Association Between Real-time Polymerase Chain Reaction Cycle Threshold Value and Clinical Presentation in Children with Bordetella Pertussis

Overview

Journal Ital J Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2024 Sep 10

PMID 39256818

Authors

Wen Li

Huaping Wang

Shu Teng

Yalin Sun

Qi Jia

Zhenghong Qi

Lingbo Wang

Zhangnv Yang

Shiyong Zhao

Affiliations

Soon will be listed here.

Abstract

Background: The cycle threshold (Ct) value is inversely proportional to the number of copies of the target region in a sample, suggesting that a low Ct value indicates a high pathogen load. The relationship between Ct value and clinical presentation in children with pertussis is not well-defined.

Methods: We investigated the relationships between the Ct value of nasopharyngeal samples positive for Bordetella pertussis deoxyribonucleic acid via real-time polymerase chain reaction (PCR), collected from children on admission and their adult family members between May 2022 and March 2024 at Hangzhou Children's Hospital, China. The study focused on the correlation between Ct value and clinical presentation in children with pertussis.

Results: The Ct value was positively correlated with age (r = 0.362, P = 0.001). The mean Ct value for children with pertussis was 28.0 (range: 22.0-32.0), which was lower than the 32.0 (range: 30.0-34.0) observed in adults. Ct value was inversely correlated with length of stay, an indicator of disease severity (r = -0.356, P = 0.001). Logistic regression analyses revealed that both Ct value (OR: 0.891, 95% CI: 0.799-0.993, P = 0.036) and white blood cell count (OR: 1.127, 95% CI: 1.005-1.263, P = 0.040) were independently associated with severity of pertussis.

Conclusions: Real-time PCR Ct values at initial diagnosis for pertussis may potentially predict severe disease outcomes in children.

References

Ganeshalingham A, McSharry B, Anderson B, Grant C, Beca J . Identifying Children at Risk of Malignant Bordetella pertussis Infection. Pediatr Crit Care Med. 2016; 18(1):e42-e47. DOI: 10.1097/PCC.0000000000001013. View

Brotons P, de Paz H, Toledo D, Villanova M, Plans P, Jordan I . Differences in Bordetella pertussis DNA load according to clinical and epidemiological characteristics of patients with whooping cough. J Infect. 2016; 72(4):460-7. DOI: 10.1016/j.jinf.2016.01.013. View

DeVincenzo J, Guyton C, Rea H, Elmore E, Patel S, Wynn L . Molecular detection and quantification of pertussis and correlation with clinical outcomes in children. Diagn Microbiol Infect Dis. 2013; 76(1):10-5. DOI: 10.1016/j.diagmicrobio.2012.12.015. View

Skoff T, Kenyon C, Cocoros N, Liko J, Miller L, Kudish K . Sources of Infant Pertussis Infection in the United States. Pediatrics. 2015; 136(4):635-41. DOI: 10.1542/peds.2015-1120. View

Oh S, Park S, Hur J, Choi E, Jin H, Kim Y . Effectiveness of rapid multiplex polymerase chain reaction for early diagnosis and treatment of pertussis. J Microbiol Immunol Infect. 2020; 54(4):687-692. PMC: 7255742. DOI: 10.1016/j.jmii.2020.05.012. View

Murray E, Nieves D, Bradley J, Gargas J, Mason W, Lehman D . Characteristics of Severe Bordetella pertussis Infection Among Infants ≤90 Days of Age Admitted to Pediatric Intensive Care Units - Southern California, September 2009-June 2011. J Pediatric Infect Dis Soc. 2015; 2(1):1-6. DOI: 10.1093/jpids/pis105. View

Bolotin S, Deeks S, Marchand-Austin A, Rilkoff H, Dang V, Walton R . Correlation of Real Time PCR Cycle Threshold Cut-Off with Bordetella pertussis Clinical Severity. PLoS One. 2015; 10(7):e0133209. PMC: 4505870. DOI: 10.1371/journal.pone.0133209. View

