of B. pertussis to cause outbreaks, result in unnecessary and costly control measures. The species specificity of Bordetella gene targets and their number of copies per genome greatly impact the performance characteristics of nucleic acid amplification tests for B. pertussis. It is crucial that laboratorians recognize these characteristics, to limit false-positive test results and prevent pseudo-outbreaks.
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Zouari A, Smaoui H, Kechrid A. The diagnosis of pertussis: which method to choose? Crit Rev Microbiol 2011; 38:111-21. [PMID: 22103249 DOI: 10.3109/1040841x.2011.622715] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Despite the introduction of routine vaccination against pertussis for more than a half century, leading to a drastic decline in the number of reported cases, pertussis continues to be an important respiratory disease afflicting unvaccinated infants and previously vaccinated children as well as adults in whom immunity has waned. The diagnosis of pertussis is challenging and accurate laboratory identification of Bordetella infections remains problematic. Common laboratory diagnostic methods used for pertussis diagnosis include culture, direct-fluorescent-antibody testing (DFA), serology and polymerase chain reaction (PCR). Culture of Bordetella pertussis is highly specific but fastidious and has limited sensitivity. DFA provides a much more rapid result, but has the disadvantage of poor sensitivity and specificity. Serology is not useful in infants. In older persons, it is hampered by the limitations of paired sera and it provides mainly a retrospective diagnosis. Such limitations of conventional diagnosis testing have led to the development of PCR assays. Notwithstanding its lack of standardization, PCR has been found to be more sensitive and more specific than other methods. In this report, we aimed to review current knowledge about the available diagnostic methods and tests that accurately diagnose pertussis.
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Affiliation(s)
- Asma Zouari
- Microbiology Laboratory, Children's Hospital of Tunis, Tunis, Tunisia.
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15
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Leber AL, Salamon DP, Prince HE. Pertussis Diagnosis in the 21st Century: Progress and Pitfalls, Part II. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.clinmicnews.2011.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Update on the Detection and Characterization of Bacterial Pathogens by Nucleic Acid Amplification. Mol Microbiol 2011. [DOI: 10.1128/9781555816834.ch23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Translating Innovation in Diagnostics: Challenges and Opportunities. GENOMIC AND PERSONALIZED MEDICINE 2009. [PMCID: PMC7150328 DOI: 10.1016/b978-0-12-369420-1.00031-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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18
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Soares S, Rocha G, Pissarra S, Carriço A, Azevedo I, Simões JS, Guimarães H. Infecção por Bordetella pertussis com hipertensão pulmonar grave num recém-nascido com boa evolução clínica – Caso clínico. REVISTA PORTUGUESA DE PNEUMOLOGIA 2008. [DOI: 10.1016/s0873-2159(15)30277-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Marimón JM, Cilla G, Pérez-Trallero E. Biología molecular en el diagnóstico de la infección respiratoria aguda de origen bacteriano. Enferm Infecc Microbiol Clin 2008; 26 Suppl 9:26-32. [DOI: 10.1016/s0213-005x(08)76538-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Development and evaluation of dual-target real-time polymerase chain reaction assays to detect Bordetella spp. Diagn Microbiol Infect Dis 2008; 61:264-72. [PMID: 18440175 DOI: 10.1016/j.diagmicrobio.2008.02.017] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2007] [Revised: 02/15/2008] [Accepted: 02/27/2008] [Indexed: 11/24/2022]
Abstract
Novel, highly specific, and sensitive real-time polymerase chain reaction (PCR) assays using 2 targets, insertion sequence (IS481) and pertussis toxin subunit 1 (ptxS1), were developed to detect Bordetella pertussis and to differentiate between relevant Bordetella spp. Sixty-four non-Bordetella isolates were negative by both assays, demonstrating the specificity of the assays. B. pertussis, Bordetella parapertussis, and Bordetella holmesii isolates were specifically identified using the assays. The lower limit of detection was less than 10 genomic equivalents per reaction for the IS481 and ptxS1 assays. These assays were evaluated using 145 human clinical specimens obtained during cough-illness outbreak investigations, and PCR results were compared with Bordetella spp. culture results. Twenty-seven (18.6%) specimens had late positive cycle threshold (Ct) values (35 <or= Ct < 40) using the IS481 assay with corresponding negative results using the ptxS1 assay and culture and were considered indeterminate. Guidelines for use of PCR testing and interpretation of results during cough-illness outbreaks are discussed.
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Vincart B, Hallin M, Struelens MJ, Denis O. Authors' reply to ‘Misidentification of Bordetella bronchiseptica as Bordetella pertussis using a newly described RT-PCR targeting the pertactin gene’. J Med Microbiol 2008; 57:399-400. [DOI: 10.1099/jmm.0.47653-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Benoit Vincart
- Center for Molecular Diagnosis, Department of Microbiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Marie Hallin
- Center for Molecular Diagnosis, Department of Microbiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Marc J. Struelens
- Center for Molecular Diagnosis, Department of Microbiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Denis
- Center for Molecular Diagnosis, Department of Microbiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
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Register KB, Nicholson TL. Misidentification of Bordetella bronchiseptica as Bordetella pertussis using a newly described real-time PCR targeting the pertactin gene. J Med Microbiol 2007; 56:1608-1610. [DOI: 10.1099/jmm.0.47511-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Recently, a real-time PCR (RT-PCR) assay based on sequence from the gene for pertactin was proposed for identification of Bordetella pertussis. Here, it is reported that the B. pertussis pertactin gene sequence for the region that encompasses the RT-PCR probe and primers is nearly identical to that of many Bordetella bronchiseptica strains of human and avian origin. Additionally, it is demonstrated that such strains are erroneously identified as B. pertussis using the RT-PCR assay. These data suggest that the use of the assay without confirmatory testing may result in erroneous identification of a significant proportion of human isolates of B. bronchiseptica as B. pertussis.
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Affiliation(s)
- Karen B. Register
- Respiratory Diseases of Livestock Research Unit, USDA/Agricultural Research Service/National Animal Disease Center, Ames, IA 50010, USA
| | - Tracy L. Nicholson
- Respiratory Diseases of Livestock Research Unit, USDA/Agricultural Research Service/National Animal Disease Center, Ames, IA 50010, USA
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Preparation of Bordetella pertussis DNA from respiratory samples for real-time PCR by commercial kits. Eur J Clin Microbiol Infect Dis 2007; 27:145-8. [DOI: 10.1007/s10096-007-0403-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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