Centre for Infectious Diseases and Microbiology - Public Health, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Westmead Hospital, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia.
Centre for Infectious Diseases and Microbiology - Public Health, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Westmead Hospital, NSW, Australia.
Pathology. 2018 Apr;50(3):322-326. doi: 10.1016/j.pathol.2017.10.014. Epub 2018 Feb 15.
Bordetella pertussis, the aetiological agent of whooping cough is routinely diagnosed by polymerase chain reaction (PCR) directed at IS481, an insertion sequence target also found in Bordetella holmesii. Recent reports have suggested that B. holmesii infections can be misdiagnosed as pertussis, which can have a significant impact on public health surveillance. This study investigated the presence of B. holmesii in B. pertussis positive clinical samples, in order to determine the incidence of B. holmesii. Clinical cases of pertussis diagnosed by IS481-specific PCR between October 2008 and March 2016 in New South Wales were included. Bordetella holmesii was detected through the simultaneous amplification of IS481 and B. holmesii specific insertions sequence, hIS1001. A total of 46 of 802 patients were identified to be positive for B. holmesii rather than B. pertussis, suggesting an incidence rate of 6.5% in 2009, 16.8% in 2010, 7.6% during 2013 and 8.1% during 2015. Bordetella holmesii infections were diagnosed during and between pertussis epidemics, however cases of B. holmesii and B. pertussis co-infections were not found. The predominant age group of B. holmesii infection was 11-18 years old, which was significantly different to the mean age of B. pertussis infections (0-6 years, p = 0.023). These findings revealed that B. holmesii was co-circulating alongside the B. pertussis epidemic for seven years, hidden from view, as B. holmesii infections have been diagnosed as B. pertussis. Confirmatory testing of B. pertussis positive samples for the presence of B. holmesii, especially during pertussis epidemics, should improve the quality of laboratory diagnosis and laboratory surveillance for pertussis. The presence of B. holmesii in Australia highlights the importance of testing for this pathogen and ongoing molecular surveillance that can guide the control of whooping cough.
百日咳博德特氏菌是百日咳的病原体，其常规诊断方法是聚合酶链反应（PCR）检测 IS481，这是一种插入序列靶标，也存在于博德特氏霍姆斯菌中。最近的报告表明，博德特氏霍姆斯菌感染可能被误诊为百日咳，这对公共卫生监测有重大影响。本研究调查了百日咳博德特氏菌阳性临床样本中博德特氏霍姆斯菌的存在情况，以确定博德特氏霍姆斯菌的发生率。该研究纳入了 2008 年 10 月至 2016 年 3 月期间，通过 IS481 特异性 PCR 诊断为百日咳的临床病例。通过同时扩增 IS481 和博德特氏霍姆斯菌特异性插入序列 hIS1001 来检测博德特氏霍姆斯菌。结果共有 802 例患者中的 46 例被鉴定为博德特氏霍姆斯菌阳性，而非百日咳博德特氏菌阳性，2009 年发病率为 6.5%，2010 年为 16.8%，2013 年为 7.6%，2015 年为 8.1%。博德特氏霍姆斯菌感染发生在百日咳流行期间和流行期之间，但未发现博德特氏霍姆斯菌和百日咳博德特氏菌混合感染的病例。博德特氏霍姆斯菌感染的主要年龄组为 11-18 岁，与百日咳博德特氏菌感染的平均年龄（0-6 岁，p=0.023）显著不同。这些发现表明，博德特氏霍姆斯菌在七年的百日咳流行期间与百日咳博德特氏菌一起循环，而没有被发现，因为博德特氏霍姆斯菌感染被诊断为百日咳博德特氏菌。对百日咳博德特氏菌阳性样本进行博德特氏霍姆斯菌存在的确认性检测，尤其是在百日咳流行期间，应提高百日咳实验室诊断和实验室监测的质量。博德特氏霍姆斯菌在澳大利亚的存在强调了检测这种病原体的重要性，以及进行分子监测的重要性，这可以指导百日咳的控制。