Jiang W, Wu M, Chen S, Li A, Wang K, Wang Y . Virus Coinfection is a Predictor of Radiologically Confirmed Pneumonia in Children with Bordetella pertussis Infection. Infect Dis Ther. 2020; 10(1):335-346. PMC: 7954939. DOI: 10.1007/s40121-020-00376-5. View

Kang L, Cui X, Fu J, Wang W, Li L, Li T . Clinical characteristics of 967 children with pertussis: a single-center analysis over an 8-year period in Beijing, China. Eur J Clin Microbiol Infect Dis. 2021; 41(1):9-20. PMC: 8365282. DOI: 10.1007/s10096-021-04336-w. View

10.

Nakamura Y, Kamachi K, Toyoizumi-Ajisaka H, Otsuka N, Saito R, Tsuruoka J . Marked difference between adults and children in Bordetella pertussis DNA load in nasopharyngeal swabs. Clin Microbiol Infect. 2010; 17(3):365-70. DOI: 10.1111/j.1469-0691.2010.03255.x. View

11.

Carbonetti N . Pertussis leukocytosis: mechanisms, clinical relevance and treatment. Pathog Dis. 2016; 74(7). PMC: 5761200. DOI: 10.1093/femspd/ftw087. View

12.

Paddock C, Sanden G, Cherry J, Gal A, Langston C, Tatti K . Pathology and pathogenesis of fatal Bordetella pertussis infection in infants. Clin Infect Dis. 2008; 47(3):328-38. DOI: 10.1086/589753. View

13.

Mahmud A, Lipsitch M, Goldstein E . On the role of different age groups during pertussis epidemics in California, 2010 and 2014. Epidemiol Infect. 2019; 147:e184. PMC: 6518560. DOI: 10.1017/S0950268819000761. View

14.

Chow M, Khandaker G, McIntyre P . Global Childhood Deaths From Pertussis: A Historical Review. Clin Infect Dis. 2016; 63(suppl 4):S134-S141. PMC: 5106618. DOI: 10.1093/cid/ciw529. View

15.

Yeung K, Duclos P, Nelson E, Hutubessy R . An update of the global burden of pertussis in children younger than 5 years: a modelling study. Lancet Infect Dis. 2017; 17(9):974-980. DOI: 10.1016/S1473-3099(17)30390-0. View

16.

Decker M, Edwards K . Pertussis (Whooping Cough). J Infect Dis. 2021; 224(12 Suppl 2):S310-S320. PMC: 8482022. DOI: 10.1093/infdis/jiaa469. View

17.

Nian X, Liu H, Cai M, Duan K, Yang X . Coping Strategies for Pertussis Resurgence. Vaccines (Basel). 2023; 11(5). PMC: 10220650. DOI: 10.3390/vaccines11050889. View

18.

Aquino-Andrade A, Martinez-Leyva G, Merida-Vieyra J, Saltigeral P, Lara A, Dominguez W . Real-Time Polymerase Chain Reaction-Based Detection of Bordetella pertussis in Mexican Infants and Their Contacts: A 3-Year Multicenter Study. J Pediatr. 2017; 188:217-223.e1. DOI: 10.1016/j.jpeds.2017.05.032. View

19.

Liu C, Yang L, Cheng Y, Xu H, Xu F . Risk factors associated with death in infants <120 days old with severe pertussis: a case-control study. BMC Infect Dis. 2020; 20(1):852. PMC: 7668018. DOI: 10.1186/s12879-020-05535-0. View

20.

Nga D, Thuy P, Ainai A, Takayama I, Huong D, Saitoh A . Association Between Real-time Polymerase Chain Reaction Cycle Threshold Value and Clinical Severity in Neonates and Infants Infected With Bordetella pertussis. Pediatr Infect Dis J. 2022; 41(5):388-393. DOI: 10.1097/INF.0000000000003471. View