<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">L Subissi</style></author></authors><secondary-authors><author><style face="normal" font="default" size="100%">Rodeghiero, C</style></author><author><style face="normal" font="default" size="100%">Huygen, K</style></author></secondary-authors><tertiary-authors><author><style face="normal" font="default" size="100%">Martini, H</style></author><author><style face="normal" font="default" size="100%">Piérard, D</style></author></tertiary-authors><subsidiary-authors><author><style face="normal" font="default" size="100%">Amber Litzroth</style></author><author><style face="normal" font="default" size="100%">G Leroux-Roels</style></author><author><style face="normal" font="default" size="100%">I Desombere</style></author></subsidiary-authors></contributors><titles><title><style face="normal" font="default" size="100%">Assessment of IgA anti-PT and IgG anti-ACT reflex testing to improve Bordetella pertussis serodiagnosis in recently vaccinated subjects.</style></title><secondary-title><style face="normal" font="default" size="100%">Clin Microbiol Infect</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">ADOLESCENT</style></keyword><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Age factors</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged, 80 and over</style></keyword><keyword><style  face="normal" font="default" size="100%">Antibodies, Bacterial</style></keyword><keyword><style  face="normal" font="default" size="100%">Antigens, Bacterial</style></keyword><keyword><style  face="normal" font="default" size="100%">Bordetella pertussis</style></keyword><keyword><style  face="normal" font="default" size="100%">Child</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Immunoglobulin A</style></keyword><keyword><style  face="normal" font="default" size="100%">Immunoglobulin G</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">middle aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Pertussis Toxin</style></keyword><keyword><style  face="normal" font="default" size="100%">Pertussis Vaccine</style></keyword><keyword><style  face="normal" font="default" size="100%">Sensitivity and Specificity</style></keyword><keyword><style  face="normal" font="default" size="100%">Serologic Tests</style></keyword><keyword><style  face="normal" font="default" size="100%">Vaccination</style></keyword><keyword><style  face="normal" font="default" size="100%">Whooping Cough</style></keyword><keyword><style  face="normal" font="default" size="100%">Young adult</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2020</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2020 May</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">26</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;b&gt;OBJECTIVES: &lt;/b&gt;Quantifying IgG antibodies to pertussis toxin (PT) is the most specific and sensitive method for the serodiagnosis of a Bordetella pertussis infection. Since PT is a component of acellular pertussis vaccines, anti-PT IgG is also induced by vaccination, precluding pertussis serodiagnosis based exclusively on anti-PT IgG in recently vaccinated subjects. Here, we aim to identify additional B.&amp;nbsp;pertussis-specific serological markers that can discriminate between infection and recent vaccination.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;METHODS: &lt;/b&gt;The clinical usefulness of measuring IgA directed to the vaccine antigen PT and IgG directed to non-vaccine antigens (Fim2/3, LPS, ACT, CatACT) was evaluated in nine well characterized subject groups, aged 10-89&amp;nbsp;years (n&amp;nbsp;=&amp;nbsp;390). Serum anti-PT IgG levels (&amp;gt;125 IU/mL) served as an indicator for a recent B.&amp;nbsp;pertussis infection. Comparing symptomatic pertussis-infected subjects (n&amp;nbsp;=&amp;nbsp;140) with recently vaccinated, non-infected subjects (n&amp;nbsp;=&amp;nbsp;100) revealed the optimal cut-off, accuracy, sensitivity and specificity for each single parameter.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;RESULTS: &lt;/b&gt;For pertussis diagnosis in recently vaccinated subjects, the measurement of anti-PT IgA (cut-off 15 IU/mL) and anti-ACT IgG (cut-off 15 U/mL) resulted in accuracies of 95% (91.5-97.1) and 87.5% (82.7-91.1), sensitivities of 92.9% (87.4-96.0) and 83.6% (76.5-88.8) and specificities of 98% (93.0-99.4) and 93% (86.3-96.6), respectively. Comparing anti-PT IgA levels between the youngest (10-19&amp;nbsp;years, n&amp;nbsp;=&amp;nbsp;38) and oldest (70-89&amp;nbsp;years, n&amp;nbsp;=&amp;nbsp;17) age groups revealed an age-dependent increase in antibody levels in pertussis-infected subjects (p&amp;nbsp;&amp;lt;&amp;nbsp;0.0001).&lt;/p&gt;

&lt;p&gt;&lt;b&gt;CONCLUSIONS: &lt;/b&gt;Reflex testing of anti-PT IgA and anti-ACT IgG improves pertussis serodiagnosis in recently vaccinated symptomatic subjects with elevated anti-PT IgG levels. Furthermore, both markers can discriminate between vaccination and recent infection in pertussis serosurveillance studies.&lt;/p&gt;
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