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Ren J, Huang Z, Tian J, Li Z, Shen S, Yan H, Wang N, Hu J, Ma X, Ma Z, Liu J, Lu Y, Sun X. Evaluation of pre-school pertussis booster vaccination in Shanghai, China: A cost-effectiveness analysis. Vaccine 2024:126162. [PMID: 39069462 DOI: 10.1016/j.vaccine.2024.126162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND In recent years, notified pertussis cases have been increasingly documented in China. It raised a new public health concern of potential optimization in immunization strategy. This study was aimed to determine the cost-effectiveness of different immunization strategies against pertussis-containing vaccines for 6-year-old pre-school children in Shanghai. METHODS A Markov-decision tree model was applied to evaluate two pertussis immunization strategies for 6-year-old pre-school children as following: (1) 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster vaccinated at 6 years of age, and (2) no booster at 6 years of age regimen. Primary outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-utility ratios (ICUR). Sensitivity analyses were performed. The analysis was conducted over a study period of 14 years from a societal perspective. RESULTS Compared to no booster immunization strategy, administering 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster at 6 years of age, resulted in an average cost reduction of CNY 814.16 (USD 116) per individual, an increase in QALYs by 0.00066, and a rise in per capita net monetary benefit (NMB) by CNY 933.51 (USD 132). The total costs over the study period were reduced by CNY 160.59 million (USD 23 million), utility increased by 130.49 QALYs, and NMB increased by CNY 184.14 million (USD 26 million). CONCLUSIONS Implementing acellular pertussis booster immunization for 6-year-old pre-school children in Shanghai emerges as a cost-saving immunization strategy, with both cost savings and utility gains.
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Affiliation(s)
- Jia Ren
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Zhuoying Huang
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Jie Tian
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
| | - Zhi Li
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Si Shen
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Han Yan
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Nan Wang
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Jiayu Hu
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Xiaoying Ma
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Zhonghui Ma
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Jiechen Liu
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China
| | - Yihan Lu
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China.
| | - Xiaodong Sun
- Department of Immunization, Shanghai Municipal Center of Disease Control and Prevention, Shanghai 200336, China.
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Liu Y, Zhang C, Wang Y, Luo X, Liu G, Zhang Z, Shen J. Seroepidemiology of pertussis in Huzhou: A population-based, cross-sectional study. PLoS One 2024; 19:e0303508. [PMID: 38768133 PMCID: PMC11104605 DOI: 10.1371/journal.pone.0303508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/25/2024] [Indexed: 05/22/2024] Open
Abstract
PURPOSE The resurgence of pertussis has occurred around the world. However, the epidemiological profiles of pertussis cannot be well understood by current diseases surveillance. This study was designed to understand the seroepidemiological characteristics of pertussis infection in the general population of Huzhou City, evaluate the prevalence infection of pertussis in the population, and offer insights to inform adjustments in pertussis prevention and control strategies. METHODS From September to October 2023, a cross-sectional serosurvey was conducted in Huzhou City, involving 1015 permanent residents. Serum samples were collected from the study subjects, and pertussis toxin IgG antibodies (Anti-PT-IgG) were quantitatively measured using enzyme-linked immunosorbent assay (ELISA). The analysis included the geometric mean concentration (GMC) of Anti-PT-IgG, rates of GMC≥40IU/mL, ≥100IU/mL, and <5IU/mL. Stratified comparisons were made based on age, vaccination history, and human categories. RESULTS Among the 1015 surveyed individuals, the geometric mean concentration (GMC) of Anti-PT-IgG was 10.52 (95% CI: 9.96-11.11) IU/mL, with a recent infection rate of 1.58%, a serum positivity rate of 11.43%, and a proportion with <5IU/mL of 40.49%. Among 357 children with clear vaccination history, susceptibility decreased with an increasing number of vaccine doses (Z = -6.793, P < 0.001). The concentration of Anti-PT-IgG exhibited a significant post-vaccination decline over time (Z = -5.143, P < 0.001). In women of childbearing age, the GMC of Anti-PT-IgG was 7.71 (95% CI: 6.90-8.62) IU/mL, with no significant difference in susceptibility among different age groups (χ2 = 0.545, P = 0.909). The annual pertussis infection rate in individuals aged ≥3 years was 9321 (95%CI: 3336-16039) per 100,000, with peak infection rates in the 20-29, 40-49, and 5-9 age groups at 34363 (95%CI: 6327-66918) per 100,000, 22307.72 (95%CI: 1380-47442) per 100,000, and 18020(95%CI: 1093-37266) per 100,000, respectively. CONCLUSIONS In 2023, the actual pertussis infection rate in the population of Huzhou City was relatively high. Vaccine-induced antibodies exhibit a rapid decay, and the estimated serum infection rate increases rapidly from post-school age, peaking in the 20-29 age group. It is recommended to enhance pertussis monitoring in adolescents and adults and refine vaccine immunization strategies.
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Affiliation(s)
- Yan Liu
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Chao Zhang
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Yuda Wang
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Xiaofu Luo
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Guangtao Liu
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Zizhe Zhang
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Jianyong Shen
- Huzhou Center for Disease Control and Prevention, Huzhou, China
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3
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First NJ, Parrish KM, Martínez-Pérez A, González-Fernández Á, Bharrhan S, Woolard M, McLachlan JB, Scott RS, Wang J, Gestal MC. Bordetella spp. block eosinophil recruitment to suppress the generation of early mucosal protection. Cell Rep 2023; 42:113294. [PMID: 37883230 DOI: 10.1016/j.celrep.2023.113294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/21/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
Bordetella spp. are respiratory pathogens equipped with immune evasion mechanisms. We previously characterized a Bordetella bronchiseptica mutant (RB50ΔbtrS) that fails to suppress host responses, leading to rapid clearance and long-lasting immunity against reinfection. This work revealed eosinophils as an exclusive requirement for RB50ΔbtrS clearance. We also show that RB50ΔbtrS promotes eosinophil-mediated B/T cell recruitment and inducible bronchus-associated lymphoid tissue (iBALT) formation, with eosinophils being present throughout iBALT for Th17 and immunoglobulin A (IgA) responses. Finally, we provide evidence that XCL1 is critical for iBALT formation but not maintenance, proposing a novel role for eosinophils as facilitators of adaptive immunity against B. bronchiseptica. RB50ΔbtrS being incapable of suppressing eosinophil effector functions illuminates active, bacterial targeting of eosinophils to achieve successful persistence and reinfection. Overall, our discoveries contribute to understanding cellular mechanisms for use in future vaccines and therapies against Bordetella spp. and extension to other mucosal pathogens.
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Affiliation(s)
- Nicholas J First
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA
| | - Katelyn M Parrish
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA
| | - Amparo Martínez-Pérez
- CINBIO, Universidade de Vigo, Immunology Group, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, 36310 Vigo, Galicia, Spain
| | - África González-Fernández
- CINBIO, Universidade de Vigo, Immunology Group, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, 36310 Vigo, Galicia, Spain
| | - Sushma Bharrhan
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA; Immunophenotyping Core, Center for Applied Immunology and Pathological Processes, Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA
| | - Matthew Woolard
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA; Immunophenotyping Core, Center for Applied Immunology and Pathological Processes, Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA
| | - James B McLachlan
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Rona S Scott
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA; Bioinformatics and Modeling Core, Center for Applied Immunology and Pathological Processes, Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA
| | - Jian Wang
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA; Bioinformatics and Modeling Core, Center for Applied Immunology and Pathological Processes, Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA
| | - Monica C Gestal
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71106, USA.
