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Lecorvaisier F. [Impact of vaccination on the evolution of Bordetella pertussis]. Med Sci (Paris) 2024; 40:161-166. [PMID: 38411424 DOI: 10.1051/medsci/2023219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Vaccines against pertussis, or whooping cough, have been commercialized and used in most countries worldwide for decades. The history of these vaccines is distinctive, marked by the transition from whole-cell vaccines to acellular vaccines in many developed countries over the last two decades. This particular history has had a significant impact on the evolution of Bordetella pertussis, the etiological agent of whooping cough. Both genetic and phenotypic changes appeared, with the emergence of novel alleles for antigens targeted by the vaccines and changes in the expression of these antigens. The main consequence of these changes is the resurgence of whooping cough in many countries and the appearance of strains capable of evading vaccine-induced immunity. The emergence of novel strains under vaccine pressure underscores the importance of considering biological evolution in the conception of new vaccines and vaccine strategies.
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Affiliation(s)
- Florian Lecorvaisier
- Université Claude Bernard Lyon 1 LBBE, UMR 5558, CNRS, VAS, Villeurbanne, France
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2
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Characterization of Bordetella pertussis Strains Isolated from India. Pathogens 2022; 11:pathogens11070794. [PMID: 35890038 PMCID: PMC9322502 DOI: 10.3390/pathogens11070794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/11/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
Despite high level vaccination and the availability of two different types of vaccines, whole cell (wP) and acellular vaccines (aP), the resurgence of pertussis has been reported in many countries. Antigenic variation within circulating and vaccine strains is the most documented reason reported for the resurgence of pertussis. Research on genetic divergence among circulating and vaccine strains has largely been reported in countries using aP vaccines. There are inadequate data available for antigenic variation in B. pertussis from wP-using countries. India has used wP for more than 40 years in their primary immunization program. The present study reports five clinical isolates of B. pertussis from samples of pediatric patients with pertussis symptoms observed in India. Genotypic and phenotypic characterization of clinical isolates were performed by serotyping, genotyping, whole genome analyses and comparative genomics. All clinical isolates showed serotype 1, 2 and 3 based on the presence of fimbriae 2 and 3. Genotyping showed genetic similarities in allele types for five aP genes within vaccine strains and clinical isolates reported from India. The presence of the ptxP3 genotype was observed in two out of five clinical isolates. Whole-genome sequencing was performed for clinical isolates using the hybrid strategy of combining Illumina (short reads) and oxford nanopore (long reads) sequencing strategies. Clinical isolates (n = 5) and vaccine strains (n = 7) genomes of B. pertussis from India were compared with 744 B. pertussis closed genomes available in the public databases. The phylogenomic comparison of B. pertussis genomes reported from India will be advantageous in better understanding pertussis resurgence reported globally with respect to pathogen adaptation.
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Asatryan A, Meyer N, Scherbakov M, Romanenko V, Osipova I, Galustyan A, Shamsheva O, Latysheva T, Myasnikova T, Baudson N, Dodet M, Xavier S, Harrington L, Kuznetsova A, Campora L, Van den Steen P. Immunogenicity, safety, and reactogenicity of combined reduced-antigen-content diphtheria-tetanus-acellular pertussis vaccine administered as a booster vaccine dose in healthy Russian participants: a phase III, open-label study. Hum Vaccin Immunother 2021; 17:723-730. [PMID: 32845735 PMCID: PMC7993191 DOI: 10.1080/21645515.2020.1796423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
As vaccine-induced immunity and protection following natural pertussis infection wane over time, adults and adolescents may develop pertussis and become transmitters to unprotected infants. In Russia, diphtheria and tetanus but not pertussis-containing vaccines are registered for older children, adolescents, or adults. The reduced-antigen-content diphtheria toxoid, tetanus toxoid, and acellular pertussis (dTpa) vaccine (Boostrix, GSK) was developed for booster vaccination of children ≥4 years of age, adolescents, and adults. A phase III, open-label, non-randomized study was performed in eight centers in Russia between January and July 2018. The objective of this study was to assess immunogenicity, reactogenicity and safety of a single dose of dTpa vaccine in healthy Russian participants ≥4 years of age (age categories 4-9 years, 10-17 years, 18-64 years, and ≥65 years). At 1 month post-booster vaccination, across all age groups, >99.0% of participants were seroprotected against diphtheria and tetanus and >96.0% of participants were seropositive for anti-pertussis antibodies. For all antibodies across all age groups, antibody GMCs increased from pre- to 1 month post-booster vaccination and booster responses to diphtheria (in 71.5% of participants), tetanus (85.3%), and pertussis antigens (≥85.6%) were observed. One serious adverse event that was not causally related to the study vaccine was reported. No fatal cases were reported throughout the study period. In conclusion, administration of the dTpa vaccine as a booster dose in healthy Russian participants induced a robust immune response to all vaccine antigens and was generally well tolerated across all age groups.
