BORDETELLA PERTUSSIS & BORDETELLA PARAPERTUSSIS BY PCR

Code
900.5460
Name
BORDETELLA PERTUSSIS & BORDETELLA PARAPERTUSSIS BY PCR
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
B. pertussis smear; Pertussis smear; Whooping cough
CPT Codes
87798 x 2
Site
SBMF
Reference Test
36129
ATLAS Test Code

Specimen Information

Type

NP swab, aspirate or washing; respiratory aspirate; or bronchoalveolar lavage in a sterile container or M4 viral transport media

Volume

One NP swab or 1.0 mL aspirate, wash or lavage

Transport Info

Refrigerated 48 Hours
If specimen will not be received within 48 hours of collection, freeze serum and transport frozen

Fasting Required?
False
Patient Instructions

Reference Range

Negative (specific Bordetella bacterial DNA not detected by PCR)

Methodology

Polymerase Chain Reaction (PCR), amplified probe technique

Clinical Significance

Bordetella pertussis, the causative bacterial agent of whooping cough, is transmitted by respiratory droplets. A related species, which may also cause pertussis syndrome, is Bordetella parapertussis. The illness caused by B. parapertussis is usually milder than that caused by B. pertussis.<,/p>

Although culture for Bordetella species has high specificity, it is maximally sensitive only in the initial phases of disease. Successful culture requires special media, incubation periods up to seven days, and is highly dependent upon specimen collection, transportation, and laboratory techniques. Diagnostic sensitivities below 60 percent are observed for both culture and DFA when nasopharyngeal secretions are obtained outside the early stage of the illness, from older or vaccinated persons, and from persons treated with certain antibiotics. Pertussis serology is often helpful to confirm pertussis in adults, but it cannot be used in the acute phase of the disease and it can be difficult to differentiate between vaccine effects and true infection.

The diagnostic sensitivity of PCR for pertussis syndrome has been reported to be 93-95%. PCR is, therefore, becoming the test of choice for detection of B. pertussis and B. parapertussis in clinical specimens. Reportedly, the increase in sensitivity for detecting B. pertussis by PCR was 219%, when compared to culture. The assay is appropriate for diagnosis of pertussis syndrome in children with consistent epidemiological and clinical features of disease and in adults with persistent cough in whom pertussis is suspect. As is true for the other diagnostic tests mentioned above, sampling patients as early in the course of clinical illness as possible is recommended. Currently, there is no data available as to how long patients with pertussis remain PCR positive and, hence, how late in the course of disease the assay is likely to be diagnostic.

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