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Comparing the Yield of Nasopharyngeal Swabs, Nasal Aspirates, and Induced Sputum for Detection of Bordetella pertussis in Hospitalized Infants.
Clin Infect Dis. 2016 Dec 01; 63(suppl 4):S181-S186.CI

Abstract

BACKGROUND

Advances in molecular laboratory techniques are changing the landscape of Bordetella pertussis illness diagnosis. Polymerase chain reaction (PCR) assays have greatly improved the sensitivity detection and the turnaround time to diagnosis compared to culture. Moreover, different respiratory specimens, such as flocked nasopharyngeal swabs (NPSs), nasopharyngeal aspirates (NPAs), and induced sputum, have been used for B. pertussis detection, although there is limited head-to-head comparison to evaluating the PCR yield from the 3 sampling methods.

METHODS

Hospitalized infants <6 months of age who fulfilled a broad syndromic criteria of respiratory illness were tested for B. pertussis infection by PCR on paired NPSs and NPAs; or paired NPSs and induced sputum. An exploratory analysis of B. pertussis culture was performed on induced sputum specimens and in a subset of NPSs.

RESULTS

From November 2014 to May 2015, 484 infants with paired NPSs and NPAs were tested; 15 (3.1%) PCR-confirmed pertussis cases were identified, 13 of which were PCR positive on both samples, while 1 each were positive only on NPS or NPA. From March to October 2015, 320 infants had NPSs and induced sputum collected, and 11 (3.4%) pertussis cases were identified by PCR, including 8 (72.7%) positive on both samples, 1 (9.1%) only positive on NPS, and 2 (18.2%) only positive on induced sputum. The 3 types of specimens had similar negative predictive value >99% and sensitivity >83%. Compared to PCR, culture sensitivity was 60% in induced sputum and 40% in NPSs.

CONCLUSIONS

Flocked nasopharyngeal swabs, nasopharyngeal aspirates, and induced sputum performed similarly for the detection of B. pertussis infection in young infants by PCR.

Authors+Show Affiliations

Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases. Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand.Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases. Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand.Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases. Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand.Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases. Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand.Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases. Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand.National Institute for Communicable Diseases, National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa.Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases. Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand. National Institute for Communicable Diseases, National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27838671

Citation

Nunes, Marta C., et al. "Comparing the Yield of Nasopharyngeal Swabs, Nasal Aspirates, and Induced Sputum for Detection of Bordetella Pertussis in Hospitalized Infants." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 63, no. suppl 4, 2016, pp. S181-S186.
Nunes MC, Soofie N, Downs S, et al. Comparing the Yield of Nasopharyngeal Swabs, Nasal Aspirates, and Induced Sputum for Detection of Bordetella pertussis in Hospitalized Infants. Clin Infect Dis. 2016;63(suppl 4):S181-S186.
Nunes, M. C., Soofie, N., Downs, S., Tebeila, N., Mudau, A., de Gouveia, L., & Madhi, S. A. (2016). Comparing the Yield of Nasopharyngeal Swabs, Nasal Aspirates, and Induced Sputum for Detection of Bordetella pertussis in Hospitalized Infants. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 63(suppl 4), S181-S186.
Nunes MC, et al. Comparing the Yield of Nasopharyngeal Swabs, Nasal Aspirates, and Induced Sputum for Detection of Bordetella Pertussis in Hospitalized Infants. Clin Infect Dis. 2016 Dec 1;63(suppl 4):S181-S186. PubMed PMID: 27838671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing the Yield of Nasopharyngeal Swabs, Nasal Aspirates, and Induced Sputum for Detection of Bordetella pertussis in Hospitalized Infants. AU - Nunes,Marta C, AU - Soofie,Nasiha, AU - Downs,Sarah, AU - Tebeila,Naume, AU - Mudau,Azwi, AU - de Gouveia,Linda, AU - Madhi,Shabir A, PY - 2016/11/14/entrez PY - 2016/11/14/pubmed PY - 2017/12/23/medline KW - Bordetella pertussis KW - detection KW - induced sputum infants KW - nasopharyngeal aspirates KW - nasopharyngeal swabs SP - S181 EP - S186 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 63 IS - suppl 4 N2 - BACKGROUND: Advances in molecular laboratory techniques are changing the landscape of Bordetella pertussis illness diagnosis. Polymerase chain reaction (PCR) assays have greatly improved the sensitivity detection and the turnaround time to diagnosis compared to culture. Moreover, different respiratory specimens, such as flocked nasopharyngeal swabs (NPSs), nasopharyngeal aspirates (NPAs), and induced sputum, have been used for B. pertussis detection, although there is limited head-to-head comparison to evaluating the PCR yield from the 3 sampling methods. METHODS: Hospitalized infants <6 months of age who fulfilled a broad syndromic criteria of respiratory illness were tested for B. pertussis infection by PCR on paired NPSs and NPAs; or paired NPSs and induced sputum. An exploratory analysis of B. pertussis culture was performed on induced sputum specimens and in a subset of NPSs. RESULTS: From November 2014 to May 2015, 484 infants with paired NPSs and NPAs were tested; 15 (3.1%) PCR-confirmed pertussis cases were identified, 13 of which were PCR positive on both samples, while 1 each were positive only on NPS or NPA. From March to October 2015, 320 infants had NPSs and induced sputum collected, and 11 (3.4%) pertussis cases were identified by PCR, including 8 (72.7%) positive on both samples, 1 (9.1%) only positive on NPS, and 2 (18.2%) only positive on induced sputum. The 3 types of specimens had similar negative predictive value >99% and sensitivity >83%. Compared to PCR, culture sensitivity was 60% in induced sputum and 40% in NPSs. CONCLUSIONS: Flocked nasopharyngeal swabs, nasopharyngeal aspirates, and induced sputum performed similarly for the detection of B. pertussis infection in young infants by PCR. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/27838671/Comparing_the_Yield_of_Nasopharyngeal_Swabs_Nasal_Aspirates_and_Induced_Sputum_for_Detection_of_Bordetella_pertussis_in_Hospitalized_Infants_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciw521 DB - PRIME DP - Unbound Medicine ER -