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Prospective Evaluation of an Australian Pertussis Toxin IgG and IgA Enzyme Immunoassay

May, Meryta L; Doi, Suhail; King, David; Evans, Jenny; Robson, Jenny

Description

Serological diagnosis of recent pertussis infection is an important part of both clinical assessment and epidemiological documentation of this disease. Standardization of serological testing and interpretation remains challenging despite international efforts to improve it. Currently, determining the anti-pertussis toxin (PT) IgG titer is recommended as the most accurate serological test in Europe and the United States, while Australia relies predominantly on measurement of Bordetella pertussis...[Show more]

dc.contributor.authorMay, Meryta L
dc.contributor.authorDoi, Suhail
dc.contributor.authorKing, David
dc.contributor.authorEvans, Jenny
dc.contributor.authorRobson, Jenny
dc.date.accessioned2016-06-14T23:19:00Z
dc.identifier.issn1556-6811
dc.identifier.urihttp://hdl.handle.net/1885/102712
dc.description.abstractSerological diagnosis of recent pertussis infection is an important part of both clinical assessment and epidemiological documentation of this disease. Standardization of serological testing and interpretation remains challenging despite international efforts to improve it. Currently, determining the anti-pertussis toxin (PT) IgG titer is recommended as the most accurate serological test in Europe and the United States, while Australia relies predominantly on measurement of Bordetella pertussis IgA antibody responses. Using B. pertussis PCR and the WHO clinical case definition as reference standards, the diagnostic utility of in-house anti-PT IgG and anti-PT IgA assays was evaluated prospectively in an Australian community-based cohort (n = 327). Patients provided up to four consecutive serum samples to document the kinetics of antibody response and decay. Previously validated cutoffs for positivity were converted to international units by using WHO-approved reference sera. At currently used cutoffs, both anti-PT IgG (>94 IU/ml) and anti-PT IgA (>20 IU/ml) assays had good specificity (80% [95% confidence interval {95% CI}, 68 to 88%] and 87% [95% CI, 77 to 94%]), but anti-PT IgG assay was consistently more sensitive than anti-PT IgA assay across a range of cutoffs (60 to 79% [95% CI, 53 to 84%] versus 41 to 62% [95% CI, 34 to 69%]). The combination of anti-PT IgG and anti-PT IgA assays performed no better than anti-PT IgG assay alone. The anti-PT IgA response in children under 12 years of age was poor. The accuracy of serology was optimal between 2 and 8 weeks after symptom onset. Cutoffs of >94 IU/ml for anti-PT IgG and >20 IU/ml for anti-PT IgA correlated well with recent pertussis infection and were consistent with recent recommendations from the EU Pertstrain group. Anti-PT IgG assay was superior to anti-PT IgA assay as the test of choice for the diagnosis of pertussis from a single sample.
dc.publisherAmerican Society for Microbiology
dc.sourceClinical and Vaccine Immunology
dc.subjectKeywords: bacterium antibody; immunoglobulin A; immunoglobulin G; pertussis toxin immunoglobulin A; pertussis toxin immunoglobulin G; unclassified drug; adolescent; adult; aged; antibody response; article; Bordetella pertussis; child; clinical classification; cohor
dc.titleProspective Evaluation of an Australian Pertussis Toxin IgG and IgA Enzyme Immunoassay
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume19
dc.date.issued2012
local.identifier.absfor110300 - CLINICAL SCIENCES
local.identifier.absfor111700 - PUBLIC HEALTH AND HEALTH SERVICES
local.identifier.ariespublicationa383154xPUB2722
local.type.statusPublished Version
local.contributor.affiliationMay, Meryta L, Sullivan Nicolaides Pathology
local.contributor.affiliationDoi, Suhail, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationKing, David, University of Queensland
local.contributor.affiliationEvans, Jenny, Sullivan Nicolaides Pathology
local.contributor.affiliationRobson, Jenny, Sullivan Nicolaides Pathology
local.description.embargo2037-12-31
local.bibliographicCitation.issue2
local.bibliographicCitation.startpage190
local.bibliographicCitation.lastpage197
local.identifier.doi10.1128/CVI.05430-11
dc.date.updated2016-06-14T08:31:23Z
local.identifier.scopusID2-s2.0-84856442592
CollectionsANU Research Publications

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