Microbiology Laboratory, Children's Hospital of Tunis, Tunis, Tunisia.
Crit Rev Microbiol. 2012 May;38(2):111-21. doi: 10.3109/1040841X.2011.622715. Epub 2011 Nov 21.
Despite the introduction of routine vaccination against pertussis for more than a half century, leading to a drastic decline in the number of reported cases, pertussis continues to be an important respiratory disease afflicting unvaccinated infants and previously vaccinated children as well as adults in whom immunity has waned. The diagnosis of pertussis is challenging and accurate laboratory identification of Bordetella infections remains problematic. Common laboratory diagnostic methods used for pertussis diagnosis include culture, direct-fluorescent-antibody testing (DFA), serology and polymerase chain reaction (PCR). Culture of Bordetella pertussis is highly specific but fastidious and has limited sensitivity. DFA provides a much more rapid result, but has the disadvantage of poor sensitivity and specificity. Serology is not useful in infants. In older persons, it is hampered by the limitations of paired sera and it provides mainly a retrospective diagnosis. Such limitations of conventional diagnosis testing have led to the development of PCR assays. Notwithstanding its lack of standardization, PCR has been found to be more sensitive and more specific than other methods. In this report, we aimed to review current knowledge about the available diagnostic methods and tests that accurately diagnose pertussis.
尽管半个多世纪以来常规接种百日咳疫苗已大大减少了报告病例数，但百日咳仍是一种重要的呼吸道疾病，未接种疫苗的婴儿、以前接种过疫苗的儿童以及免疫力下降的成年人都会受到影响。百日咳的诊断具有挑战性，准确鉴定博德特氏菌感染仍然存在问题。常用于百日咳诊断的常见实验室诊断方法包括培养、直接荧光抗体检测（DFA）、血清学和聚合酶链反应（PCR）。培养博德特氏菌具有高度特异性，但很挑剔，敏感性有限。DFA 提供了更快的结果，但灵敏度和特异性差。血清学在婴儿中没有用。在老年人中，它受到配对血清的限制，主要提供回顾性诊断。这些传统诊断检测的局限性导致了 PCR 检测方法的发展。尽管缺乏标准化，但 PCR 已被发现比其他方法更敏感、更特异。在本报告中，我们旨在综述有关准确诊断百日咳的现有诊断方法和检测方法的现有知识。
