Prevalence of Bordetella pertussis and Bordetella parapertussis in infants presenting to the emergency department with bronchiolitis

Paul F. Walsh, Lauren Kimmel, Melanie Feola, Ty Tran, Christina Lim, Lisa De Salvia, James Pusavat, Scott Michaelson, Tuan Anh Nguyen, Kirt Emery, Eli Mordechai, Martin E. Adelson

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Background: The clinical presentation of Bordetella pertussis can overlap with that of respiratory syncytial virus (RSV), and coinfection does occur, but management differs. Hypothesis: The prevalence of B. pertussis is < 2% among Emergency Department (ED) patients with bronchiolitis. Our secondary hypothesis was that the prevalence of Bordetella parapertussis is also < 2% among these patients. Methods: Nasal washings were obtained from children up to 18 months of age (inclusive) who presented to a county hospital ED with a clinical diagnosis of bronchiolitis. These washings were frozen to -70°C before testing for B. pertussis and B. parapertussis using species-specific real-time polymerase chain reaction (PCR) assays. The assays were optimized to target conserved regions within a complement gene and the CarB gene, respectively. A Bordetella spp. genus-specific real-time PCR assay was designed to detect the Bhur gene of B. pertussis, B. parapertussis, and B. bronchiseptica. RSV antigen detection was also performed. Results: There were 227 patients enrolled. After exclusions, 204 remained in the analysis. RSV antigen testing was positive in 109/186 (59%) of the patients in whom it was performed. All samples were tested for B. pertussis. B. parapertussis testing could not be completed on 23 samples. No cases (0/204; 95% confidence interval [CI] 0-1.8%) tested positive for B. pertussis or B. parapertussis (0/181; 95% CI 0-2%). Conclusion: The prevalence of B. pertussis in children presenting to the ED with bronchiolitis was < 2%.

Original languageEnglish (US)
Pages (from-to)256-261
Number of pages6
JournalJournal of Emergency Medicine
Volume40
Issue number3
DOIs
StatePublished - Mar 2011
Externally publishedYes

Keywords

  • Bordetella parapertussis
  • Bordetella pertussis
  • bronchiolitis
  • diagnostic testing
  • pediatric
  • respiratory syncytial virus

ASJC Scopus subject areas

  • Emergency Medicine

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  • Cite this

    Walsh, P. F., Kimmel, L., Feola, M., Tran, T., Lim, C., Salvia, L. D., Pusavat, J., Michaelson, S., Nguyen, T. A., Emery, K., Mordechai, E., & Adelson, M. E. (2011). Prevalence of Bordetella pertussis and Bordetella parapertussis in infants presenting to the emergency department with bronchiolitis. Journal of Emergency Medicine, 40(3), 256-261. https://doi.org/10.1016/j.jemermed.2008.04.048