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Table 2: Advantages and Disadvantages of Laboratory Tests for Identification of
B. pertussis
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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.
Learn more about Respiratory Case Study: Possible Pertussis Infection (online CE course)
Table 2: 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.
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