Evaluation of three real-time PCR methods for the detection and the differentiation of Bordetella pertussis, Bordetella parapertussis and Bordetella holmesii.

introductionWhooping cough, caused by Bordetella pertussis, is a re-emerging vaccine-preventable respiratory disease with serious complications, especially in infants, making early and accurate diagnosis essential. This study aimed to compare the clinical performance of three PCR methods for Bordetella detection, highlighting the importance of CE-IVDR-certified tests and the potential of point of care testing (POCT) for effective disease management. MATERIALS AND

methodsFrom October 2023 to March 2024, nasopharyngeal swabs from suspected pertussis cases were collected and tested with the Bordetella ELITe MGB Kit, FlexStar

resultsA total of 94 nasopharyngeal samples were tested, of which 57 were positive and 22 negatives across all three PCR assays. The concordance rate between the Altona and ELITe MGB assays was 91.75%. Concordance between Altona and Vivalytic reached 87.63%, while the agreement between the Vivalytic assay and the ELITe MGB Kit was 89.69%. Based on the composite reference standard, both the Altona and ELITe MGB Kit assays demonstrated a positive percent agreement (PPA) of 98.4% for the detection of Bordetella species. For B. pertussis specifically, high PPA values (> 98% and > 92%) and negative percent agreement (NPA) values (> 96% and > 92%) were observed, indicating strong diagnostic performance across platforms.

conclusionThis study compared three PCR methods (Altona, ELITe MGB Kit, and Vivalytic) for Bordetella detection. Practical considerations such as sample throughput, operational costs, and reimbursement policies in Belgium suggest that POCT is particularly beneficial in pediatric emergency settings, while larger labs might prefer batch processing.