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Lv Z, Yin S, Jiang K, Wang W, Luan Y, Wu S, Shi J, Li Z, Ma X, Wang Z, Yan H. The whole-cell proteome shows the characteristics of macrolides-resistant Bordetella pertussis in China linked to the biofilm formation. Arch Microbiol 2023; 205:219. [PMID: 37148370 PMCID: PMC10164027 DOI: 10.1007/s00203-023-03566-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/08/2023]
Abstract
The macrolides-resistant Bordetella pertussis (MR-Bp) isolates in China evolved from the ptxP1/fhaB3 allele and rapidly became predominant, suggestive of an adaptive transmission ability. This was different from the global prevalent ptxP3 strains, in which MR-Bp was rarely reported. The study aimed to determine the underlying mechanism responsible for fitness and resistance in these two strains. We identify proteomic differences between ptxP1/fhaB3 and ptxP3/fhaB1 strains using tandem mass tag (TMT)-based proteomics. We then performed in-depth bioinformatic analysis to determine differentially expressed genes (DEGs), followed by gene ontology (GO), and protein-protein interaction (PPI) network analysis. Further parallel reaction monitoring (PRM) analysis confirmed the expression of four target proteins. Finally, the crystal violet method was used to determine biofilm-forming ability. The results showed that the main significantly different proteins between the two represent isolates were related to biofilm formation. Furthermore, we have confirmed that ptxP1/fhaB3 showed hyperbiofilm formation in comparison with ptxP3/fhaB1. It is suggested that the resistance and adaptability of ptxP1/fhaB3 strains may be related to the formation of biofilm through proteomics. In a word, we determined the significantly different proteins between the ptxP1/fhaB3 and ptxP3/fhaB1 strains through whole-cell proteome, which were related to biofilm formation.
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Affiliation(s)
- Zhe Lv
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, China
| | - Sha Yin
- National Regional Children's Medical Center (Northwest), Key Laboratory of Precision Medicine to Pediatric Diseases of Shaanxi Province, Xi'an Key Laboratory of Children's Health and Diseases, Shaanxi Institute for Pediatric Diseases; Xi'an Children's Hospital, Affiliated Children's Hospital of Xi'an Jiaotong University, No. 69, Xijuyuan Lane, Xi'an, 710003, China
| | - Kaichong Jiang
- National Regional Children's Medical Center (Northwest), Key Laboratory of Precision Medicine to Pediatric Diseases of Shaanxi Province, Xi'an Key Laboratory of Children's Health and Diseases, Shaanxi Institute for Pediatric Diseases; Xi'an Children's Hospital, Affiliated Children's Hospital of Xi'an Jiaotong University, No. 69, Xijuyuan Lane, Xi'an, 710003, China
| | - Wei Wang
- Department of Clinical Laboratory, Xi'an Children's Hospital, Affiliated Children's Hospital of Xi'an Jiaotong University, No. 69, Xijuyuan Lane, Xi'an, 710003, China
| | - Yang Luan
- Xi'an Center for Disease Control and Prevention, 599 Xiying Road, Xi'an, 710054, China
| | - Shuang Wu
- Department of Clinical Laboratory, Xi'an Children's Hospital, Affiliated Children's Hospital of Xi'an Jiaotong University, No. 69, Xijuyuan Lane, Xi'an, 710003, China
| | - Jianfei Shi
- Department of Clinical Laboratory, Xi'an Children's Hospital, Affiliated Children's Hospital of Xi'an Jiaotong University, No. 69, Xijuyuan Lane, Xi'an, 710003, China
| | - Zhe Li
- Department of Diphtheria, Tetanus and Pertussis Vaccine and Toxins, National Institute for Food and Drug Control, Beijing, China
| | - Xiao Ma
- Department of Diphtheria, Tetanus and Pertussis Vaccine and Toxins, National Institute for Food and Drug Control, Beijing, China
| | - Zengguo Wang
- Department of Clinical Laboratory, Xi'an Children's Hospital, Affiliated Children's Hospital of Xi'an Jiaotong University, No. 69, Xijuyuan Lane, Xi'an, 710003, China.
| | - Hong Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, China.
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5
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Koide K, Yao S, Chiang C, Thuy PTB, Nga DTT, Huong DT, Dien TM, Vichit O, Vutthikol Y, Sovannara S, Samnang C, Takayama I, Ainai A, Nakajima N, Otsuka N, Kamachi K, Saitoh A. Genotyping and macrolide-resistant mutation of Bordetella pertussis in East and South-East Asia. J Glob Antimicrob Resist 2022; 31:263-269. [PMID: 36270447 PMCID: PMC9750937 DOI: 10.1016/j.jgar.2022.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Macrolide-resistant Bordetella pertussis (MRBP) has been emerging and prevailing in mainland China since 2011. In this study, we aimed to investigate the genotype and macrolide resistance of circulating B. pertussis in East and Southeast Asia using genetic analyses. METHODS A total of 302 DNA extracts from clinical specimens and isolates from 2010 to 2020 were analyzed: 145 from Vietnam, 76 from Cambodia, 48 from Taiwan, and 33 from Japan. Genotypes were determined by multilocus variable-number tandem-repeat analysis (MLVA). Macrolide-resistant A2047G mutation in B. pertussis 23S rRNA was investigated using the duplex Cycleave real-time polymerase chain reaction (PCR) assay. Whole-genome sequencing was performed on two MRBP isolates that were identified for the first time in Taiwan. RESULTS Overall, 286 DNA extracts (95%) generated a complete MLVA genotype and 283 DNA extracts (94%) yielded a complete result for the A2047G mutation analysis. The A2047G mutation was detected in 18 DNA extracts: fourteen from Vietnam, one from Cambodia, two from Taiwan, and one from Japan. Most of them (78%) showed the genotypes MT104 and MT195, which have previously been reported in Chinese MRBP isolates. Further, the Taiwanese MRBP isolates were classified into the MT104 clade of Chinese MRBP isolates. CONCLUSION After MRBP emerged and spread in mainland China, it may have spread to East and Southeast Asia in the 2010s. Continued surveillance targeting the A2047G mutation of MRBP is needed to prevent further spread of this emerging pathogen.
