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Real-Time Polymerase Chain Reaction-Based Detection of Bordetella pertussis in Mexican Infants and Their Contacts: A
Alejandra Aquino-Andrade1, Gabriel Martínez-Leyva1, Jocelin Mérida-Vieyra1
1Molecular Microbiology Laboratory, National Institute of Pediatrics, Mexico City, Mexico.
Insights
Real-time polymerase chain reaction (RT-PCR) improves Bordetella pertussis detection in infants with whooping cough. Household contacts are a significant source of pertussis infection in young children, highlighting the need for comprehensive family screening.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Whooping cough (pertussis) remains a significant concern in infants.
- Accurate and timely diagnosis is crucial for effective management and control.
- Identifying sources of infection, particularly within households, is vital for preventing transmission.
Purpose of the Study:
- To assess the utility of real-time polymerase chain reaction (RT-PCR) for diagnosing Bordetella pertussis in hospitalized infants.
- To investigate the role of household contacts as a source of pertussis infection in infants.
Main Methods:
- Prospective, multicenter study involving infants under one year old with suspected whooping cough.
- Nasopharyngeal samples collected for Bordetella pertussis detection using culture and RT-PCR.
- Analysis of clinical, epidemiological data, and outcomes; investigation of household contacts for B. pertussis and symptoms.
Main Results:
- Bordetella pertussis was detected in 67.1% of 286 infants; Bordetella spp. in 4.5%.
- Complications were observed in 20% of patients, with a mortality rate of 6.7%.
- Mothers were the most frequently infected household contacts (111 of 434 contacts), often symptomatic.
Conclusions:
- RT-PCR enhances the detection and diagnosis of pertussis, improving epidemiological understanding.
- Pertussis continues to present high complication and mortality rates in infants.
- Household contacts are a confirmed, frequent source of Bordetella pertussis transmission to young children.
Objectives:
To evaluate the usefulness of real-time polymerase chain reaction (RT-PCR) as a diagnostic method for the detection of Bordetella pertussis in hospitalized patients aged <1 year with a clinical diagnosis of whooping cough, as well as to identify the role of household contacts as a source of infection.
Study Design:
This was a prospective, multicenter study of infants aged <1 year who were hospitalized with symptoms suggestive of whooping cough. Nasopharyngeal samples were obtained for culture and RT-PCR testing. The clinical and epidemiologic characteristics and outcomes were analyzed. B pertussis detection and symptoms in household contacts of patients diagnosed with pertussis were studied.
Results:
A total of 286 patients were included; of these, 67.1% had B pertussis and 4.5% had Bordetella spp. Complications occurred in 20% of patients, and the mortality rate was 6.7%. Of 434 contacts studied, 111 were mothers of study infants, representing the most frequently B pertussis-infected group and the main symptomatic contact.
Conclusion:
The use of RT-PCR permits improved detection and diagnosis of pertussis and a better understanding of the epidemiology of sources of infection. The complications and mortality rate of pertussis continue to be high. Household contacts are confirmed as a frequent source of infection of B pertussis in young children.
