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The diagnosis of pertussis: which method to choose?

Asma Zouari1, Hanen Smaoui, Amel Kechrid

  • 1Microbiology Laboratory, Children's Hospital of Tunis, Tunis, Tunisia. zouariasma1@yahoo.fr

Critical Reviews in Microbiology
|November 23, 2011
PubMed

Insights

Accurate diagnosis of pertussis remains challenging. Polymerase chain reaction (PCR) assays show promise for identifying Bordetella infections, offering greater sensitivity and specificity than traditional methods.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Pertussis (whooping cough) persists despite widespread vaccination due to waning immunity and unvaccinated populations.
  • Accurate laboratory diagnosis of Bordetella pertussis infections is difficult, impacting effective treatment and control.
  • Conventional diagnostic methods like culture, DFA, and serology have significant limitations in sensitivity, specificity, and applicability.

Purpose of the Study:

  • To review current knowledge on diagnostic methods for pertussis.
  • To evaluate the accuracy and limitations of available laboratory tests for Bordetella identification.

Main Methods:

  • Review of existing literature on pertussis diagnostic techniques.
  • Comparative analysis of culture, direct-fluorescent-antibody testing (DFA), serology, and polymerase chain reaction (PCR).

Main Results:

  • Culture is specific but lacks sensitivity; DFA is rapid but has poor sensitivity/specificity.
  • Serology is limited for infants and provides retrospective diagnosis in older individuals.
  • Polymerase chain reaction (PCR) assays demonstrate higher sensitivity and specificity despite a lack of standardization.

Conclusions:

  • Existing diagnostic methods for pertussis have notable limitations.
  • PCR assays represent a more sensitive and specific approach for diagnosing Bordetella infections.
  • Further standardization of PCR is needed to optimize pertussis diagnosis and management.

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