提交用于 RSV 筛查的样本中百日咳博德特菌和副百日咳博德特菌的流行率。
Prevalence of Bordetella pertussis and Bordetella parapertussis in Samples Submitted for RSV Screening.
机构信息
Kern Medical Center, Department of Emergency Medicine and David Geffen School of Medicine, University of California Los Angeles.
出版信息
West J Emerg Med. 2008 Aug;9(3):135-40.
BACKGROUND
The clinical presentation of Bordetella pertussis can overlap with that of respiratory syncytial virus (RSV); however, management differs.
HYPOTHESIS
First, the prevalence of B. pertussis is less than 2% among patients screened for RSV, and second the prevalence of B. parapertussis is also less than 2% among these patients.
METHODS
Nasal washings submitted to a clinical laboratory for RSV screening were tested for B. pertussis and B. parapertussis, using species-specific real-time polymerase chain reaction (PCR) assays. These were optimized to target conserved regions within a complement gene and the CarB gene, respectively. A Bordetella spp. genus-specific real-time PCR assay was designed to detect the Bhur gene of B. pertussis, B. parapertussis, and B. bronchiseptica. RSV A and B subtypes were tested by reverse transcription-PCR.
RESULTS
Four hundred and eighty-nine clinical samples were tested. There was insufficient material to complete testing for one B. pertussis, 10 RSV subtype A, and four RSV subtype B assays. Bordetella pertussis was detected in 3/488 (0.6%) (95% CI 0.1% to 1.8%), while B. parapertussis was detected in 5/489 (1.0%) (95% CI 0.3% to 2.4%). Dual infection of B. pertussis with RSV and of B. parapertussis with RSV occurred in two and in three cases respectively. RSV was detected by PCR in 127 (26.5%).
CONCLUSION
The prevalence of B. pertussis in nasal washings submitted for RSV screening was less than 2%. The prevalence of parapertussis may be higher than 2%. RSV with B. pertussis and RSV with B. parapertussis coinfection do occur.
背景
百日咳博德特氏菌的临床表现可能与呼吸道合胞病毒 (RSV) 重叠，但治疗方法不同。
假设
首先，在筛查 RSV 的患者中，百日咳博德特氏菌的患病率低于 2%，其次，这些患者中副百日咳博德特氏菌的患病率也低于 2%。
方法
将提交给临床实验室进行 RSV 筛查的鼻洗液，使用针对物种特异性的实时聚合酶链反应（PCR）检测百日咳博德特氏菌和副百日咳博德特氏菌。这些方法分别针对补体基因和 CarB 基因的保守区域进行了优化。设计了一种针对 B. pertussis、B. parapertussis 和 B. bronchiseptica 的 Bhur 基因的 Bordetella spp. 属特异性实时 PCR 检测方法。通过逆转录-PCR 检测 RSV A 和 B 亚型。
结果
共检测了 489 个临床样本。有一个 B. pertussis、10 个 RSV 亚型 A 和 4 个 RSV 亚型 B 的检测因材料不足而无法完成。在 488 个样本中检测到 3 株百日咳博德特氏菌（0.6%）（95%CI 0.1%至 1.8%），而检测到 5 株副百日咳博德特氏菌（1.0%）（95%CI 0.3%至 2.4%）。RSV 和 B. pertussis 的双重感染以及 RSV 和 B. parapertussis 的双重感染分别发生在 2 例和 3 例患者中。127 例（26.5%）通过 PCR 检测到 RSV。
结论
在筛查 RSV 的鼻洗液中，百日咳博德特氏菌的患病率低于 2%。副百日咳博德特氏菌的患病率可能高于 2%。RSV 与 B. pertussis 和 RSV 与 B. parapertussis 的合并感染确实存在。
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