Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec 1;63(suppl 4):S181-S186.
doi: 10.1093/cid/ciw521.

Comparing the Yield of Nasopharyngeal Swabs, Nasal Aspirates, and Induced Sputum for Detection of Bordetella pertussis in Hospitalized Infants

Marta C Nunes  1   2 , Nasiha Soofie  1   2 , Sarah Downs  1   2 , Naume Tebeila  1   2 , Azwi Mudau  1   2 , Linda de Gouveia  3 , Shabir A Madhi  1   2   3
Affiliations

Comparing the Yield of Nasopharyngeal Swabs, Nasal Aspirates, and Induced Sputum for Detection of Bordetella pertussis in Hospitalized Infants

Marta C Nunes et al. Clin Infect Dis. .

Abstract

Background: Advances in molecular laboratory techniques are changing the landscape of Bordetella pertussis illness diagnosis. Polymerase chain reaction (PCR) assays have greatly improved the sensitivity detection and the turnaround time to diagnosis compared to culture. Moreover, different respiratory specimens, such as flocked nasopharyngeal swabs (NPSs), nasopharyngeal aspirates (NPAs), and induced sputum, have been used for B. pertussis detection, although there is limited head-to-head comparison to evaluating the PCR yield from the 3 sampling methods.

Methods: Hospitalized infants <6 months of age who fulfilled a broad syndromic criteria of respiratory illness were tested for B. pertussis infection by PCR on paired NPSs and NPAs; or paired NPSs and induced sputum. An exploratory analysis of B. pertussis culture was performed on induced sputum specimens and in a subset of NPSs.

Results: From November 2014 to May 2015, 484 infants with paired NPSs and NPAs were tested; 15 (3.1%) PCR-confirmed pertussis cases were identified, 13 of which were PCR positive on both samples, while 1 each were positive only on NPS or NPA. From March to October 2015, 320 infants had NPSs and induced sputum collected, and 11 (3.4%) pertussis cases were identified by PCR, including 8 (72.7%) positive on both samples, 1 (9.1%) only positive on NPS, and 2 (18.2%) only positive on induced sputum. The 3 types of specimens had similar negative predictive value >99% and sensitivity >83%. Compared to PCR, culture sensitivity was 60% in induced sputum and 40% in NPSs.

Conclusions: Flocked nasopharyngeal swabs, nasopharyngeal aspirates, and induced sputum performed similarly for the detection of B. pertussis infection in young infants by PCR.

Keywords: Bordetella pertussis; detection; induced sputum infants; nasopharyngeal aspirates; nasopharyngeal swabs.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Diagram representing the number of infants enrolled and specimens analyzed during the study period. Abbreviations: NPA, nasopharyngeal aspirate; NPS, nasopharyngeal swab; PCR, polymerase chain reaction.
See this image and copyright information in PMC

References

    1. Amirthalingam G, Gupta S, Campbell H. Pertussis immunisation and control in England and Wales, 1957 to 2012: a historical review. Euro Surveill 2013;18. - PubMed
    1. Wood N, McIntyre P. Pertussis: review of epidemiology, diagnosis, management and prevention. Paediatr Respir Rev 2008; 9:201–11; quiz 211–2. - PubMed
    1. Crowcroft NS, Pebody RG. Recent developments in pertussis. Lancet 2006; 367:1926–36. - PubMed
    1. Wendelboe AM, Van Rie A. Diagnosis of pertussis: a historical review and recent developments. Expert Rev Mol Diagn 2006; 6:857–64. - PubMed
    1. Leber AL. Pertussis: relevant species and diagnostic update. Clin Lab Med 2014; 34:237–55. - PubMed