Evaluation of pooled and individual components of Bordetella pertussis as antigens in an enzyme immunoassay for diagnosis of pertussis.

Six different antigen preparations for use in an enzyme immunoassay (EIA) to detect IgM, IgA and IgG antibodies to Bordetella pertussis were evaluated using sera from 13 randomly selected culture-positive patients and from 87 patients with suspected pertussis during a pertussis outbreak. Based on results in 80 healthy control sera a specificity limit of 99.9% was selected. Sera from all culture-positive patients reacted with at least one of the antigens. The sensitivity of the EIA using the individual antigen preparations was 85% for filamentous hemagglutinin, 92% for pertussis toxin, 62% for 69 kDa outer membrane protein, 85% for a pool of these three antigens, 54% for sonicated whole bacteria and 69% for 21 kDa pertussis toxin subunit S1. In the outbreak patient group 49 (56%) of the initial sera reacted with at least one of five antigen preparations. The EIA using sonicated bacteria detected only 41% of all seropositive cases compared with 51% using filamentous hemagglutinin, 61% using pertussis toxin, 65% using 69 kDa OMP and 65% using pooled antigen. It is concluded that either the pooled antigen or pertussis toxin antigen are suitable antigen preparations for use in the EIA for diagnosis of pertussis.