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Affiliation(s)
- Kentaro Koide
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - ShuMan Yao
- Centre for Diagnostics and Vaccine Development, Centres for Disease Control, Taipei, Taiwan
| | - Chuen‑Sheue Chiang
- Centre for Diagnostics and Vaccine Development, Centres for Disease Control, Taipei, Taiwan
| | - Phung Thi Bich Thuy
- Department of Molecular Biology for Infectious Disease, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Do Thi Thuy Nga
- Division of General Internal Medicine, Centre for Tropical Diseases, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Do Thu Huong
- Division of General Internal Medicine, Centre for Tropical Diseases, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Tran Minh Dien
- Surgical Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Ork Vichit
- National Immunization Program, Ministry of Health, Cambodia
| | - Yong Vutthikol
- National Immunization Program, Ministry of Health, Cambodia
| | | | - Chham Samnang
- Vaccine-Preventable Diseases and Immunization, World Health Organization, Cambodia
| | - Ikuyo Takayama
- Research Centre for Influenza and Respiratory Viruses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Akira Ainai
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Noriko Nakajima
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Nao Otsuka
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunari Kamachi
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan,Corresponding author. Mailing address: Department of Bacteriology II, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama, Tokyo 208-0011, Japan.
| | - Akihiko Saitoh
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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6
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Jamal A, Jahan S, Choudhry H, Rather IA, Khan MI. A Subtraction Genomics-Based Approach to Identify and Characterize New Drug Targets in Bordetella pertussis: Whooping Cough. Vaccines (Basel) 2022; 10:vaccines10111915. [PMID: 36423010 PMCID: PMC9692278 DOI: 10.3390/vaccines10111915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Bordetella pertussis is a Gram-negative bacterium known to cause pertussis or whooping cough. The disease affects the respiratory system and is contagious. Pertussis causes high mortality among infants aged less than one-year-old, although it can affect anyone of any age. Globally, 16 million cases of pertussis were reported in 2008, 95% of which were in developing nations, and approximately 195,000 children died from the disease. Under a computational subtractive genomics approach, the total proteome of a pathogen is gently trimmed down to a few potential drug targets. First, from NCBI, we obtained the pathogen proteins followed by CD hit for removal of duplicate proteins. The BLAST step was applied to find non-similar proteins, and then, we applied BLAST to these non-similar bacterial proteins with DEG to find essential bacterial proteins. After this, to find the location, these vital proteins were screened via PSORTb; the majority of proteins were in cytoplasm. The KASS server was used to determine the involvement of these proteins in the metabolic pathways of bacteria, and KEGG was applied to find the unique metabolic pathways of the pathogen. Finally, we applied BLAST to these vital, unique, and non-similar proteins with FDA-approved drug targets, and four proteins of the B. pertussis strain B1917 were identified that might be powerful drug targets. A variety of therapeutic molecules could be designed to target these proteins in order to treat infections caused by bacteria.
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Affiliation(s)
- Alam Jamal
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Sadaf Jahan
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 15362, Saudi Arabia
| | - Hani Choudhry
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Centre of Artificial Intelligence for Precision Medicines, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Irfan A. Rather
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence: (I.A.R.); (M.I.K.)
| | - Mohammad Imran Khan
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Centre of Artificial Intelligence for Precision Medicines, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence: (I.A.R.); (M.I.K.)
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7
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Ivaska L, Barkoff AM, Mertsola J, He Q. Macrolide Resistance in Bordetella pertussis: Current Situation and Future Challenges. Antibiotics (Basel) 2022; 11:1570. [PMID: 36358225 PMCID: PMC9686491 DOI: 10.3390/antibiotics11111570] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 01/19/2024] Open
Abstract
Pertussis is a highly contagious respiratory infection caused by Bordetella pertussis bacterium. The mainstay of treatment is macrolide antibiotics that reduce transmissibility, shorten the duration of symptoms and decrease mortality in infants. Recently, the macrolide resistance of B. pertussis has been reported globally but is especially widespread in mainland China. In this review, we aim to summarise the current understanding of the epidemiology, resistance mechanisms and clinical implications of B. pertussis macrolide resistance. Since the first appearance of macrolide-resistant B. pertussis in Arizona, USA, in 1994, only sporadic cases have been reported outside China. In certain parts of China, on the other hand, up to 70-100% of the recent clinical isolates have been found to be macrolide resistant. Reasons for macrolide resistance being centred upon China during the last decade can only be speculated on, but the dominant B. pertussis lineage is different between China and most of the high-income countries. It seems evident that efforts to increase awareness, guide molecular epidemiological surveillance and carry out systematic screening of B. pertussis positive samples for macrolide resistance should be implemented globally. In addition, practices to improve the clinical care of infants with pertussis caused by resistant strains should be studied vigorously.
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Affiliation(s)
- Lauri Ivaska
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20521 Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, 20520 Turku, Finland
| | - Alex-Mikael Barkoff
- Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, 20520 Turku, Finland
| | - Jussi Mertsola
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20521 Turku, Finland
- Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, 20520 Turku, Finland
| | - Qiushui He
- InFLAMES Research Flagship Center, University of Turku, 20520 Turku, Finland
- Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, 20520 Turku, Finland
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8
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Lefrancq N, Bouchez V, Fernandes N, Barkoff AM, Bosch T, Dalby T, Åkerlund T, Darenberg J, Fabianova K, Vestrheim DF, Fry NK, González-López JJ, Gullsby K, Habington A, He Q, Litt D, Martini H, Piérard D, Stefanelli P, Stegger M, Zavadilova J, Armatys N, Landier A, Guillot S, Hong SL, Lemey P, Parkhill J, Toubiana J, Cauchemez S, Salje H, Brisse S. Global spatial dynamics and vaccine-induced fitness changes of Bordetella pertussis. Sci Transl Med 2022; 14:eabn3253. [PMID: 35476597 DOI: 10.1126/scitranslmed.abn3253] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
As with other pathogens, competitive interactions between Bordetella pertussis strains drive infection risk. Vaccines are thought to perturb strain diversity through shifts in immune pressures; however, this has rarely been measured because of inadequate data and analytical tools. We used 3344 sequences from 23 countries to show that, on average, there are 28.1 transmission chains circulating within a subnational region, with the number of chains strongly associated with host population size. It took 5 to 10 years for B. pertussis to be homogeneously distributed throughout Europe, with the same time frame required for the United States. Increased fitness of pertactin-deficient strains after implementation of acellular vaccines, but reduced fitness otherwise, can explain long-term genotype dynamics. These findings highlight the role of vaccine policy in shifting local diversity of a pathogen that is responsible for 160,000 deaths annually.
