Missed pertussis diagnosis during co-infection with Bordetella holmesii

AbstractThe purpose of this study is to identify predictive factors associated with missed diagnosis ofB. pertussis–B. holmesii co-infection by assessing the analytical performance of a commercially available multiplexed PCR assay and by building a prediction model based on clinical signs and symptoms for detecting co-infections. This is a retrospective study on the electronic health records of all clinical samples that tested positive to eitherB. pertussis orB. holmesii from January 2015 to January 2018 at Geneva University Hospitals. Multivariate logistic regression was used to build a model for co-infection prediction based on the electronic health record chart review. Limit of detection was determined for all targets of the commercial multiplexed PCR assay used on respiratory samples. A regression model, developed from clinical symptoms and signs, predictedB. pertussis andB. holmesii co-infection with an accuracy of 82.9% (95% CI 67.9 –92.8%,p value  = .012), for respiratory samples positive with any of the two testedBordetella species. We found that the LOD of the PCR reaction targetingptxS1 is higher than that reported by the manufacturer by a factor 10. The current testing strategy missesB. pertussis andB. holmesii co-infections by reporting onlyB. holmesii infections. Thus, we advocate to perform serological testing for detecting a response against pertussis toxin whenever a sample is found positive forB. holmesii. These findings are important, both from a cli...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research