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01.12.2019 | Research article | Ausgabe 1/2019 Open Access

BMC Infectious Diseases 1/2019

Challenges and clinical relevance of molecular detection of Bordetella pertussis in South Africa

BMC Infectious Diseases > Ausgabe 1/2019
Fahima Moosa, Mignon du Plessis, Nicole Wolter, Maimuna Carrim, Cheryl Cohen, Claire von Mollendorf, Sibongile Walaza, Stefano Tempia, Halima Dawood, Ebrahim Variava, Anne von Gottberg
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12879-019-3869-7) contains supplementary material, which is available to authorized users.



We assessed the utility of a multi-target, real-time PCR assay for Bordetella pertussis detection and diagnosis in patients with severe respiratory illness (SRI), influenza-like illness (ILI), and asymptomatic controls.


Real-time PCR detection of IS481, pIS1001, hIS1001 and ptxS1 was performed on nasopharyngeal specimens (SRI, ILI and controls) and induced sputum (SRI) collected from June 2012 to May 2016 through respiratory illness surveillance. Using PCR cycle threshold (Ct) value cut-offs, IS481 positive cases were classified as confirmed (Ct < 35) or possible (Ct 35–39) pertussis disease.


Among 12,922 samples, 146 (1.1%) were IS481 positive of which 62% (90/146) were classified as confirmed. The attributable fraction (AF) was 92.2% (95% CI, 65.6 to 98.2%) and 90.5% (95% CI, 57.5 to 97.9%) amongst SRI and ILI PCR-confirmed pertussis cases, respectively. Amongst possible pertussis cases, AF was 36.9% (95% CI, − 142.3 to 83.6%) and 67.5% (95% CI, − 30.6 to 91.9%) in the SRI and ILI groups, respectively.


All IS481 positive specimens could be considered as B. pertussis infection, and potentially pertussis disease with supportive clinical information.
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