<i>Bordetella pertussis</i>, Nasopharyngeal Culture

Bordetella pertussis, Nasopharyngeal Culture

Number
	180224
CPT
	87070
Related Information
	Bordetella pertussis Smear, DFA Default Test Order for Ambiguous Orders
Synonyms
	Bordetella pertussis Culture ; Culture, Bordetella pertussis, Nasopharyngeal ; Pertussis Culture ; Whooping Cough Culture
Test Includes
	Culture; isolation and identification by fluorescent antibody staining (additional charges/CPT code[s] may apply). CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed. Requests with only a written order and no test number indicated will be processed according to Default Test Order for Ambiguous Orders .
Special Instructions
	The request form must state evaluate for Bordetella pertussis.
Specimen
	Nasopharyngeal swab
Volume
	One swab
Container
	Flexible swab and special charcoal-containing Bordetella transport media (available from laboratory).
Collection
	Guide the flexible swab into the contour of the nares and into the nasopharynx. Pass the swab gently through the nose. Leave swab in place near septum and floor of nose for 15-30 seconds. Rotate and remove. Place into special transport media available from the laboratory.
Storage Instructions
	If possible, preincubate at 37°C; then use refrigerated temperature for transport.
Patient Preparation
	Patient must not be on antimicrobial therapy.
Causes for Rejection
	Unlabeled specimen or name discrepancy between specimen and request label; prolonged delay in transport (usually more than 72 hours); inappropriate specimen transport device (eg, noncharcoal-containing transport medium)
Use
	Isolate and identify B. pertussis and B. parapertussis; establish diagnosis of whooping cough
Methodology
	Culture: confirmation by fluorescent antibody staining
Additional Information
	Direct fluorescent antibody (DFA) procedures provide more rapid results and have been increasingly used in the diagnosis of B. pertussis infection. The DFA procedures are most useful in the first 2-3 weeks of the illness. DFA test detected 42 of 164 (26%) of patients who proved culture positive for B. pertussis and 8 of 38 (21%) of patients who proved culture positive for B. parapertussis. False-negatives may be caused by inadequate specimens having little cellular material (leukocytes and brush border epithelial cells).¹ Studies have shown that the best yield is obtained when DFA, culture, and PCR are used to diagnose this infection.
Footnotes
	Young SA, Anderson GL, and Mitchell PD, “Laboratory Observations During an Outbreak of Pertussis,” Clin Microbiol Newslet, 1987, 9:22, 176-9
References
	Gilligan PH and Fisher MC, “Importance of Culture in Laboratory Diagnosis of Bordetella pertussis Infections,” J Clin Microbiol, 1984, 20(5):891-3. Hakansson S, Sundin CG, Granstrom M, et al, “Diagnosis of Whooping Cough - A Comparison of Culture, Immunofluorescence and Serology With ELISA,” Scand J Infect Dis, 1984, 16(3):281-4. Hinman AR and Koplan JP, “Pertussis and Pertussis Vaccine. Reanalysis of Benefits, Risks, and Costs,” JAMA, 1984, 251(23):3109-13. Loeffelholz MJ, Thompson CJ, Long KS, et al, “Comparison of PCR, Culture, and Direct Fluorescent-Antibody Testing for Detection of Bordetella pertussis,” J Clin Microbiol, 1999, 37(9):2872-6.