Molecular detection and quantification of pertussis and correlation with clinical outcomes in children |
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Authors: | J.P. DeVincenzo Cliff Guyton Harrison Rea Evan Elmore Shivam Patel Luke Wynn Lisa Harrison Chadi M. El Saleeby Bindiya Bagga |
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Affiliation: | 1. Memphis University School, Memphis, TN 38119, USA;2. White Station High School, Memphis TN 38117, USA;3. Division of Infectious Diseases, Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN 38103, USA;4. Division of Pediatric Infectious Diseases, Department of Pediatrics, Harvard Medical School, Massachusetts General Hospital for Children, Boston, MA 02114, USA;5. Infectious Diseases, St Jude Children''s Research Hospital, Memphis, TN 38105, USA;6. Le Bonheur Children''s Hospital Memphis, Memphis, TN 38103, USA;g The Children''s Foundation Research Institute, Memphis, TN 38103, USA |
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Abstract: | Pertussis is an under-recognized serious infection. Conventional cultures are insensitive and of limited utility after antibiotic exposure. We corroborated the utility of real-time polymerase chain reaction (PCR) as a diagnostic tool in pertussis and investigated its role as a prognostic tool by evaluating its benefit in the quantification of pertussis bacterial load. All pertussis-positive PCR tests (n = 104) submitted over 5 years were collected for retrospective study. PCR cycle threshold was compared to quantitative culture in 43. Compared to PCR, the sensitivity of culture was 41%. Our PCR assay reliably quantified bacterial load and was quantitatively reproducible. Higher bacterial load correlated with longer duration of hospitalization (P = 0.0003), and multivariate logistic regression models demonstrated this association to be independent. The study confirmed PCR as a superior diagnostic tool in pertussis. PCR quantification of bacterial load at initial diagnosis predicts later clinical disease severity, suggesting a potential benefit of PCR as a prognostic tool in pertussis. |
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Keywords: | Pertussis PCR Semi-quantitative PCR Bacterial load |
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