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Affiliation(s)
- Noémie Lefrancq
- Insitut Pasteur, Université Paris Cité, Mathematical Modelling of Infectious Diseases Unit, UMR2000, CNRS, 75015 Paris, France.,Department of Genetics, University of Cambridge, Cambridge CB2 3EH, UK
| | - Valérie Bouchez
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
| | - Nadia Fernandes
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France
| | - Alex-Mikael Barkoff
- University of Turku UTU, Institute of Biomedicine, Research Center for Infections and Immunity, FI-20520 Turku, Finland
| | - Thijs Bosch
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, Netherlands
| | - Tine Dalby
- Statens Serum Institut, Bacteria, Parasites and Fungi/Infectious Disease Preparedness, 2300 Copenhagen, Denmark
| | - Thomas Åkerlund
- The Public Health Agency of Sweden, Unit for Laboratory Surveillance of Bacterial Pathogens, SE-171 82 Solna, Sweden
| | - Jessica Darenberg
- The Public Health Agency of Sweden, Unit for Laboratory Surveillance of Bacterial Pathogens, SE-171 82 Solna, Sweden
| | - Katerina Fabianova
- National Institute of Public Health, Department of Infectious Diseases Epidemiology, CZ-10000 Prague, Czech Republic
| | - Didrik F Vestrheim
- Norwegian Institute of Public Health, Department of Infectious Disease Control and Vaccine, N-0213 Oslo, Norway
| | - Norman K Fry
- Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England-National Infection Service, London NW9 5EQ, UK.,Immunisation and Countermeasures Division, Public Health England-National Infection Service, London NW9 5EQ, UK
| | - Juan José González-López
- University Hospital Vall d'Hebron, Microbiology Department, 08035 Barcelona, Spain.,Universitat Autònoma de Barcelona, Department of Genetics and Microbiology, 08193 Barcelona, Spain
| | - Karolina Gullsby
- Centre for Research and Development, Uppsala University/Region Gävleborg, 80187 Gävle, Sweden
| | - Adele Habington
- Molecular Microbiology Laboratory, Children's Health Ireland, Crumlin, D12 N512 Dublin, Ireland
| | - Qiushui He
- University of Turku UTU, Institute of Biomedicine, Research Center for Infections and Immunity, FI-20520 Turku, Finland.,InFLAMES Research Flagship Center, University of Turku, FI-20520 Turku, Finland
| | - David Litt
- Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England-National Infection Service, London NW9 5EQ, UK
| | - Helena Martini
- Department of Microbiology, National Reference Centre for Bordetella pertussis, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), B-1090 Brussels, Belgium
| | - Denis Piérard
- Department of Microbiology, National Reference Centre for Bordetella pertussis, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), B-1090 Brussels, Belgium
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, IT-00161 Rome, Italy
| | - Marc Stegger
- Statens Serum Institut, Bacteria, Parasites and Fungi/Infectious Disease Preparedness, 2300 Copenhagen, Denmark
| | - Jana Zavadilova
- National Institute of Public Health, National Reference Laboratory for Pertussis and Diphtheria, 100 00 Prague, Czech Republic
| | - Nathalie Armatys
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
| | - Annie Landier
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
| | - Sophie Guillot
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
| | - Samuel L Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Julian Parkhill
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Julie Toubiana
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France.,Université Paris Cité, Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades Hospital, APHP, 75015 Paris, France
| | - Simon Cauchemez
- Insitut Pasteur, Université Paris Cité, Mathematical Modelling of Infectious Diseases Unit, UMR2000, CNRS, 75015 Paris, France
| | - Henrik Salje
- Insitut Pasteur, Université Paris Cité, Mathematical Modelling of Infectious Diseases Unit, UMR2000, CNRS, 75015 Paris, France.,Department of Genetics, University of Cambridge, Cambridge CB2 3EH, UK
| | - Sylvain Brisse
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
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9
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Zhang J, Zhang D, Wang X, Wei X, Li H. Macrolide susceptibility and molecular characteristics of Bordetella pertussis. J Int Med Res 2022; 50:3000605221078782. [PMID: 35225710 PMCID: PMC8894965 DOI: 10.1177/03000605221078782] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To analyse macrolide resistance and molecular characteristics of Bordetella pertussis clinical isolates from western China, and to explore the relationship between macrolide-resistance and genotypes. Methods Susceptibilities of B. pertussis clinical isolates to erythromycin, azithromycin and clarithromycin were determined by epsilometer test (E-test). Isolated strains were sequenced to ascertain the presence of the 23S rRNA gene A2047G mutation. Strains were typed using multilocus antigen sequence typing, multilocus variable-number tandem-repeat analysis (MLVA) and pulsed-field gel electrophoresis (PFGE). Results Of 58 B. pertussis strains isolated in this study, 46 were macrolide-resistant and 12 were macrolide sensitive. All macrolide-resistant strains carried the A2047G mutation and were the prn1/ptxP1/ptxA1/fim3-1/fim2-1 genotype; the MLVA types were MT195 (19/58), MT55 (13/58) and MT104 (14/58), and the PFGE profiles were classified into BpSR23 (17/58) and BpFINR9 (29/58) types. None of the macrolide-sensitive strains carried the A2047G mutation; genotypes were (prn9 or prn2)/ptxP3/ptxA1/fim3-1/fim2-1, and all were MT27. PFGE profiles differed from the macrolide-resistant strains. Conclusions B. pertussis clinical isolates from western China were severely resistant to macrolides. Genotypes differed between macrolide-resistant and macrolide-sensitive strains, and there may be a correlation between acquisition of macrolide resistance and changes in specific molecular types.
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Affiliation(s)
- Juansheng Zhang
- Microbiology laboratory, Xi'an Centre for Disease Control and Prevention, Xi'an, Shaanxi Province, China
| | - Diqiang Zhang
- Department of Obstetrics and Gynaecology, Pingchuan District People's Hospital, Baiyin, Gansu Province, China
| | - Xiaoqiang Wang
- Microbiology laboratory, Xi'an Centre for Disease Control and Prevention, Xi'an, Shaanxi Province, China
| | - Xiaoguang Wei
- Microbiology laboratory, Xi'an Centre for Disease Control and Prevention, Xi'an, Shaanxi Province, China
| | - Hao Li
- Microbiology laboratory, Xi'an Centre for Disease Control and Prevention, Xi'an, Shaanxi Province, China
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10
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Sun C, Xiao F, Fu J, Huang X, Jia N, Xu Z, Wang Y, Cui X. Loop-Mediated Isothermal Amplification Coupled With Nanoparticle-Based Lateral Biosensor for Rapid, Sensitive, and Specific Detection of Bordetella pertussis. Front Bioeng Biotechnol 2022; 9:797957. [PMID: 35211469 PMCID: PMC8861531 DOI: 10.3389/fbioe.2021.797957] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2022] Open
Abstract
Bordetella pertussis is the most frequent causative agent for pertussis, which is a highly contagious disease. Here, we developed a method based on loop-mediated isothermal amplification (LAMP) and nanoparticle-based lateral flow biosensor (LFB) for the timely diagnosis of B. pertussis infections. A set of six primers was designed for LAMP reactions, and the LAMP results were rapidly and visually indicated using LFB. The recommended condition for the B. pertussis LAMP reactions is 40 min at 66°C. Our results confirmed that the LAMP-LFB assay could specifically detect B. pertussis and did not cross-react with non-B. pertussis isolates. The sensitivity of the B. pertussis LAMP-LFB assay was 50 fg per reaction. In particular, 108 nasopharyngeal swab (NPS) samples were collected to evaluate the B. pertussis LAMP-LFB assay, and the results were compared with those of the quantitative PCR (qPCR) method. The positive rates of B. pertussis LAMP-LFB and qPCR were 40.7% and 38.8%, respectively, and the agreement between the LAMP-LFB and qPCR results was 98%, with a kappa value of 0.96. The whole process of LAMP-LFB can be completed within 1 h, which is much shorter than that of qPCR, including about 15 min of rapid DNA extraction, 40 min of LAMP reaction, and within 2 min of the LFB test. Collectively, the B. pertussis LAMP-LFB assay developed in this report offers a new option for the rapid, reliable, and simple diagnosis of B. pertussis infections.
