Le diagnostic biologique de la coqueluche : culture,PCR ou sérologie ?

Because of the whooping cough resurgence, currently observed in France, in non vaccinated infants contaminated by adults, very often clinically atypical, whooping cough biological diagnosis are necessary. Those diagnosis are either direct, like culture or PCR, or indirect, such as measurement of agglutinins by agglutination or of anti-toxin antibodies by ELISA or western blot analysis in the serum of the patients. Culture is a rather unexpensive and reimbursed diagnosis, while PCR is expensive and not reimbursed. PCR is a more sensitive technique than culture, but culture should not be given up being the only technique allowing to follow evolution of B. pertussis isolates under the effect of vaccinal strategies. Agglutination is unexpensive non reimbursed technique, while immunoassay is expensive but reimbursed. The type of diagnosis will be chosen according to the patient's age and immune condition.