Evaluation of Bordetella pertussis Infection in Adults by Real-Time PCR and Serology: A Comparative Study with Culture Method

Project no. 32380 · Status: Kapanmış (Yayın bekleniyor) · 2024

Summary

<p><strong>Objective:</strong>&nbsp;Although&nbsp;<em>Bordetella&nbsp;pertussis</em>&nbsp;infection&nbsp;is&nbsp;vaccine-preventable,&nbsp;it&nbsp;continues&nbsp;to&nbsp;represent&nbsp;an&nbsp;important&nbsp;public&nbsp;health&nbsp;concern&nbsp;worldwide&nbsp;and&nbsp;in&nbsp;Türkiye.&nbsp;In&nbsp;adolescents&nbsp;and&nbsp;adults,&nbsp;diagnosis&nbsp;is&nbsp;frequently&nbsp;delayed&nbsp;or&nbsp;missed&nbsp;due&nbsp;to&nbsp;atypical&nbsp;clinical&nbsp;presentations.&nbsp;This&nbsp;study&nbsp;aimed&nbsp;to&nbsp;investigate&nbsp;pertussis&nbsp;infection&nbsp;in&nbsp;adult&nbsp;patients&nbsp;using&nbsp;culture,&nbsp;real-time&nbsp;PCR,&nbsp;and&nbsp;serological&nbsp;methods,&nbsp;and&nbsp;to&nbsp;compare&nbsp;the&nbsp;diagnostic&nbsp;performance&nbsp;of&nbsp;these&nbsp;approaches.</p><p><strong>Methods:</strong>&nbsp;This&nbsp;prospective&nbsp;descriptive&nbsp;study&nbsp;was&nbsp;conducted&nbsp;between&nbsp;September&nbsp;1&nbsp;and&nbsp;December&nbsp;31,&nbsp;2025,&nbsp;and&nbsp;included&nbsp;81&nbsp;adult&nbsp;patients&nbsp;presenting&nbsp;to&nbsp;a&nbsp;Chest&nbsp;Diseases&nbsp;Clinic&nbsp;with&nbsp;suspected&nbsp;pertussis.&nbsp;Nasopharyngeal&nbsp;swabs&nbsp;and&nbsp;venous&nbsp;blood&nbsp;samples&nbsp;were&nbsp;collected&nbsp;from&nbsp;all&nbsp;participants.&nbsp;Culture&nbsp;was&nbsp;performed&nbsp;on&nbsp;selective&nbsp;media&nbsp;and&nbsp;evaluated&nbsp;after&nbsp;10&nbsp;days&nbsp;of&nbsp;incubation.&nbsp;Real-time&nbsp;PCR&nbsp;analyses&nbsp;were&nbsp;carried&nbsp;out&nbsp;according&nbsp;to&nbsp;the&nbsp;manufacturer’s&nbsp;instructions.&nbsp;Serological&nbsp;testing&nbsp;was&nbsp;performed&nbsp;using&nbsp;Euroimmun®&nbsp;ELISA&nbsp;kits&nbsp;to&nbsp;measure&nbsp;anti-PT&nbsp;IgG,&nbsp;IgA,&nbsp;IgM&nbsp;and&nbsp;anti-FHA&nbsp;IgG,&nbsp;IgA&nbsp;levels.</p><p><strong>Results:</strong>&nbsp;No&nbsp;<em>Bordetella</em>&nbsp;spp.&nbsp;growth&nbsp;was&nbsp;detected&nbsp;by&nbsp;culture&nbsp;in&nbsp;any&nbsp;of&nbsp;the&nbsp;cases&nbsp;(0/81).&nbsp;Real-time&nbsp;PCR&nbsp;identified&nbsp;<em>B.&nbsp;pertussis</em>&nbsp;in&nbsp;only&nbsp;one&nbsp;patient&nbsp;(1.23%).&nbsp;Serological&nbsp;evaluation&nbsp;showed&nbsp;anti-PT&nbsp;IgA&nbsp;positivity&nbsp;in&nbsp;3&nbsp;patients&nbsp;(3.7%)&nbsp;and&nbsp;borderline&nbsp;anti-PT&nbsp;IgG&nbsp;levels&nbsp;in&nbsp;7&nbsp;patients&nbsp;(8.6%).&nbsp;Anti-PT&nbsp;IgM&nbsp;was&nbsp;negative&nbsp;in&nbsp;all&nbsp;cases.&nbsp;Anti-FHA&nbsp;IgA&nbsp;positivity&nbsp;was&nbsp;detected&nbsp;in&nbsp;12&nbsp;patients&nbsp;(14.8%),&nbsp;while&nbsp;anti-FHA&nbsp;IgG&nbsp;positivity&nbsp;was&nbsp;observed&nbsp;in&nbsp;7&nbsp;patients&nbsp;(8.6%).&nbsp;In&nbsp;the&nbsp;PCR-positive&nbsp;case,&nbsp;culture&nbsp;was&nbsp;negative&nbsp;and&nbsp;all&nbsp;serological&nbsp;parameters&nbsp;were&nbsp;also&nbsp;negative.</p><p><strong>Conclusion:</strong>&nbsp;In&nbsp;this&nbsp;study,&nbsp;no&nbsp;<em>Bordetella</em>&nbsp;spp.&nbsp;were&nbsp;detected&nbsp;by&nbsp;culture&nbsp;in&nbsp;adult&nbsp;patients,&nbsp;whereas&nbsp;real-time&nbsp;PCR&nbsp;identified&nbsp;a&nbsp;limited&nbsp;number&nbsp;of&nbsp;cases.&nbsp;The&nbsp;absence&nbsp;of&nbsp;serological&nbsp;positivity&nbsp;in&nbsp;the&nbsp;PCR-positive&nbsp;patient&nbsp;suggests&nbsp;the&nbsp;diagnostic&nbsp;superiority&nbsp;of&nbsp;molecular&nbsp;methods&nbsp;in&nbsp;the&nbsp;early&nbsp;phase&nbsp;of&nbsp;infection.&nbsp;The&nbsp;limited&nbsp;serological&nbsp;positivity&nbsp;rates&nbsp;observed&nbsp;may&nbsp;reflect&nbsp;past&nbsp;or&nbsp;subclinical&nbsp;Bordetella&nbsp;infections.&nbsp;Our&nbsp;findings&nbsp;indicate&nbsp;that&nbsp;culture&nbsp;has&nbsp;low&nbsp;sensitivity&nbsp;in&nbsp;adult&nbsp;pertussis&nbsp;diagnosis&nbsp;and&nbsp;that&nbsp;molecular&nbsp;and&nbsp;serological&nbsp;methods&nbsp;provide&nbsp;complementary&nbsp;diagnostic&nbsp;value.</p>

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