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Affiliation(s)
| | | | | | | | | | - Anna Galustyan
- Medical Technologies Ltd, St. Petersburg, Russian Federation.,Federal State Budgetary Educational Institution of Higher Education, St. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation, St. Petersburg, Russian Federation
| | - Olga Shamsheva
- Pirogov Russian National Research Medical University, Moscow, Russian Federation
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Alai S, Ghattargi VC, Gautam M, Patel K, Pawar SP, Dhotre DP, Shaligram U, Gairola S. Comparative genomics of whole-cell pertussis vaccine strains from India. BMC Genomics 2020; 21:345. [PMID: 32381023 PMCID: PMC7204287 DOI: 10.1186/s12864-020-6724-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/06/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite high vaccination coverage using acellular (ACV) and whole-cell pertussis (WCV) vaccines, the resurgence of pertussis is observed globally. Genetic divergence in circulating strains of Bordetella pertussis has been reported as one of the contributing factors for the resurgence of the disease. Our current knowledge of B. pertussis genetic evolution in circulating strains is mostly based on studies conducted in countries using ACVs targeting only a few antigens used in the production of ACVs. To better understand the adaptation to vaccine-induced selection pressure, it will be essential to study B. pertussis populations in developing countries which are using WCVs. India is a significant user and global supplier of WCVs. We report here comparative genome analyses of vaccine and clinical isolates reported from India. Whole-genome sequences obtained from vaccine strains: WCV (J445, J446, J447 and J448), ACV (BP165) were compared with Tohama-I reference strain and recently reported clinical isolates from India (BPD1, BPD2). Core genome-based phylogenetic analysis was also performed using 166 isolates reported from countries using ACV. RESULTS Whole-genome analysis of vaccine and clinical isolates reported from India revealed high genetic similarity and conserved genome among strains. Phylogenetic analysis showed that clinical and vaccine strains share genetic closeness with reference strain Tohama-I. The allelic profile of vaccine strains (J445:ptxP1/ptxA2/prn1/fim2-1/fim3-1; J446: ptxP2/ptxA4/prn7/fim2-2/fim3-1; J447 and J448: ptxP1/ptxA1/ prn1/fim2-1/fim3-1), which matched entirely with clinical isolates (BPD1:ptxP1/ptxA1/prn1/fim2-1 and BPD2: ptxP1/ptxA1/prn1/fim2-1) reported from India. Multi-locus sequence typing (MLST) demonstrated the presence of dominant sequence types ST2 and primitive ST1 in vaccine strains which will allow better coverage against circulating strains of B. pertussis. CONCLUSIONS The study provides a detailed characterization of vaccine and clinical strains reported from India, which will further facilitate epidemiological studies on genetic shifts in countries which are using WCVs in their immunization programs.
