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Bordetella pertussis: emerging epidemiology, diagnosis and management

Samuel W L Baumgart1, Isaac Freelander1, Winkie Fong2

  • 1SydPath St Vincent's Microbiology, St Vincent's Hospital, Darlinghurst, NSW, Australia.

Pathology
|June 24, 2026
PubMed

Insights

Bordetella pertussis, causing whooping cough, is increasing globally. This review examines diagnostic tests, focusing on bacterial culture and resistance detection to combat rising cases and macrolide resistance.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Bordetella pertussis causes whooping cough, a vaccine-preventable illness with recent epidemic outbreaks.
  • Increasing case numbers worldwide necessitate a re-evaluation of diagnostic strategies.
  • Emerging macrolide resistance and pertactin-deficient strains pose challenges to control efforts.

Purpose of the Study:

  • To review the performance of diagnostic tests for Bordetella pertussis.
  • To focus on bacterial culture, susceptibility testing (phenotypic and genotypic), and molecular typing.
  • To address the need for improved diagnostics in light of resistance and strain variations.

Main Methods:

  • Literature review of Bordetella diagnostic test performance.
  • Analysis of bacterial culture techniques.
  • Evaluation of phenotypic and genotypic susceptibility testing methods.
  • Assessment of molecular typing for strain characterization.

Main Results:

  • Current diagnostic methods face challenges with increasing Bordetella pertussis cases.
  • Macrolide resistance in Bordetella pertussis is an emerging concern.
  • Pertactin-deficient strains complicate diagnosis and surveillance.
  • Bacterial culture and advanced molecular methods are crucial for characterization.

Conclusions:

  • Improved diagnostics are essential to detect and characterize macrolide resistance in Bordetella pertussis.
  • Enhanced surveillance through effective diagnostics is needed to manage whooping cough outbreaks.
  • Continued research into Bordetella pertussis diagnostics is vital for public health.
Keywords:
Bordetella diagnosticsBordetella pertussismacrolide resistancepertactin-deficientwhole genome sequencingwhooping cough

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