PCR, using primers PIp1 and PIp2, was evaluated for the detection of DNA from Bordetella pertussis in bacterial strains and in nasopharyngeal samples from patients with a cough lasting at least 7 days. The assay could detect DNA from 6 CFU of B., pertussis/10 mu l of sample, Results of the PCR assay were compared with those of cultures, a determination of serum antibodies against pertussis toxin and filamentous hemagglutinin, and a clinical evaluation of 2,442 coughing episodes, The overall sensitivity of PCR was 65% (623 of 956), which was higher than the sensitivity of cultures (58%) (P < 0.001), Factors influencing the sensitivity of PCR were the interval between the onset of symptoms and sampling and the vaccination status of the patient, The specificity of PCR was 98% (1,451 of 1,486), The positive and negative predictive values were 95 and 81%, respectively, Parapertussis PCR, using primers BPPA and BPPZ, was positive in 11 of 18 culture-positive cases and was confirmed by serology in another 4 cases, In conclusion, PCR is a valuable complement to cultures and can probably replace cultures for diagnosis of B., pertussis and Bordetella parapertussis infections.