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Affiliation(s)
- Shweta Alai
- Department of Health and Biological Sciences, Symbiosis International University, Pune, Maharashtra, 412115, India
| | - Vikas C Ghattargi
- National Centre for Microbial Resource, National Centre for Cell Science, Pune, Maharashtra, 411021, India
| | - Manish Gautam
- Serum Institute of India Pvt. Ltd, Pune, Maharashtra, 411028, India
| | - Krunal Patel
- Serum Institute of India Pvt. Ltd, Pune, Maharashtra, 411028, India
| | - Shrikant P Pawar
- National Centre for Microbial Resource, National Centre for Cell Science, Pune, Maharashtra, 411021, India
| | - Dhiraj P Dhotre
- National Centre for Microbial Resource, National Centre for Cell Science, Pune, Maharashtra, 411021, India
| | - Umesh Shaligram
- Serum Institute of India Pvt. Ltd, Pune, Maharashtra, 411028, India
| | - Sunil Gairola
- Serum Institute of India Pvt. Ltd, Pune, Maharashtra, 411028, India.
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Carriquiriborde F, Regidor V, Aispuro PM, Magali G, Bartel E, Bottero D, Hozbor D. Rare Detection of Bordetella pertussis Pertactin-Deficient Strains in Argentina. Emerg Infect Dis 2020; 25:2048-2054. [PMID: 31625838 PMCID: PMC6810201 DOI: 10.3201/eid2511.190329] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Pertussis resurgence had been attributed to waning vaccine immunity and Bordetella pertussis adaptation to escape vaccine-induced immunity. Circulating bacteria differ genotypically from strains used in production of pertussis vaccine. Pertactin-deficient strains are highly prevalent in countries that use acellular vaccine (aP), suggesting strong aP-imposed selection of circulating bacteria. To corroborate this hypothesis, systematic studies on pertactin prevalence of infection in countries using whole-cell vaccine are needed. We provide pertussis epidemiologic data and molecular characterization of B. pertussis isolates from Buenos Aires, Argentina, during 2000–2017. This area used primary vaccination with whole-cell vaccine. Since 2002, pertussis case incidences increased at regular 4-year outbreaks; most cases were in infants <1 year of age. Of the B. pertussis isolates analyzed, 90.6% (317/350) contained the ptxP3-ptxA1-prn2-fim3-2 allelic profile. Immunoblotting and sequencing techniques detected only the 2 pertactin-deficient isolates. The low prevalence of pertactin-deficient strains in Argentina suggests that loss of pertactin gene expression might be driven by aP vaccine.
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Nikbin VS, Keramati M, Noofeli M, Tayebzadeh F, Kahali B, Shahcheraghi F. Engineering of an Iranian Bordetella pertussis strain producing inactive pertussis toxin. J Med Microbiol 2019; 69:111-119. [PMID: 31778110 DOI: 10.1099/jmm.0.001114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Differences between the genomic and virulence profile of Bordetella pertussis circulating strains and vaccine strains are considered as one of the important reasons for the resurgence of whooping cough (pertussis) in the world. Genetically inactivated B. pertussis is one of the new strategies to generate live-attenuated vaccines against whooping cough.Aim. The aim of this study was to construct a B. pertussis strain based on a predominant profile of circulating Iranian isolates that produces inactivated pertussis toxin (PTX).Methodology. The B. pertussis strain BPIP91 with predominant genomic and virulence pattern was selected from the biobank of the Pasteur Institute of Iran. A BPIP91 derivative with R9K and E129G alterations in the S1 subunit of PTX (S1mBPIP91) was constructed by the site-directed mutagenesis and homologous recombination. Genetic stability and antigen expression of S1mBPIP91 were tested by serially in vitro passages and immunoblot analyses, respectively. The reduction in toxicity of S1mBPIP91 was determined by Chinese hamster ovary (CHO) cell clustering.Results. All constructs and S1mBPIP91 were confirmed via restriction enzyme analysis and DNA sequencing. The engineered mutations in S1mBPIP91 were stable after 20 serial in vitro passages. The production of virulence factors was also confirmed in S1mBPIP91. The CHO cell-clustering test demonstrated the reduction in PTX toxicity in S1mBPIP91.Conclusion. A B. pertussis of the predominant genomic and virulence lineage in Iran was successfully engineered to produce inactive PTX. This attenuated strain will be useful to further studies to develop both whole cell and acellular pertussis vaccines.