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Affiliation(s)
- Chunrong Sun
- Experiment Center, Captital Institute of Pediatrics, Beijing, China
| | - Fei Xiao
- Experiment Center, Captital Institute of Pediatrics, Beijing, China
| | - Jin Fu
- Experiment Center, Captital Institute of Pediatrics, Beijing, China
| | - Xiaolan Huang
- Experiment Center, Captital Institute of Pediatrics, Beijing, China
| | - Nan Jia
- Experiment Center, Captital Institute of Pediatrics, Beijing, China
| | - Zheng Xu
- Experiment Center, Captital Institute of Pediatrics, Beijing, China
| | - Yi Wang
- Experiment Center, Captital Institute of Pediatrics, Beijing, China
| | - Xiaodai Cui
- Experiment Center, Captital Institute of Pediatrics, Beijing, China
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11
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Villalba M, Venturelli L, Arnal L, Masson C, Dietler G, Vela ME, Yantorno O, Kasas S. Effect of antibiotics on mechanical properties of Bordetella pertussis examined by atomic force microscopy. Micron 2022; 155:103229. [DOI: 10.1016/j.micron.2022.103229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 12/12/2021] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
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12
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Macina D, Evans KE. Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in Asia. Infect Dis Ther 2021; 10:1115-1140. [PMID: 33928533 PMCID: PMC8322225 DOI: 10.1007/s40121-021-00439-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022] Open
Abstract
Cyclic epidemics of pertussis (whooping cough) have been observed globally over the past twenty years despite high infant vaccine coverage. The resurgence of pertussis in high-income countries is partly due to waning vaccine immunity in older children and adults, as well as better surveillance and diagnostics. Moreover, in adolescents and adults, pertussis symptoms are mild and similar to common cough syndromes, meaning that it is under-diagnosed in older populations. A systematic search of MEDLINE, EMBASE, and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology, burden of illness, and mortality in school-aged children, adolescents, and adults in Asia. Studies identified for inclusion were reviewed narratively because a statistical comparison was not possible due to the mix of methodologies used. The results showed that in East Asia, including Japan, South Korea, China, and Taiwan, pertussis is circulating in older children and adults. Diphtheria-tetanus-pertussis (DTP4) coverage is high in East Asia, yet outbreaks observed in Japan and South Korea suggest that vaccine-acquired immunity had waned in adolescents and adults. Several school outbreaks in China show that pertussis is circulating in young children, with continued circulation in adolescents and adults. There was a lack of information from Southeast/South Asian countries, although pan-Asian serosurveys showed that recent pertussis infection was common in adolescents and in adults with persistent cough. To conclude, the circulation of pertussis in Asian countries with high DTP4 coverage supports the expansion of routine vaccination to include booster doses for children at school entry and adolescents. However, surveillance is weak or absent in many countries, meaning that the true burden of pertussis, particularly among older populations, is unknown.
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Affiliation(s)
- Denis Macina
- Global Medical, Sanofi Pasteur, 14 Espace Henry Vallée, 69007, Lyon, France.
| | - Keith E Evans
- InScience Communications, Chowley Oak Business Park, Chowley Oak Lane, Tattenhall, Cheshire, UK
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13
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Zhang Z, Pan J, Chen M, Zhang T, Li J, Lu L. Seroepidemiology of pertussis in China: A population-based, cross-sectional study. Vaccine 2021; 39:1687-1692. [PMID: 33642160 DOI: 10.1016/j.vaccine.2021.02.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/07/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite high pertussis vaccination coverage and significant decrease of pertussis since the adoption of the Expanded Programme on Immunization (1978), increased pertussis incidence has been reported in China from 2013 to 2017. This study aimed at evaluating the immune response to pertussis among vaccinated children and beyond in China. METHODS The study recruited 2 144 healthy subjects. Serum IgG antibodies against pertussis toxin (anti-PT IgG) were measured by ELISA. Anti-PT IgG concentration (GMC), seropositivity rate (GMC ≥ 40 IU/ml), and recent infection rate (GMC > 100 IU/ml) were calculated. Participants ≤ 2 years-old were further stratified by vaccination schedule intervals and participants ≤ 6 years-old by vaccine used (Domestic DTaP or DTaP-IPV//PRP ~ T (Pentaxim, SP)). RESULTS Among 0-6-year-olds, the anti-PT IgG GMC was 5.99 IU/ml (95%CI 5.39-6.67). The GMC increased in accordance with the primary vaccination series (4-6 months) and the toddler booster (18-23 months), and continuously declined thereafter to its nadir at 6 years-old [3.72 IU/ml (95%CI 2.91-4.77)]. GMCs were markedly higher in those vaccinated with DTaP-IPV/PRP ~ T compared to DTaP. In individuals > 6 years-old, the GMC was 5.67 IU/ml (95%CI 5.36-6.00), the seropositivity rate was 6.7% (95%CI 5.5-7.9) and the recent infection rate was 1.2% (95%CI 0.7-1.7). The seropositivity rates increased from 6 years-old and peaked at 9 years-old (10.3% [95%CI 0.7-19.8]). CONCLUSIONS Vaccination against pertussis increases anti-PT IgG, but wanes over time. The sero-estimated infection rates increase from school age and peak at about 9 years-old. These results support the addition of a booster of pertussis vaccine at preschool age.
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Affiliation(s)
- Zhujiazi Zhang
- Department of Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
| | - Jingbin Pan
- Department of Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
| | - Meng Chen
- Department of Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
| | - Tiegang Zhang
- Department of Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
| | - Juan Li
- Department of Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
| | - Li Lu
- Department of Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China.
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14
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Emerging macrolide resistance in Bordetella pertussis in mainland China: Findings and warning from the global pertussis initiative. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 8:100098. [PMID: 34327426 PMCID: PMC8315362 DOI: 10.1016/j.lanwpc.2021.100098] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/10/2021] [Accepted: 01/14/2021] [Indexed: 11/22/2022]
Abstract
Whooping cough, or pertussis, is a highly communicable infectious disease caused by the bacterium Bordetella pertussis. Vaccination once reduced the incidence of the disease, but a global resurgence of the infection happened during the past two decades, likely due to the waning immunity of vaccination. Macrolides such as erythromycin and azithromycin are the drugs of primary choice for treatment. In this personal view, we call for attention to macrolide-resistant B. pertussis (MRBP), which has emerged and prevailed in mainland China for years and are exclusively mediated by mutations in the 23S rRNA gene. Whether the prevalence of MRBP in China results from overuse of azithromycin in clinical medicine remains unknown. The incidence of MRBP is low in other countries, but this could be a technical illusion since China employs culture as the mainstream diagnostic method whereas nucleic-acid amplification test being widely used in other countries fail to test antimicrobial susceptibility. Given the increasingly frequent global travel that facilitates microbial transmission worldwide, there is a pressing need to perform international surveillance on MRBP to prevent the potential circulation of the organism. Finding alternative agents that possess good activity against B. pertussis is also urgently required.
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15
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Cock IE, Van Vuuren SF. The traditional use of southern African medicinal plants for the treatment of bacterial respiratory diseases: A review of the ethnobotany and scientific evaluations. JOURNAL OF ETHNOPHARMACOLOGY 2020; 263:113204. [PMID: 32730881 PMCID: PMC7383173 DOI: 10.1016/j.jep.2020.113204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/07/2020] [Accepted: 07/20/2020] [Indexed: 05/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Multiple plant species were used traditionally in southern Africa to treat bacterial respiratory diseases. This review summarises this usage and highlights plant species that are yet to be verified for these activities. AIM OF THE STUDY This manuscript reviews the traditional usage of southern African plant species to treat bacterial respiratory diseases with the aim of highlighting gaps in the literature and focusing future studies. MATERIALS AND METHODS An extensive review of ethnobotanical books, reviews and primary scientific studies was undertaken to identify southern African plants which are used in traditional southern African medicine to treat bacterial respiratory diseases. We also searched for southern African plants whose inhibitory activity against bacterial respiratory pathogens has been conmfirmed, to highlight gaps in the literature and focus future studies. RESULTS One hundred and eighty-seven southern African plant species are recorded as traditional therapies for bacterial respiratory infections. Scientific evaluations of 178 plant species were recorded, although only 42 of these were selected for screening on the basis of their ethnobotanical uses. Therefore, the potential of 146 species used teraditionally to treat bacterial respiratory diseases are yet to be verified. CONCLUSIONS The inhibitory properties of southern African medicinal plants against bacterial respiratory pathogens is relatively poorly explored and the antibacterial activity of most plant species remains to be verified.
