Bordetella pertussis, Nasopharyngeal Culture

CPT: 87070
Updated on 10/31/2017
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Test Details

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 Testing for Routine Microbiology.

Use

Isolate and identify B pertussis and B parapertussis; establish diagnosis of whooping cough

Methodology

Culture

Additional Information

Nucleic Acid Amplification (NAA/PCR) procedures provide more rapid results and have been increasingly used in the diagnosis of B pertussis infection. Studies have shown that the best yield is obtained when PCR and culture are used to diagnose this infection.

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 two to three weeks of the illness. DFA test detected 42 of 164 (26%) of patients who proved culture positive for B pertussis and eight 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.

Nucleic Acid Amplification (NAA/PCR) procedures provide more rapid results and have been increasingly used in the diagnosis of B pertussis infection. Studies have shown that the best yield is obtained when PCR and culture are used to diagnose this infection.

Specimen Requirements

Specimen

Nasopharyngeal (NP) swab

Volume

One swab

Container

Flexible swab and special charcoal-containing Bordetella transport media (available from laboratory).

Patient Preparation

Patient must not be on antimicrobial therapy.

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 to 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 (2°C to 8°C) for transport.

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)

Clinical Information

Special Instructions

The request form must state evaluate for Bordetella pertussis.

References

Gilligan PH, Fisher MC. Importance of culture in laboratory diagnosis of Bordetella pertussis infections. J Clin Microbiol. 1984 Nov; 20(5):891-893. 6096397
Håkansson S, Sundin CG, Granström M, Gästrin B. Diagnosis of whooping cough−A comparison of culture, immunofluorescence and serology with ELISA. Scand J Infect Dis. 1984; 16(3):281-284. 6149614
Hinman AR, Koplan JP. Pertussis and pertussis vaccine. Reanalysis of benefits, risks, and costs. JAMA. 1984 Jun; 251(23):3109-3113. 6427489
Loeffelholz MJ1, Thompson CJ, Long KS, Gilchrist MJ. Comparison of PCR, culture, and direct fluorescent-antibody testing for detection of Bordetella pertussis.J Clin Microbiol. 1999 Sep; 37(9):2872-2876. 10449467

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
180224 B pertussis, Nasophar Culture 48741-3 180224 B pertussis, Nasophar Culture 48741-3

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