From the *Section of Infectious Diseases, Nationwide Children's Hospital; †College of Medicine, The Ohio State University; ‡Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH; and §Epidemic Intelligence Service, assigned to the Ohio Department of Health, Centers for Disease Control and Prevention, Atlanta, GA.
Pediatr Infect Dis J. 2014 Jul;33(7):e162-7. doi: 10.1097/INF.0000000000000262.
An increase in laboratory diagnosis of pertussis was noted in central Ohio during 2010. Diagnosis was made using a polymerase chain reaction assay targeting the multicopy insertion sequence IS481, which is found in both Bordetella pertussis (Bp) and Bordetella holmesii (Bh). An increase in specimens testing positive for Bordetella parapertussis (Bpp) using insertion sequence IS1001 was also noted.
Nasopharyngeal swab specimens submitted April 1, 2010, to March 31, 2011, were tested using a multiplex polymerase chain reaction assay for Bp/Bh (IS481) and Bpp followed by singleplex assays for Bp and Bh. A subgroup of specimens was also cultured for Bordetella species, and antimicrobial susceptibility testing was performed on recovered organisms. Demographic and clinical features were compared for patients with Bp, Bh and Bpp.
Of 520 IS481-positive specimens, 214 (41.1%) were positive for Bp, 79 (15.2%) were positive for Bh and 5 (1.0%) were positive for both Bp and Bh; 222 (42.7%) were negative for both targets. An additional 220 specimens were positive for Bpp. Among a sample of 155 IS481-positive specimens, 40, 15 and 0 were culture positive for Bp, Bh and Bpp, respectively. Among a sample of 55 BparaIS1001-positive (Bpp) specimens, 22, 0 and 0 were culture positive for Bpp, Bp and Bh, respectively. All Bordetella species were susceptible to macrolide antibiotics. Patients with Bh were older than patients with Bp, who were older than those positive for Bpp (mean ages: 12.0, 8.0 and 4.2 years, respectively; P < 0.001). One or more classic signs of pertussis (ie, paroxysmal cough, whoop, post-tussive emesis) were seen in 55.9% of 263 patients (59 Bp, 24 Bh, 80 Bpp and 100 negative for Bordetella species), but did not differ statistically among the groups (χ = 5.1, P = 0.17).
All 3 Bordetella species, Bp, Bh and Bpp, were detected during on outbreak of pertussis-like cough illness. There were noted differences in age and seasonality, but clinical features at the time of presentation did not allow clear differentiation of these infections. All Bordetella species recovered from culture and tested were susceptible in vitro to macrolide antibiotics. Additional study is necessary to further characterize epidemiologic and clinical characteristics of Bh-associated cough illness and to determine potential co-occurrence of Bordetella species with other bacterial and viral respiratory tract pathogens.
2010 年，俄亥俄州中部的实验室诊断百日咳病例有所增加。使用针对多拷贝插入序列 IS481 的聚合酶链反应检测方法进行诊断，该序列存在于百日咳博德特氏菌（Bp）和霍姆斯博德特氏菌（Bh）中。使用插入序列 IS1001 检测到博德特氏菌属副百日咳（Bpp）阳性的标本也有所增加。
2010 年 4 月 1 日至 2011 年 3 月 31 日提交的鼻咽拭子标本采用多重聚合酶链反应检测 Bp/Bh（IS481）和 Bpp，然后采用单重聚合酶链反应检测 Bp 和 Bh。还对一部分标本进行了 Bordetella 属培养，对分离的生物体进行了药敏试验。比较了 Bp、Bh 和 Bpp 患者的人口统计学和临床特征。
在 520 份 IS481 阳性标本中，214 份（41.1%）Bp 阳性，79 份（15.2%）Bh 阳性，5 份（1.0%）Bp 和 Bh 均阳性；222 份（42.7%）两个靶标均为阴性。另外 220 份标本 Bpp 阳性。在 155 份 IS481 阳性标本中，40、15 和 0 分别为 Bp、Bh 和 Bpp 培养阳性。在 55 份 BparaIS1001 阳性（Bpp）标本中，22、0 和 0 分别为 Bpp、Bp 和 Bh 培养阳性。所有博德特氏菌均对大环内酯类抗生素敏感。Bh 患者比 Bp 患者年龄大，而 Bp 患者比 Bpp 患者年龄大（平均年龄：12.0、8.0 和 4.2 岁，P<0.001）。在 263 名患者（59 名 Bp、24 名 Bh、80 名 Bpp 和 100 名 Bordetella 属阴性）中，有 55.9%（1 例或更多经典百日咳症状（即阵发性咳嗽、哮鸣、咳嗽后呕吐），但在各组之间无统计学差异（χ=5.1，P=0.17）。
在百日咳样咳嗽疾病的暴发中，均检测到了 3 种博德特氏菌，即 Bp、Bh 和 Bpp。在年龄和季节性方面存在差异，但在出现症状时的临床特征无法明确区分这些感染。从培养物中分离并测试的所有博德特氏菌对大环内酯类抗生素在体外均敏感。需要进一步研究以进一步描述 Bh 相关咳嗽疾病的流行病学和临床特征，并确定博德特氏菌与其他细菌和病毒呼吸道病原体的潜在共同发生。
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