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Affiliation(s)
- Vajihe Sadat Nikbin
- Pertussis Reference Laboratory, Bacteriology Department, Pasteur Institute of Iran, Tehran, Iran
| | - Malihe Keramati
- Nano-Biotechnology Department, Pasteur Institute of Iran, Tehran, Iran
| | - Mojtaba Noofeli
- Razi Vaccines and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Faranak Tayebzadeh
- Pertussis Reference Laboratory, Bacteriology Department, Pasteur Institute of Iran, Tehran, Iran
| | - Bahram Kahali
- Pertussis Reference Laboratory, Bacteriology Department, Pasteur Institute of Iran, Tehran, Iran
| | - Fereshteh Shahcheraghi
- Pertussis Reference Laboratory, Bacteriology Department, Pasteur Institute of Iran, Tehran, Iran
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Emerging of ptxP3 lineage in Bordetella pertussis strains circulating in a population in northeastern Mexico. Epidemiol Infect 2018; 146:2096-2101. [PMID: 30136639 DOI: 10.1017/s0950268818002303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We determined the molecular epidemiology of Bordetella pertussis isolates to evaluate its potential impact on pertussis reemergence in a population of Mexico. Symptomatic and asymptomatic cases were included. Pertussis infection was confirmed by culture and real-time polymerase chain reaction (PCR). Selected B. pertussis isolates were further analysed; i.e. clonality was analysed by pulsed-field gel electrophoresis (PFGE) and ptxP-ptxA, prn, fim2 and fim3 typing was performed by PCR and sequencing. Out of 11 864 analysed samples, 687 (5.8%) were positive for pertussis, with 244 (36%) confirmed by both culture and PCR whereas 115 (17%) were positive only by culture and 328 (48%) were positive only by PCR. One predominant clone (clone A, n = 62/113; 55%) and three major subtypes (A1, A2 and A3) were identified by PFGE. All 113 selected isolates had the allelic combination ptxP3-ptxA1. The predominant clone A and the three major subtypes (A1, A2 and A3) corresponded to the emerging genotypes ptxP3-ptxA1-prn2-fim2-1-fim3-2 and ptxP3-ptxA1-prn2-fim2-1-fim3-1. In conclusion, the presence of an endemic clone and three predominant subtypes belonging to the genotypes ptxP3-ptxA1-prn2-fim2-1-fim3-2 and ptxP3-ptxA1-prn2-fim2-1-fim3-1 were detected. This finding supports the global spread/expansion reported for these outbreaks associated genotypes.
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Dorji D, Mooi F, Yantorno O, Deora R, Graham RM, Mukkur TK. Bordetella Pertussis virulence factors in the continuing evolution of whooping cough vaccines for improved performance. Med Microbiol Immunol 2017; 207:3-26. [PMID: 29164393 DOI: 10.1007/s00430-017-0524-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 10/19/2017] [Indexed: 02/07/2023]
Abstract
Despite high vaccine coverage, whooping cough caused by Bordetella pertussis remains one of the most common vaccine-preventable diseases worldwide. Introduction of whole-cell pertussis (wP) vaccines in the 1940s and acellular pertussis (aP) vaccines in 1990s reduced the mortality due to pertussis. Despite induction of both antibody and cell-mediated immune (CMI) responses by aP and wP vaccines, there has been resurgence of pertussis in many countries in recent years. Possible reasons hypothesised for resurgence have ranged from incompliance with the recommended vaccination programmes with the currently used aP vaccine to infection with a resurged clinical isolates characterised by mutations in the virulence factors, resulting in antigenic divergence with vaccine strain, and increased production of pertussis toxin, resulting in dampening of immune responses. While use of these vaccines provide varying degrees of protection against whooping cough, protection against infection and transmission appears to be less effective, warranting continuation of efforts in the development of an improved pertussis vaccine formulations capable of achieving this objective. Major approaches currently under evaluation for the development of an improved pertussis vaccine include identification of novel biofilm-associated antigens for incorporation in current aP vaccine formulations, development of live attenuated vaccines and discovery of novel non-toxic adjuvants capable of inducing both antibody and CMI. In this review, the potential roles of different accredited virulence factors, including novel biofilm-associated antigens, of B. pertussis in the evolution, formulation and delivery of improved pertussis vaccines, with potential to block the transmission of whooping cough in the community, are discussed.
