Abstract
In the past, three methods have been used to provide laboratory confirmation of the clinical diagnosis of infection with B.pertussis (Bp): culture, direct fluorescein-labelled antibody-stained smear (FA) and serology. Each, however, is frought with problems, including requirement for fresh, selective medium, slow growth of Bp organisms, interobserver variability in FA reading, and need for paired specimens in serology. Two new methods show promise in pertussis diagnosis. First, DNA hybridization using a sequence highly repeated in the pertussis genome can identify as few as 103 Bp in nasopharyngeal (NP) secretions. Second, Bp adenylate cyclase can be detected by enzymatic assay of the organisms also in NP secretions. In this study, specimens from 21 children with cough and vomiting were evaluated for Bp infection with five methods: 1) culture; 2) FA; 3) agglutinin serology; 4) DNA hybridization and 5) adenylate cyclase assay. All but one of the children were < 1 year of age and had received no DPT. Two or more tests were positive for 9 of the 21 patients. The sensitivities for identification of Bp infection by these tests were: culture, 44%; FA, 67%; adenylate cyclase 67% and DNA probe 89%. These data indicate that use of NP secretions and the recently developed DNA probe can provide a rapid and sensitive method for pertussis diagnosis which is superior to currently available procedures.
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Hewlett, E., Bromberg, K., Gray, M. et al. DIAGNOSIS OF INFECTION WITH BORDETELLA PERTUSSIS. Pediatr Res 21 (Suppl 4), 326 (1987). https://doi.org/10.1203/00006450-198704010-00954
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DOI: https://doi.org/10.1203/00006450-198704010-00954