Jansen D L, Gray G C, Putnam S D, Lynn F, Meade B D
U.S. Food and Drug Administration, Rockville, Maryland 20852, USA.
Clin Infect Dis. 1997 Nov;25(5):1099-107. doi: 10.1086/516099.
One hundred twenty male U.S. Marine Corps trainees with histories of at least 7 days of cough underwent evaluation for Bordetella pertussis infection by culture, B. pertussis-specific polymerase chain reaction (PCR) analysis, and serology. Antibody levels in preexposure, acute-phase, and convalescent-phase serum samples were measured in a microagglutination assay and in enzyme linked immunosorbent assays (ELISAs) for IgG and IgA antibodies to pertussis toxin, filamentous hemagglutinin, pertactin, and fimbriae types 2 and 3. Culture and PCR analysis revealed that none of the patients were positive for B. pertussis; however, 20 of 120 trainees had serological evidence of B. pertussis infection. Of these cases, one was confirmed by a rise in the level of antibody to pertussis toxin, and six were classified as probable by increases in levels of antibodies measured by two or more assays. Of the 20 individuals with serological evidence of infection, 16 had rises in levels of antibodies to fimbriae or agglutinating antibodies. The utility of ELISA for detecting antibodies to fimbriae and the microagglutination assay for diagnosing pertussis in adults should be evaluated by application to larger and more diverse study populations. These results indicate that pertussis should be considered in the diagnosis of coughing illness in military populations.
120名有至少7天咳嗽史的美国海军陆战队男性新兵接受了百日咳博德特氏菌感染评估，评估方法包括培养、百日咳博德特氏菌特异性聚合酶链反应（PCR）分析和血清学检测。在微量凝集试验以及针对百日咳毒素、丝状血凝素、百日咳黏附素和2型及3型菌毛的IgG和IgA抗体的酶联免疫吸附测定（ELISA）中，测量了暴露前、急性期和恢复期血清样本中的抗体水平。培养和PCR分析显示，所有患者的百日咳博德特氏菌检测均为阴性；然而，120名新兵中有20人有百日咳博德特氏菌感染的血清学证据。在这些病例中，1例通过百日咳毒素抗体水平升高得到确诊，6例通过两种或更多检测方法测得的抗体水平升高被归类为可能感染。在有感染血清学证据的20人中，16人的菌毛抗体或凝集抗体水平有所升高。ELISA检测菌毛抗体的效用以及微量凝集试验诊断成人百日咳的效用，应通过应用于更大且更多样化的研究人群来评估。这些结果表明，在军人咳嗽疾病的诊断中应考虑百日咳。