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Affiliation(s)
- Dorji Dorji
- School of Biomedical Sciences and Curtin Health Innovation Research Institute, Curtin University, Bentley, Perth, 6102, Australia
- Jigme Dorji Wangchuck National Referral Hospital, Khesar Gyalpo Medical University of Bhutan, Thimphu, Bhutan
| | - Frits Mooi
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Institute for Infection, Inflammation and Immunity, Radboud University Medical Centre, Nijmegen, The Netherlands
- Netherlands Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Osvaldo Yantorno
- Laboratorio de Biofilms Microbianos, Centro de Investigación y Desarrollo de Fermentaciones Industriales (CINDEFI-CONICET-CCT La Plata), Facultad de Ciencias Exactas, UNLP, La Plata, Argentina
| | - Rajendar Deora
- Department of Microbiology and Immunology, Wake Forest University School of Medicine, Medical Center Blvd., Winston Salem, NC, 27157, USA
| | - Ross M Graham
- School of Biomedical Sciences and Curtin Health Innovation Research Institute, Curtin University, Bentley, Perth, 6102, Australia
| | - Trilochan K Mukkur
- School of Biomedical Sciences and Curtin Health Innovation Research Institute, Curtin University, Bentley, Perth, 6102, Australia.
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Guimarães LM, Carneiro ELNDC, Carvalho-Costa FA. Increasing incidence of pertussis in Brazil: a retrospective study using surveillance data. BMC Infect Dis 2015; 15:442. [PMID: 26498058 PMCID: PMC4619034 DOI: 10.1186/s12879-015-1222-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many countries have reported an increase in the incidence of pertussis, which has become a global public health concern. METHODS In this study, the epidemiology of pertussis in Brazil was assessed retrospectively using surveillance data gathered from case notification forms from 2007 to 2014. RESULTS From 2007 to 2014, 80,068 suspected cases of pertussis were reported in Brazil. Of these, 24,612 (32 %) were confirmed by various criteria. The annual distribution of confirmed cases demonstrated a significant increase in incidence rate since 2012. A seasonal pattern in which cases occur most frequently between the end of spring and midsummer has been identified. Among the confirmed cases, 34.5 % occurred in infants aged 0-2 months, 22.4 % occurred in infants aged 3-6 months, 21 % occurred in children aged 7 months to 4 years, and 8 % were reported in adults >21 years. Of the confirmed cases, 47.2 % met only clinical criteria, 15.5 % met clinical and epidemiological criteria, and 36.6 % were confirmed in a laboratory. The overall case fatality rate was 2.1 %, reaching 4.7 % among infants aged 0-2 months. The complications most commonly reported in the notification forms were pneumonia, encephalitis, dehydration, otitis, and malnutrition. Of the confirmed cases, 23.1 % occurred in subjects who received at least 3 doses of the pertussis vaccine. Within this group, there were 1098 infants aged 7 to 15 months and 2079 children aged 16 months to 4 years. In 2012, 18 states did not achieve 95 % immunization coverage, a number that dropped to 10 and 6 in 2013 and 2014, respectively. CONCLUSIONS Brazil's main challenges in facing pertussis resurgence will be to offer the best quality medical attention to reduce mortality, to improve the infrastructure for laboratory diagnosis and to increase vaccination coverage. Additional studies to assess the effectiveness of the current vaccination schedule and basic research on the genetics and evolution of circulating B. pertussis strains are also needed.