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Affiliation(s)
- Ian E Cock
- School of Environment and Science, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia; Environmental Futures Research Institute, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia.
| | - Sandy F Van Vuuren
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Parktown, 2193, South Africa
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16
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Alimohamadi Y, Zahraei SM, Karami M, Yaseri M, Lotfizad M, Holakouie-Naieni K. The comparative performance of wavelet-based outbreak detector, exponential weighted moving average, and Poisson regression-based methods in detection of pertussis outbreaks in Iranian infants: A simulation-based study. Pediatr Pulmonol 2020; 55:3497-3508. [PMID: 32827358 DOI: 10.1002/ppul.25036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 08/14/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Early detection of outbreaks of transmissible diseases is essential for public health. This study aimed to determine the performance of the wavelet-based outbreak detection method (WOD) in detecting outbreaks and to compare its performance with the Poisson regression-based model and exponentially weighted moving average (EWMA) using data of simulated pertussis outbreaks in Iran. METHOD The data on suspected cases of pertussis from 25th February 2012 to 23rd March 2018 in Iran was used. The performance of the WOD (Daubechies 10 [db10] and Haar wavelets), Poisson regression-based method, and EWMA Compared in terms of timeliness and detection of outbreak days using the simulation of different outbreaks. In the current study, two simulations were used, one based on retrospectively collected data (literature-based) on pertussis cases and another one on a synthetic dataset created by the researchers. The sensitivity, specificity, false alarm, and false-negative rate, positive and negative likelihood ratios, under receiver operating characteristics areas, and median timeliness were used to assess the performance of the methods. RESULTS In a literature-based outbreak simulation, the highest and lowest sensitivity, false negative in the detection of injected outbreaks were seen in db10, with sensitivity 0.59 (0.56-0.62), and Haar wavelets with 0.57 (0.54-0.60). In the researcher simulated data, the EWMA (K = 0.5) with sensitivity 0.92 (0.90-0.94) had the best performance. About timeliness, the WOD methods showed the best performance in the early warning of the outbreak in both simulation approaches. CONCLUSION Performance of the WOD in the early alarming outbreaks was appropriate. However, this method would be best used along with other methods of public health surveillance.
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Affiliation(s)
- Yousef Alimohamadi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Lotfizad
- School of Electrical & Computer Engineering, Tarbiat Modares University, Tehran, Iran
| | - Kourosh Holakouie-Naieni
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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17
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Alimohamadi Y, Zahraei SM, Karami M, Yaseri M, Lotfizad M, Holakouie-Naieni K. Alarm Thresholds for Pertussis Outbreaks in Iran: National Data Analysis. Osong Public Health Res Perspect 2020; 11:309-318. [PMID: 33117636 PMCID: PMC7577381 DOI: 10.24171/j.phrp.2020.11.5.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives The purpose of the current study was to determine the upper threshold number of cases for which pertussis infection would reach an outbreak level nationally in Iran. Methods Data on suspected cases of pertussis from the 25th February 2012 to the 23rd March 2018 from the Center for Disease Control and Prevention in Iran was used. The national upper threshold level was estimated using the exponentially weighted moving average (EWMA) method and the Poisson regression method. Results In total, 2,577 (33.6%) and 1,714 (22.3%) cases were reported in the Spring and Summer respectively. There were 1,417 (18.5%) and 1,971 (25.6%) cases reported in the Autumn and Winter, respectively. The overall upper threshold using the EWMA and the Poisson regression methods, was estimated as a daily occurrence of 8 (7.55) and 7.50 (4.48–11.06) suspected cases per 10,000,000 people, respectively. The daily seasonal thresholds estimated by the EWMA and the Poisson regression methods were 10, 7, 6, 8 cases and 10, 7, 7, 9 cases for the Spring, Summer, Autumn, and Winter, respectively. Conclusion The overall and seasonal estimated thresholds by the 2 methods were similar. Therefore, the estimated thresholds of 6–10 cases in a day, per 10,000,000 people could be used to detect pertussis outbreaks and epidemics by health policymakers.
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Affiliation(s)
- Yousef Alimohamadi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Lotfizad
- School of Electrical and Computer Engineering, Tarbiat Modares University, Tehran, Iran
| | - Kourosh Holakouie-Naieni
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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18
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Dominguez DC. A profile of the Simplexa™ Bordetella Direct assay for the detection and differentiation of Bordetella pertussis and Bordetella parapertussis in nasopharyngeal swabs. Expert Rev Mol Diagn 2020; 20:889-894. [PMID: 32885709 DOI: 10.1080/14737159.2020.1819240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Pertussis is a highly contagious respiratory infection caused by Bordetella pertussis and to minor extent B. parapertussis. Despite high vaccination coverage, epidemics persist worldwide. Laboratory testing with the capacity to support increasing demand and generate fast and accurate results is needed to promptly provide treatment to mitigate symptoms, prevent transmission, and thus impact infection control and disease surveillance. AREAS COVERED This review will describe the features of the Simplexa™ Bordetella Direct Assay and compare this technology with other existing assays. Unmet needs and future directions will be discussed. EXPERT COMMENTARY Resurgence of pertussis highlights the importance of reliable and accurate diagnosis. The Simplexa™ Bordetella Direct Assay provides an easy workflow, reduced hand-on time, less risk of contamination, and rapid turnaround time. The use of efficient molecular assays in routine clinical laboratory is valuable for increasing demand, improvement of infection control, and surveillance.
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Affiliation(s)
- Delfina C Dominguez
- Clinical Laboratory Science/Public Health Sciences, The University of Texas at El Paso , El Paso, TX, USA
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19
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Ray U, Dutta S. Pertussis: Re-emergence or underdiagnosed? Lung India 2020; 37:340-342. [PMID: 32643645 PMCID: PMC7507929 DOI: 10.4103/lungindia.lungindia_500_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Ujjwayini Ray
- Department of Microbiology, Apollo Gleneagles Hospitals, Kolkata, West Bengal, India
| | - Soma Dutta
- Department of Microbiology, Apollo Gleneagles Hospitals, Kolkata, West Bengal, India
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20
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Thiriard A, Raze D, Locht C. Development and Standardization of a High-Throughput Bordetella pertussis Growth-Inhibition Assay. Front Microbiol 2020; 11:777. [PMID: 32425912 PMCID: PMC7212404 DOI: 10.3389/fmicb.2020.00777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 03/31/2020] [Indexed: 12/24/2022] Open
Abstract
Bordetella pertussis, the main causative agent of whooping cough, is a reemerging pathogen, and recent vaccine-resistant strain outbreaks and emergence of macrolides-resistant strains in China raised new concerns for control of the disease. New vaccines and potentially new antibiotics are thus needed. B. pertussis is tedious to culture and requires several days of growth to count isolated colonies on agar-based media, making large-scale screening of new anti-B. pertussis compounds or functional evaluation of large sample sizes of immune sera difficult. Here, we developed a scalable, rapid, high-throughput luminescence-based Bordetella growth inhibition assay (BGIA) to quantify surviving bacteria after treatment with anti-B. pertussis compounds. A strong correlation between luminescence and colony-forming units (r2 = 0.9345, p < 0.0001) was found and the BGIA showed high sensitivity and reproducibility. We demonstrate here that the BGIA can be used to quantify resistance of B. pertussis to antibiotics, sensitivity to complement and to human serum in an easy-to-operate and fast manner. We have optimized the assay and tested the effects of different B. pertussis strains and growth conditions on serum and complement sensitivity. We also uncovered complement-independent antibody-mediated inhibition of B. pertussis growth. The BGIA can thus effectively be implemented for large-scale serum studies to further investigate anti-B. pertussis immune responses at a functional level, as well as for screening of B. pertussis strains for their resistance to antibiotics or complement, and for high-throughput screening of novel anti-B. pertussis compounds.
