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Effectiveness of rapid multiplex polymerase chain reaction for early diagnosis and treatment of pertussis
Journal of Microbiology, Immunology and Infection ( IF 7.4 ) Pub Date : 2020-05-28 , DOI: 10.1016/j.jmii.2020.05.012
Se Chang Oh 1 , Soo Min Park 1 , Jian Hur 2 , Eun Young Choi 2 , Hyun Jung Jin 2 , Yu Kyung Kim 3 , Jong Ho Lee 4 , Ji Young Ahn 5 , Jae Min Lee 5
Affiliation  

Background

Pertussis, is an infectious respiratory disease caused by Bordetella pertussis. The incidence of pertussis has been increasing in South Korea to due to waning vaccine-induced immunity. Culture has a low sensitivity and a long turnaround time (TAT). Recently, a rapid multi-polymerase chain reaction (mPCR) test with a TAT of about 1 h was developed for the detection of respiratory pathogens (17 viruses and three bacteria), including B. pertussis. This study aimed to investigate the effectiveness of mPCR for early diagnosis and treatment of pertussis.

Methods

We performed a retrospective study of patients with pertussis diagnosed from May 2017 to June 2019 at a university hospital in South Korea. Nasopharyngeal swab specimens were tested using mPCR. Data were extracted from medical records.

Results

A total of 27 patients with a median age of 48.9 years (range: 3.3–82.2 years) were diagnosed with pertussis, of whom 9 (33.3%) were male. Eleven (40.7%) had fever, 12 (44.4%) had dyspnea, three (11.1%) had paroxysmal cough, and nine (33.3%) had inspiratory whooping. The median interval from symptom onset to diagnosis was 9.0 days (range: 1–31 days). Twenty-four patients (81.5%) were diagnosed within 2 weeks from symptom onset. All but one patient was prescribed macrolide antibiotics. Twenty-two patients (81.5%) required hospitalization, including three (11.1%) who required intensive care unit care for ventilation.

Conclusion

Testing patients with respiratory symptoms using mPCR can improve early diagnosis of pertussis, ensure proper treatment, and may help with outbreak control.



中文翻译:

快速多重聚合酶链反应对百日咳早期诊断和治疗的有效性

背景

百日咳,是由百日咳博德特氏菌引起的传染性呼吸道疾病。由于疫苗诱导的免疫力下降,韩国百日咳的发病率一直在增加。培养具有低敏感性和长周转时间 (TAT)。最近,开发了一种 TAT 约为 1 小时的快速多聚酶链反应 (mPCR) 测试,用于检测呼吸道病原体(17 种病毒和 3 种细菌),包括百日咳杆菌。本研究旨在探讨 mPCR 在百日咳早期诊断和治疗中的有效性。

方法

我们对 2017 年 5 月至 2019 年 6 月在韩国一家大学医院诊断出的百日咳患者进行了回顾性研究。使用 mPCR 检测鼻咽拭子标本。数据是从病历中提取的。

结果

共有 27 名中位年龄为 48.9 岁(范围:3.3-82.2 岁)的患者被诊断为百日咳,其中 9 名(33.3%)为男性。11 人 (40.7%) 发烧,12 人 (44.4%) 有呼吸困难,3 人 (11.1%) 有阵发性咳嗽,9 人 (33.3%) 有吸气性百日咳。从症状出现到诊断的中位间隔为 9.0 天(范围:1-31 天)。24 名患者 (81.5%) 在症状出现后 2 周内被诊断出来。除一名患者外,所有患者都服用了大环内酯类抗生素。22 名患者 (81.5%) 需要住院治疗,其中 3 名 (11.1%) 需要重症监护室通气治疗。

结论

使用 mPCR 检测有呼吸道症状的患者可以改善百日咳的早期诊断,确保正确治疗,并可能有助于控制疫情。

更新日期:2020-05-28
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