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Affiliation(s)
- Lucas Melo Guimarães
- Regional Office Oswaldo Cruz Foundation (Fiocruz), Teresina, Piauí, Brazil. .,Laboratory of Epidemiology and Molecular Systematics, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
| | | | - Filipe Anibal Carvalho-Costa
- Regional Office Oswaldo Cruz Foundation (Fiocruz), Teresina, Piauí, Brazil. .,Laboratory of Epidemiology and Molecular Systematics, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
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Wagner B, Melzer H, Freymüller G, Stumvoll S, Rendi-Wagner P, Paulke-Korinek M, Repa A, Mooi FR, Kollaritsch H, Mittermayer H, Kessler HH, Stanek G, Steinborn R, Duchêne M, Wiedermann U. Genetic Variation of Bordetella pertussis in Austria. PLoS One 2015; 10:e0132623. [PMID: 26182210 PMCID: PMC4504479 DOI: 10.1371/journal.pone.0132623] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/16/2015] [Indexed: 02/07/2023] Open
Abstract
In Austria, vaccination coverage against Bordetella pertussis infections during infancy is estimated at around 90%. Within the last years, however, the number of pertussis cases has increased steadily, not only in children but also in adolescents and adults, indicating both insufficient herd immunity and vaccine coverage. Waning immunity in the host and/or adaptation of the bacterium to the immunised hosts could contribute to the observed re-emergence of pertussis. In this study we therefore addressed the genetic variability in B. pertussis strains from several Austrian cities. Between the years 2002 and 2008, 110 samples were collected from Vienna (n = 32), Linz (n = 63) and Graz (n = 15) by nasopharyngeal swabs. DNA was extracted from the swabs, and bacterial sequence polymorphisms were examined by MLVA (multiple-locus variable number of tandem repeat analysis) (n = 77), by PCR amplification and conventional Sanger sequencing of the polymorphic regions of the prn (pertactin) gene (n = 110), and by amplification refractory mutation system quantitative PCR (ARMS-qPCR) (n = 110) to directly address polymorphisms in the genes encoding two pertussis toxin subunits (ptxA and ptxB), a fimbrial adhesin (fimD), tracheal colonisation factor (tcfA), and the virulence sensor protein (bvgS). Finally, the ptxP promoter region was screened by ARMS-qPCR for the presence of the ptxP3 allele, which has been associated with elevated production of pertussis toxin. The MLVA analysis revealed the highest level of polymorphisms with an absence of MLVA Type 29, which is found outside Austria. Only Prn subtypes Prn1/7, Prn2 and Prn3 were found with a predominance of the non-vaccine type Prn2. The analysis of the ptxA, ptxB, fimD, tcfA and bvgS polymorphisms showed a genotype mixed between the vaccine strain Tohama I and a clinical isolate from 2006 (L517). The major part of the samples (93%) displayed the ptxP3 allele. The consequences for the vaccination strategy are discussed.