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Affiliation(s)
- Anaïs Thiriard
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, Lille, France
| | - Dominique Raze
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, Lille, France
| | - Camille Locht
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, Lille, France
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21
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Wang H, Zheng Y, de Groot R, Yang Y, Diavatopoulos DA, Chen Y, de Jonge MI, Deng J. High prevalence of Bordetella pertussis in young hospitalized infants with acute respiratory infection in the south of China: age- and season-dependent effects. J Infect 2020; 80:578-606. [PMID: 31981637 DOI: 10.1016/j.jinf.2020.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Heping Wang
- Shenzhen Children's Hospital, Shenzhen, Guangdong, China; Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yuejie Zheng
- Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Ronald de Groot
- Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yonghong Yang
- Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Dimitri A Diavatopoulos
- Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yunsheng Chen
- Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Marien I de Jonge
- Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Jikui Deng
- Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
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22
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Buchy P, Ascioglu S, Buisson Y, Datta S, Nissen M, Tambyah PA, Vong S. Impact of vaccines on antimicrobial resistance. Int J Infect Dis 2019; 90:188-196. [PMID: 31622674 DOI: 10.1016/j.ijid.2019.10.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 12/28/2022] Open
Abstract
DRIVERS OF ANTIMICROBIAL RESISTANCE Antibiotic use drives the development and spread of resistant bacterial infections. Antimicrobial resistance (AMR) has become a prolific global issue, due to significant increases in antibiotic use in humans, livestock and agriculture, inappropriate use (under-dosing and over-prescribing), and misuse of antibiotics (for viral infections where they are ineffective). Fewer new antibiotics are being developed. THE PROBLEM OF AMR AMR is now considered a key threat to global health, leading to more mortality and increased healthcare costs threatening future conduct of routine medical procedures. Traditional approaches to address AMR include antibiotic stewardship, better hygiene/infection control, promoting antibiotic research and development, and restricting use for agricultural purposes. VACCINES AS A TOOL TO REDUCE AMR While antibiotic development is declining, vaccine technology is growing. This review shows how vaccines can decrease AMR by preventing bacterial and viral infections, thereby reducing the use/misuse of antibiotics, and by preventing antibiotic-resistant infections. Vaccines are less likely to induce resistance. Some future uses and developments of vaccines are also discussed. CONCLUSIONS Vaccines, along with other approaches, can help reduce AMR by preventing (resistant) infections and reducing antibiotic use. Industry and governments must focus on the development of novel vaccines and drugs against resistant infections to successfully reduce AMR. A graphical abstract is available online.
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Affiliation(s)
| | | | - Yves Buisson
- Académie Nationale de Médecine, 16 rue Bonaparte, 75006 Paris, France.
| | - Sanjoy Datta
- GSK, 23 Rochester Park, Singapore 139234, Singapore.
| | | | | | - Sirenda Vong
- World Health Organization, Regional Office for South-East Asia (WHO SEARO), Metropolitan Hotel, Bangla Sahib Road, Connaught Place, New Delhi 110001, India.
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23
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Dewan KK, Skarlupka AL, Rivera I, Cuff LE, Gestal MC, Taylor-Mulneix DL, Wagner S, Ryman VE, Rodriguez C, Hamidou Soumana I, Levin BR, Harvill ET. Development of macrolide resistance in Bordetella bronchiseptica is associated with the loss of virulence. J Antimicrob Chemother 2019; 73:2797-2805. [PMID: 30107601 DOI: 10.1093/jac/dky264] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 06/07/2018] [Indexed: 01/30/2023] Open
Abstract
Background Why resistance to specific antibiotics emerges and spreads rapidly in some bacteria confronting these drugs but not others remains a mystery. Resistance to erythromycin in the respiratory pathogens Staphylococcus aureus and Streptococcus pneumoniae emerged rapidly and increased problematically. However, resistance is uncommon amongst the classic Bordetella species despite infections being treated with this macrolide for decades. Objectives We examined whether the apparent progenitor of the classic Bordetella spp., Bordetella bronchiseptica, is able to rapidly generate de novo resistance to antibiotics and, if so, why such resistance might not persist and propagate. Methods Independent strains of B. bronchiseptica resistant to erythromycin were generated in vitro by successively passaging them in increasing subinhibitory concentrations of this macrolide. Resistant mutants obtained were evaluated for their capacity to infect mice, and for other virulence properties including adherence, cytotoxicity and induction of cytokines. Results B. bronchiseptica rapidly developed stable and persistent antibiotic resistance de novo. Unlike the previously reported trade-off in fitness, multiple independent resistant mutants were not defective in their rates of growth in vitro but were consistently defective in colonizing mice and lost a variety of virulence phenotypes. These changes rendered them avirulent but phenotypically similar to the previously described growth phase associated with the ability to survive in soil, water and/or other extra-mammalian environments. Conclusions These observations raise the possibility that antibiotic resistance in some organisms results in trade-offs that are not quantifiable in routine measures of general fitness such as growth in vitro, but are pronounced in various aspects of infection in the natural host.
