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Real-life requests for Bordetella polymerase chain reaction testing in children presenting to hospital
Insights
Pediatricians frequently ordered Bordetella polymerase chain reaction (PCR) tests for children, but results were rarely positive. The study suggests reserving PCR testing for young children with respiratory symptoms or incomplete pertussis immunization to avoid overuse.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
Background:
- Bordetella polymerase chain reaction (PCR) testing is a key diagnostic tool for pertussis.
- Overutilization of diagnostic tests can lead to increased healthcare costs and unnecessary patient anxiety.
Purpose of the Study:
- To evaluate the clinical utility and appropriateness of Bordetella PCR testing in a pediatric tertiary care setting.
- To identify patterns of Bordetella PCR test ordering and assess the yield of positive results.
Main Methods:
- Retrospective analysis of Bordetella PCR test results performed between 2015 and 2017.
- Review of patient demographics, clinical indications, and diagnostic outcomes.
Main Results:
- A total of 3197 Bordetella PCR tests were performed on 2760 children.
- Only 1% (32/3197) of tests were positive, predominantly in children under one year old (90.6%).
- In 2017, 39% of tests were deemed clinically unjustified due to nonspecific respiratory symptoms.
Conclusions:
- Bordetella PCR testing is overused in pediatric practice.
- Testing should be reserved for young children presenting with symptoms suggestive of respiratory illness and/or incomplete pertussis immunization.
Abstract:
From 2015 to 2017, 3197 interpretable Bordetella polymerase chain reaction (PCR) tests were performed for 2760 children presenting to our tertiary university hospital. Requests mainly came from the emergency department (62%) and for children older than 1 year (68%). Only 32 PCR (1%) results were positive, mainly in children younger than 1 year (n = 29/32, 90.6%; p<0.001). When focusing on the PCR indications in 2017, we found the requests were mainly based on nonspecific respiratory symptoms and were clinically unjustified in 383 cases (39%). Pediatricians overused Bordetella PCR in clinical practice. They should reserve their requests for cases of young children with symptoms suggestive of respiratory illness and/or incomplete pertussis immunization.
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