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Affiliation(s)
- Birgit Wagner
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Helen Melzer
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- Astellas Pharma, Vienna, Austria
| | - Georg Freymüller
- Genomics Core Facility, VetCore, University of Veterinary Medicine, Vienna, Austria
| | - Sabine Stumvoll
- Department of Hygiene, Microbiology and Tropical Medicine, Elisabethinen Hospital, Linz, Austria
- analyse BioLab, Linz, Austria
| | - Pamela Rendi-Wagner
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- Federal Ministry of Health, Vienna, Austria
| | - Maria Paulke-Korinek
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- Federal Ministry of Health, Vienna, Austria
| | - Andreas Repa
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Frits R. Mooi
- Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Herwig Kollaritsch
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Helmut Mittermayer
- Department of Hygiene, Microbiology and Tropical Medicine, Elisabethinen Hospital, Linz, Austria
- analyse BioLab, Linz, Austria
| | - Harald H. Kessler
- Department of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Graz, Austria
| | - Gerold Stanek
- Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Ralf Steinborn
- Genomics Core Facility, VetCore, University of Veterinary Medicine, Vienna, Austria
| | - Michael Duchêne
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | - Ursula Wiedermann
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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van Gent M, Heuvelman CJ, van der Heide HG, Hallander HO, Advani A, Guiso N, Wirsing von Kőnig CH, Vestrheim DF, Dalby T, Fry NK, Pierard D, Detemmerman L, Zavadilova J, Fabianova K, Logan C, Habington A, Byrne M, Lutyńska A, Mosiej E, Pelaz C, Gröndahl-Yli-Hannuksela K, Barkoff AM, Mertsola J, Economopoulou A, He Q, Mooi FR. Analysis of Bordetella pertussis clinical isolates circulating in European countries during the period 1998-2012. Eur J Clin Microbiol Infect Dis 2014; 34:821-30. [PMID: 25527446 PMCID: PMC4365279 DOI: 10.1007/s10096-014-2297-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 12/07/2014] [Indexed: 12/31/2022]
Abstract
Despite more than 50 years of vaccination, pertussis is still an endemic disease, with regular epidemic outbreaks. With the exception of Poland, European countries have replaced whole-cell vaccines (WCVs) by acellular vaccines (ACVs) in the 1990s. Worldwide, antigenic divergence in vaccine antigens has been found between vaccine strains and circulating strains. In this work, 466 Bordetella pertussis isolates collected in the period 1998–2012 from 13 European countries were characterised by multi-locus antigen sequence typing (MAST) of the pertussis toxin promoter (ptxP) and of the genes coding for proteins used in the ACVs: pertussis toxin (Ptx), pertactin (Prn), type 2 fimbriae (Fim2) and type 3 fimbriae (Fim3). Isolates were further characterised by fimbrial serotyping, multi-locus variable-number tandem repeat analysis (MLVA) and pulsed-field gel electrophoresis (PFGE). The results showed a very similar B. pertussis population for 12 countries using ACVs, while Poland, which uses a WCV, was quite distinct, suggesting that ACVs and WCVs select for different B. pertussis populations. This study forms a baseline for future studies on the effect of vaccination programmes on B. pertussis populations.
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Affiliation(s)
- M van Gent
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands,
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Sedaghat M, Nakhost Lotfi M, Talebi M, Saifi M, Pourshafie MR. Status of pertussis in iran. Jundishapur J Microbiol 2014; 7:e12421. [PMID: 25774274 PMCID: PMC4332236 DOI: 10.5812/jjm.12421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 09/28/2013] [Accepted: 11/11/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Pertussis is a respiratory and contagious disease which is mostly caused by Bordetella pertussis and B. parapertussis. It usually spreads from person to personduring the incubation or catarrhal phase of the disease. Despite of large-scale vaccination, whooping cough is still an endemic disease with several outbreaks. OBJECTIVES The aim of this study was to determine the prevalence of pertussis and identify its causative agents, B. pertussis or B. parapertussis, from specimens collected from Iranian patients from 2004 to 2008. PATIENTS AND METHODS Nasopharyngeal swab samples from 347 suspected pertussis cases were collected from 18 provinces of Iran. The patients were in different age groups and were either unvaccinated or vaccinated for pertussis with whole cell vaccine (WCV). Bacterial culture, agglutination tests and quantitative PCR (qPCR) targeting IS481 and IS1001 for B. pertussis and B. parapertussis were done for every specimen, respectively. RESULTS The results showed that seven nasopharyngeal swab samples (2%) were positive for B. pertussis (1.7%) and B. parapertussis (0.3%) by culture and agglutination test and 30 patients had positive qPCR test results (9%). CONCLUSIONS Despite the fact that bacterial culture is the golden standard for the detection of B. pertussis, direct detection of bacteria from nasopharyngeal specimens can be performed by a rapid qPCR assay. In this study, high percentage of positive qPCR cases may indicate that the patients might have recovered from pertussis following antibiotic treatment before samples were collected. Rapid detection by qPCR could be important for immediate diagnosis and treatment of patients with pertussis.