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Affiliation(s)
- Kalyan K Dewan
- Department of Infectious Diseases, Coverdell Center for Biomedical and Health Sciences, 500 D. W. Brooks Drive, University of Georgia, Athens, GA, USA
| | - Amanda L Skarlupka
- Graduate Program in Microbiology, University of Georgia, Athens, GA, USA
| | - Israel Rivera
- Graduate Program in Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Laura E Cuff
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia, 501 D. W. Brooks Drive, Athens, GA, USA
| | - Monica C Gestal
- Department of Infectious Diseases, Coverdell Center for Biomedical and Health Sciences, 500 D. W. Brooks Drive, University of Georgia, Athens, GA, USA
| | - Dawn L Taylor-Mulneix
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia, 501 D. W. Brooks Drive, Athens, GA, USA
| | - Shannon Wagner
- Department of Infectious Diseases, Coverdell Center for Biomedical and Health Sciences, 500 D. W. Brooks Drive, University of Georgia, Athens, GA, USA
| | - Valerie E Ryman
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia, 501 D. W. Brooks Drive, Athens, GA, USA
| | - Coralis Rodriguez
- Graduate Program in Microbiology, University of Georgia, Athens, GA, USA
| | - Illiassou Hamidou Soumana
- Department of Infectious Diseases, Coverdell Center for Biomedical and Health Sciences, 500 D. W. Brooks Drive, University of Georgia, Athens, GA, USA
| | - Bruce R Levin
- Department of Biology, Emory University, 1510 Clifton Road, Atlanta, GA, USA
| | - Eric T Harvill
- Department of Infectious Diseases, Coverdell Center for Biomedical and Health Sciences, 500 D. W. Brooks Drive, University of Georgia, Athens, GA, USA.,Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia, 501 D. W. Brooks Drive, Athens, GA, USA
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24
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Xu Z, Wang Z, Luan Y, Li Y, Liu X, Peng X, Octavia S, Payne M, Lan R. Genomic epidemiology of erythromycin-resistant Bordetella pertussis in China. Emerg Microbes Infect 2019; 8:461-470. [PMID: 30898080 PMCID: PMC6455148 DOI: 10.1080/22221751.2019.1587315] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Macrolides such as erythromycin are the empirical treatment of Bordetella pertussis infections. China has experienced an increase in erythromycin-resistant B. pertussis isolates since they were first reported in 2013. Here, we undertook a genomic study on Chinese B. pertussis isolates from 2012 to 2015 to elucidate the origins and phylogenetic relationships of erythromycin-resistant B. pertussis isolates in China. A total of 167 Chinese B. pertussis isolates were used for antibiotic sensitivity testing and multiple locus variable-number tandem repeat (VNTR) analysis (MLVA). All except four isolates were erythromycin-resistant and of the four erythromycin-sensitive isolates, three were non-ptxP1. MLVA types (MT), MT55, MT104 and MT195 were the predominant types. Fifty of those isolates were used for whole genome sequencing and phylogenetic analysis. Genome sequencing and phylogenetic analysis revealed three independent erythromycin-resistant lineages and all resistant isolates carried a mutation in the 23S rRNA gene. A novel fhaB3 allele was found uniquely in Chinese ptxP1 isolates and these Chinese ptxP1-ptxA1-fhaB3 had a 5-fold higher mutation rate than the global ptxP1-ptxA1 B. pertussis population. Our results suggest that the evolution of Chinese B. pertussis is likely to be driven by selection pressure from both vaccination and antibiotics. The emergence of the new non-vaccine fhaB3 allele in Chinese B. pertussis population may be a result of selection from vaccination, whereas the expansion of ptxP1-fhaB3 lineages was most likely to be the result of selection pressure from antibiotics. Further monitoring of B. pertussis in China is required to better understand the evolution of the pathogen.
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Affiliation(s)
- Zheng Xu
- a School of Biotechnology and Biomolecular Sciences , University of New South Wales , Sydney , Australia
| | - Zengguo Wang
- b Xi'an Center for Disease Prevention and Control , Xi'an , People's Republic of China.,c Department of Infectious Diseases , Xi'an Children's Hospital , Xi'an , People's Republic of China
| | - Yang Luan
- b Xi'an Center for Disease Prevention and Control , Xi'an , People's Republic of China
| | - Yarong Li
- c Department of Infectious Diseases , Xi'an Children's Hospital , Xi'an , People's Republic of China
| | - Xiaoguai Liu
- c Department of Infectious Diseases , Xi'an Children's Hospital , Xi'an , People's Republic of China
| | - Xiaokang Peng
- c Department of Infectious Diseases , Xi'an Children's Hospital , Xi'an , People's Republic of China
| | - Sophie Octavia
- a School of Biotechnology and Biomolecular Sciences , University of New South Wales , Sydney , Australia
| | - Michael Payne
- a School of Biotechnology and Biomolecular Sciences , University of New South Wales , Sydney , Australia
| | - Ruiting Lan
- a School of Biotechnology and Biomolecular Sciences , University of New South Wales , Sydney , Australia
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25
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Pertussis in the Association of Southeast Asian Nations: epidemiology and challenges. Int J Infect Dis 2019; 87:75-83. [PMID: 31369823 DOI: 10.1016/j.ijid.2019.07.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/13/2019] [Accepted: 07/20/2019] [Indexed: 12/24/2022] Open
Abstract
Pertussis is a highly infectious respiratory disease caused by Bordetella pertussis. Infants and young children are particularly at risk of severe and life-threatening disease. Infectious older individuals may transmit Bordetella pertussis to unprotected infants. Pertussis control measures have even failed in some countries with high pertussis vaccination coverage rates, leading to increased incidence rates. In 2014, this caused the World Health Organization to declare pertussis resurgent in some countries and led to recommendations regarding pertussis surveillance and national immunization programs. Despite the resurgence of pertussis, epidemiology of the disease in Southeast Asia has received little attention. In this narrative review, we describe pertussis surveillance systems, control measures, epidemiologic trends, and region-specific pertussis research in Southeast Asia. We also make recommendations for the intensification of pertussis surveillance and research in the region.
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26
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Fu P, Wang C, Tian H, Kang Z, Zeng M. Bordetella pertussis Infection in Infants and Young Children in Shanghai, China, 2016-2017: Clinical Features, Genotype Variations of Antigenic Genes and Macrolides Resistance. Pediatr Infect Dis J 2019; 38:370-376. [PMID: 30882726 DOI: 10.1097/inf.0000000000002160] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The global resurgence of pertussis in countries with high vaccination coverage has been a concern of public health. METHODS Nasopharyngeal swabs were collected for Bordetella pertussis culture from children with suspected pertussis. Clinical and vaccination information were reviewed through electronic medical chart and immunization record. Antibiotics susceptibility was evaluated using E-test for erythromycin, azithromycin, clarithromycin and sulfamethoxazole/trimethoprim. The MLST genotypes and 7 antigenic genes (ptxP, ptxA, ptxC, Prn, fim3, fim2 and tcfA) of Bordetella pertussis were identified by polymerase chain reaction amplification and sequencing. RESULTS During January 2016 to September 2017, a total of 141 children 1-48 months of age were culture-confirmed with pertussis, of whom 98 (69.5%) were younger than 6 months, 25 (17.7%) had completed at least 3 doses of DTaP and 75 (53.2%) had a clear exposure to household members with persistent cough. Fully vaccinated cases manifested milder disease than unvaccinated and not-fully vaccinated cases. All strains were MLST2. High-virulent strains characteristic of ptxP3/prn2/ptxC2 constituted 41.1% (58/141) and were all susceptible to macrolides while low-virulent strains characteristic of ptxP1/prn1/ptxC1 constituted 58.9% (83/141) and 97.6% (81/83), respectively, were highly resistant to macrolides. CONCLUSIONS Pertussis is resurging among infants and young children in Shanghai, and household transmission is the main exposure pathway. The high-virulent strains harboring ptxP3/prn2/ptxC2 and the macrolide-resistant Bordetella pertussis strains are quite prevalent. These issues impose a public health concern in Shanghai. Our findings are important to modify the DTaP vaccination strategy and the management guideline of pertussis in China.
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Affiliation(s)
- Pan Fu
- From the Department of Clinical Microbiology Laboratory, Clinical Laboratory Medicine, Children's Hospital of Fudan University, Shanghai, China
| | - Chuanqing Wang
- From the Department of Clinical Microbiology Laboratory, Clinical Laboratory Medicine, Children's Hospital of Fudan University, Shanghai, China
- Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China
| | - He Tian
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Zhihua Kang
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
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