南非百日咳博德特氏菌分子检测的挑战和临床相关性。
Challenges and clinical relevance of molecular detection of Bordetella pertussis in South Africa.
机构信息
Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Private Bag X4, Sandringham, Gauteng, 2131, South Africa.
University of the Witwatersrand, Johannesburg, South Africa.
出版信息
BMC Infect Dis. 2019 Mar 21;19(1):276. doi: 10.1186/s12879-019-3869-7.
BACKGROUND
We assessed the utility of a multi-target, real-time PCR assay for Bordetella pertussis detection and diagnosis in patients with severe respiratory illness (SRI), influenza-like illness (ILI), and asymptomatic controls.
METHODS
Real-time PCR detection of IS481, pIS1001, hIS1001 and ptxS1 was performed on nasopharyngeal specimens (SRI, ILI and controls) and induced sputum (SRI) collected from June 2012 to May 2016 through respiratory illness surveillance. Using PCR cycle threshold (C) value cut-offs, IS481 positive cases were classified as confirmed (C < 35) or possible (C 35-39) pertussis disease.
RESULTS
Among 12,922 samples, 146 (1.1%) were IS481 positive of which 62% (90/146) were classified as confirmed. The attributable fraction (AF) was 92.2% (95% CI, 65.6 to 98.2%) and 90.5% (95% CI, 57.5 to 97.9%) amongst SRI and ILI PCR-confirmed pertussis cases, respectively. Amongst possible pertussis cases, AF was 36.9% (95% CI, - 142.3 to 83.6%) and 67.5% (95% CI, - 30.6 to 91.9%) in the SRI and ILI groups, respectively.
CONCLUSION
All IS481 positive specimens could be considered as B. pertussis infection, and potentially pertussis disease with supportive clinical information.
背景
我们评估了一种用于检测和诊断严重呼吸道疾病（SRI）、流感样疾病（ILI）和无症状对照者中百日咳博德特氏菌的多靶标实时 PCR 检测方法。
方法
通过呼吸道疾病监测，从 2012 年 6 月至 2016 年 5 月，采集鼻咽标本（SRI、ILI 和对照者）和诱导痰（SRI），进行实时 PCR 检测 IS481、pIS1001、hIS1001 和 ptxS1。根据 PCR 循环阈值（C）值截断值，将 IS481 阳性病例分为确诊（C < 35）或可能（C 35-39）百日咳病。
结果
在 12922 个样本中，有 146 个（1.1%）IS481 阳性，其中 62%（90/146）被归类为确诊。归因分数（AF）分别为 92.2%（95%CI，65.6 至 98.2%）和 90.5%（95%CI，57.5 至 97.9%），SRI 和 ILI PCR 确诊的百日咳病例中。在可能的百日咳病例中，SRI 和 ILI 组中的 AF 分别为 36.9%（95%CI，-142.3 至 83.6%）和 67.5%（95%CI，-30.6 至 91.9%）。
结论
所有 IS481 阳性标本都可以被认为是百日咳博德特氏菌感染，在有支持性临床信息的情况下，可能是百日咳病。
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