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Published on: January 26, 2019
Prevalence of Bordetella pertussis and Bordetella parapertussis in Samples Submitted for RSV Screening
Paul Walsh1, Christina Overmeyer, Lauren Kimmel
1Kern Medical Center, Department of Emergency Medicine and David Geffen School of Medicine, University of California Los Angeles.
Background:
The clinical presentation of Bordetella pertussis can overlap with that of respiratory syncytial virus (RSV); however, management differs.
Hypothesis:
First, the prevalence of B. pertussis is less than 2% among patients screened for RSV, and second the prevalence of B. parapertussis is also less than 2% among these patients.
Methods:
Nasal washings submitted to a clinical laboratory for RSV screening were tested for B. pertussis and B. parapertussis, using species-specific real-time polymerase chain reaction (PCR) assays. These were optimized to target conserved regions within a complement gene and the CarB gene, respectively. A Bordetella spp. genus-specific real-time PCR assay was designed to detect the Bhur gene of B. pertussis, B. parapertussis, and B. bronchiseptica. RSV A and B subtypes were tested by reverse transcription-PCR.
Results:
Four hundred and eighty-nine clinical samples were tested. There was insufficient material to complete testing for one B. pertussis, 10 RSV subtype A, and four RSV subtype B assays. Bordetella pertussis was detected in 3/488 (0.6%) (95% CI 0.1% to 1.8%), while B. parapertussis was detected in 5/489 (1.0%) (95% CI 0.3% to 2.4%). Dual infection of B. pertussis with RSV and of B. parapertussis with RSV occurred in two and in three cases respectively. RSV was detected by PCR in 127 (26.5%).
Conclusion:
The prevalence of B. pertussis in nasal washings submitted for RSV screening was less than 2%. The prevalence of parapertussis may be higher than 2%. RSV with B. pertussis and RSV with B. parapertussis coinfection do occur.
Insights
Bordetella pertussis and Bordetella parapertussis are uncommon in patients screened for respiratory syncytial virus (RSV). Coinfections with RSV do occur, highlighting the need for accurate diagnostic methods.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Clinical presentation of Bordetella pertussis (whooping cough) can mimic Respiratory Syncytial Virus (RSV) infections.
- Accurate differentiation is crucial as management strategies differ significantly between these two pathogens.
Purpose of the Study:
- To determine the prevalence of Bordetella pertussis and Bordetella parapertussis in patients undergoing screening for RSV.
- To investigate the occurrence of coinfections between Bordetella species and RSV.
Main Methods:
- Real-time polymerase chain reaction (PCR) assays were developed and optimized to detect B. pertussis and B. parapertussis in nasal wash samples.
- Species-specific and genus-specific PCR assays were employed, alongside reverse transcription-PCR for RSV A and B subtypes.
Main Results:
- Bordetella pertussis was detected in 0.6% of samples, and B. parapertussis in 1.0%.
- Respiratory Syncytial Virus (RSV) was detected in 26.5% of samples.
- Coinfections were observed: B. pertussis with RSV (2 cases) and B. parapertussis with RSV (3 cases).
Conclusions:
- The prevalence of B. pertussis is low (<2%) in this patient cohort screened for RSV.
- B. parapertussis prevalence may exceed 2%, warranting consideration in differential diagnosis.
- The study confirms that coinfections with RSV and Bordetella species are clinically relevant.
