Bordetella pertussis and parapertussis DNA, NAAT, Nasopharyngeal Swab
Test Mnemonic
BORAMP
CPT Codes
- 87798 - QTY (2)
LOINC ®
43913-3
Aliases
- BORAMP
- SQBORAMP
- whooping cough
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 3 mL | Nasopharyngeal swab | Universal Transport Media (UTM) | Refrigerated | 1. Tilt patient's head back 70 degrees. 2. Gently and slowly insert a mini-tipped flocked swab with a flexible shaft (ie. Oracle 1172111) through the nostril parallel to the palate (not upwards) until resistance is encountered or the distance is equivalent to that from the ear to the nostril of the patient, indicating contact with the nasopharynx. 3. Gently rub and roll the swab. 4. Leave swab in place for several seconds to absorb secretions. 5. Slowly remove swab while rotating it. Specimens can be collected from both sides using the same swab, but it is not necessary to collect specimens from both sides if the swab is saturated with fluid from the first collection. If a deviated septum or blockage create difficulty in obtaining the specimen from one nostril, use the same swab to obtain the specimen from the other nostril. 6. Place swab, tip first, into the transport tube provided. Break the swab shaft at the score line, discard the top portion of the stem, and close the cap. |
Alternate Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 3 mL | Nasopharyngeal swab | Saline | Refrigerated | Sterile saline may be used if UTM cannot be sourced. | |
| 3 mL | Nasopharyngeal swab | Viral Transport Media | Refrigerated | Viral transport media (including VTM, M4RT, M5, or M6) may be used if UTM cannot be sourced. |
Stability
| Environmental Condition | Description |
|---|---|
| Refrigerated | 97 hours |
| Ambient | 49 hours |
| Frozen | 5 months at or below -70C |
Days Performed
7 days a week
Turnaround Time
1 - 3 days
Methodology
| Name | Description |
|---|---|
| Target amplification nucleic acid probe, qualitative |
Reference Range
Clinical Info
Bordetella pertussis (BP), a gram-negative bacterium, is the predominant causative agent of whooping cough or pertussis, a vaccine-preventable, highly infectious disease that is reportable to public health organizations. Pertussis occurs most commonly in children but also occurs in adolescents and adults and outbreaks have been documented in fully vaccinated populations due to waning immunity (immunity has been shown to decrease 5-10 years after vaccination). Early (catarrhal) pertussis disease is non-specific, and classic signs of pertussis (paroxysmal coughing, inspiratory ‘whoop’, post-tussive emesis, as well as apnea or cyanosis in infants) do not arise until approximately two weeks after the initial onset of symptoms. Bordetella parapertussis (BPP) is known to cause a milder pertussis-like disease. For diagnosis of pertussis, NAAT performed on a nasopharyngeal swab collected within 2-3 weeks of symptom onset is the most sensitive method. The Solana Bordetella Complete Assay is an in vitro diagnostic test for the qualitative detection of BP and BPP nucleic acids isolated from nasopharyngeal swab specimens obtained from patients suspected of having respiratory tract infection attributable to Bordetella pertussis and Bordetella parapertussis. The assay uses isothermal helicase-dependent amplification to target the IS481 and IS1001 sequence of BP and BPP genomes, respectively. Both targets can exhibit cross reactivity with other members of the Bordetella genus.
Clinical Limitation
The IS481 sequence used in the Solana Bordetella Complete Assay can also be found in strains of other organisms (i.e., B. holmesii and B. bronchiseptica). The IS1001 sequence may also be found in strains of other organisms (i.e., B. bronchiseptica). B. holmesii infection may cause clinical illness similar to B. pertussis, and mixed outbreaks involving both B. pertussis and B. holmesii infection have been reported. Additional testing should be performed if necessary to differentiate B. holmesii and B. pertussis. B. bronchiseptica is a rare cause of infection in humans. When clinical factors suggest that B. pertussis may not be the cause of respiratory infection, other clinically appropriate investigation(s) should be carried out in accordance with published guidelines. Environmental contamination of an exam room from a prior patient or a recent pertussis vaccination administration may result in false-positive test results. As with any nucleic acid amplification test, positive results do not rule out coinfection with other organisms, detected organisms may not be the definite cause of disease, and negative results do not rule out infection.
Clinical Reference
Chow SK, Arbefeville S, Boyanton BL Jr, Dault EM, Dunn J, Ferrieri P, Greene W, Pence MA, Otiso J, Richter S, Schutzbank TE. Multicenter Performance Evaluation of the Simplexa Bordetella Direct Kit in Nasopharyngeal Swab Specimens. J Clin Microbiol. 2020 Dec 17;59(1):e01041-20. doi: 10.1128/JCM.01041-20. PMID: 33055187