Clinics and Departments

Laboratory Services

Lab Dept:

Microbiology/Virology

Test Name:

BORDETELLA PERTUSSIS PCR

General Information

Lab Order Codes:

BPPCR

Synonyms:

Bordetella pertussis and parapertussis PCR; Pertussis PCR; Whooping cough

CPT Codes:

87801 – Infectious agent detection by nucleic acid, not otherwise specified; amplified probe technique, each organism

Test Includes:

Bordetella pertussis and Bordetella parapertussis DNA reported as positive or negative.

Logistics

Test Indications:

Diagnosis of Bordetella pertussis/parapertussis infection.

Lab Testing Sections:

Microbiology/Virology - Sendouts

Referred to:

Mayo Medical Laboratories (MML Test#: 80910/BPRP)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6550

Test Availability:

Daily, 24 hours

Turnaround Time:

1 - 3 days, performed Monday – Friday at 10 am and Sunday 10 am

Special Instructions:

Test is only performed on nasopharyngeal swabs in appropriate transport media or on nasopharyngeal aspirate/washes.

Specimen

Specimen Type:

Nasopharyngeal (throat, nose or nasal specimens are not acceptable) swab or aspirate/wash.

Container:

Swab: Rayon swab with aluminum or plastic shaft to be placed in transport media (either Stuart’s with charcoal or Amies with charcoal)

Sterile Container: for nasopharyngeal wash/aspirate

Draw Volume:

Swab or entire wash/aspirate

Collection:

NP Swabs:

1. Carefully insert a rayon swab with aluminum shaft into the posterior nasopharnyx via the nose.
2.
Rotate the swab slowly for 5 seconds to absorb secretions, keeping the swab near the floor and the septum of the nose.
3.
Remove the swab and place swab in Amies or Stuart’s transport medium with charcoal.

Nasal Aspiration:

1. Prepare suction set up on low to medium suction.
2.
Wash hands.
3.
Put on protective barriers (e.g., gloves, gown, mask).
4.
Place child supine and obtain assistant to hold child during procedure.
5.
Attach luki tube to suction tubing and #6 french suction catheter.
6.
Insert catheter into nostril and pharynx without applying suction.
7.
Apply suction as catheter is withdrawn.
8.
If necessary, suction 0.5 - 1cc normal saline through catheter in order to clear the catheter and increase the amount of specimen in the luki tube.

Nasopharyngeal Washings:

1. Tilt patient’s head back at a 70 angle.
2.
Insert rubber bulb syringe containing 1 – 2 mL of sterile saline until it occludes the nostril.
3.
Collect specimen (Minimum: 1 mL) with one complete squeeze and release bulb.
4.
Repeat in other nostril.
5.
Place washings in container and forward promptly.
6.
Apply suction as catheter is withdrawn. If necessary, suction 0.5 – 1.0 mL of normal saline through catheter in order to clear the catheter and increase the amount of specimen in the luki tube.

Special Processing:

Lab Staff: Send swab or wash/aspirate refrigerated, include specimen source.

Patient Preparation:

None

Sample Rejection:

Specimens other than nasopharyngeal swab or aspirate/wash; calcium alginate swabs; cotton-tipped swabs; swabs sent in gel transport media; swabs sent in viral or universal transport media; swabs submitted in Regan Lowe media; Stuart’s or Amies medium without charcoal; mislabeled or unlabeled specimens; frozen swabs

Interpretive

Reference Range:

Negative for Bordetella pertussis DNA
Negative for Bodetella parapertussis DNA

Interpretation: A positive result indicates the presence of DNA from Bordetella pertussis or Bordetella parapertussis. In some cases, a patient may test positive for both Bordetella pertussis and Bordetella parapertussis. Cross-reactivity with Bordetella holmseii and Bordetella bronchiseptica may occur with the Bordetella pertussis assay (See Limitations).

A negative result indicates the absence of detectable Bordetella pertussis or Bordetella parapertussis DNA in the specimen but does not negate the presence of organism or active or recent disease (known inhibition rate of <1%) and may occur due to inhibition of PCR, sequence variability underlying primers and/or probes, or the presence of Bordetella pertussis or Bordetella parapertussis in quantities less than the limit of detection of the assay.

Alert Values:

The physician or patient’s nurse and Infection Prevention will be notified of all positive Bordetella pertussis PCR results.

Limitations:

Cross-reactivity with Bordetella holmesii may occur with the Bordetella pertussis PCR assay. The prevalence of Bordetella holmesii is relatively low, with a positivity in <1% of nasopharyngeal swabs. Bordetella holmesii has, however, been associated with pertussis-like symptoms.

Cross-reactivity of the Bordetella pertussis assay has been demonstrated with a limited number of Bordetella bronchiseptica isolates. The prevalence of the insertion sequence target, IS481, has been reported to be between 1% and 5% in Bordetella bronchiseptica isolates.

This assay is not recommended for screening asymptomatic individuals who may carry Bordetella pertussis or parapertussis.

This assay is not recommended for follow-up of patients previously diagnosed with pertussis (ie, as a test of cure).

Methodology:

Polymerase Chain Reaction (PCR) DNA Probe Hybridization, includes DNA extraction from specimen, PCR amplification and hybridization

References:

Mayo Medical Laboratories March 2013

Updates:

5/15/2012: Critical value changed to Alert Value and notification information was added.
3/25/2013: Bordetella pertussis and Bordetella parapertussis will now be resulted individually.



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