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The page below is a sample from the LabCE course Respiratory Case Study: Possible Pertussis Infection. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Advantages and Disadvantages of Laboratory Tests for Identification of B. pertussis

Method
Specificity
Sensitivity
Advantages
Disadvantages
Culture
100%
12-60%
  • Highest yield:
    • young children
    • unvaccinated
    • early in illness
    • prior to antibiotics
  • Isolation of the organism confirms pertussis.
  • Important if outbreak is suspected
      • Long incubation time
      • Many factors affect sensitivity:
        • type and quality of specimen
        • age of patient
        • appropriate transport
        • culture media
        • culture incubation time
      Direct fluorescent antibody (DFA)
      7-44%
      18-78%
      • More rapid than culture
      • Uses a direct smear
      • Requires the presence of large numbers of organisms (>10.000/mL)
      • Requires highly trained personnel to perform the test correctly.
      • Antibiotic therapy can affect binding of DFA reagent to cell wall.
      • Not recommended for diagnosis of B. pertussis.
      Nucleic acid amplification testing (NAAT) such as PCR
      ~93% 70-90%
      • Faster turnaround time than culture
      • Very sensitive (< 1 CFU/5mL sample)
      • Does not require viable organism
      • More expensive to perform than culture
      • Cross reaction with different Bordetella species
      Serology
      Varies
      Varies
      • Measures antibody in the late phase of the illness when both NAAT and culture may be negative
      • Requires acute and convalescent specimens
      • Infection occurring in previously vaccinated individuals may not be detectible with serologic methods.