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Affiliation(s)
- Manijeh Sedaghat
- Department of Microbiology, Pasteur Institute of Iran, Tehran, IR Iran
| | | | - Malihe Talebi
- Department of Microbiology, School of Medicine, Iran Medical University, Tehran, IR Iran
- Corresponding authors: Malihe Talebi, Department of Microbiology, School of Medicine, Iran Medical University, Tehran, IR Iran. Tel/Fax: +98-2166405535, E-mail: ; Mohammad Reza Pourshafie, Pasteur Institute of Iran, Tehran, IR Iran. Tel/Fax +98-2166405535, E-mail:
| | - Mahnaz Saifi
- Department of Microbiology, Pasteur Institute of Iran, Tehran, IR Iran
- Corresponding authors: Malihe Talebi, Department of Microbiology, School of Medicine, Iran Medical University, Tehran, IR Iran. Tel/Fax: +98-2166405535, E-mail: ; Mohammad Reza Pourshafie, Pasteur Institute of Iran, Tehran, IR Iran. Tel/Fax +98-2166405535, E-mail:
| | - Mohammad Reza Pourshafie
- Department of Microbiology, Pasteur Institute of Iran, Tehran, IR Iran
- Corresponding authors: Malihe Talebi, Department of Microbiology, School of Medicine, Iran Medical University, Tehran, IR Iran. Tel/Fax: +98-2166405535, E-mail: ; Mohammad Reza Pourshafie, Pasteur Institute of Iran, Tehran, IR Iran. Tel/Fax +98-2166405535, E-mail:
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13
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Kallonen T, He Q. Bordetella pertussisstrain variation and evolution postvaccination. Expert Rev Vaccines 2014; 8:863-75. [DOI: 10.1586/erv.09.46] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Syed MA, Bana NF. Pertussis. A reemerging and an underreported infectious disease. Saudi Med J 2014; 35:1181-7. [PMID: 25316461 PMCID: PMC4362115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pertussis or whooping cough is a highly infectious, vaccine preventable disease. The incidence of the disease has greatly been reduced since the introduction of the diphtheria, tetanus, pertussis vaccine. Pertussis resurgence has been observed in highly vaccinated populations of Western countries since 1990s. Poor vaccine quality, waning vaccine induced immunity, pathogen adaptation, and enhanced surveillance as well as advancements in diagnostic facilities are some of the reasons considered responsible for the increased reporting of pertussis cases. Pertussis may have been ignored and unnoticed due to its atypical manifestations in partially immunized population or people with waning immunity. We review the reports of pertussis resurgence from different countries and attempt to investigate reasons behind the reappearance of the disease. Pertussis is still an under reported disease and the available data from the developing countries is not a true picture of the story. Therefore, developing countries need to improve their surveillance systems.
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Affiliation(s)
- Muhammad A. Syed
- From the Department of Microbiology (Syed), University of Haripur, Pakistan, and the Department of Nursing (Bana), Triple A Living Communities Inc., Calgary, Canada.,Address correspondence and reprint request to: Dr. Muhammad A. Syed, Assistant Professor, Department of Microbiology, University of Haripur, Hattar Road, Haripur 22620, Pakistan. Tel. +92 995615394. E-mail:
| | - Noureen F. Bana
- From the Department of Microbiology (Syed), University of Haripur, Pakistan, and the Department of Nursing (Bana), Triple A Living Communities Inc., Calgary, Canada.
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Perplexities of pertussis: recent global epidemiological trends and their potential causes. Epidemiol Infect 2013; 142:672-84. [PMID: 23324361 DOI: 10.1017/s0950268812003093] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Recent much-publicized increases in pertussis case reports in some countries with high vaccine coverage have raised concerns about its current and future control. The ubiquity of this trend, however, remains unexamined. In an attempt to paint a global picture, we used case counts to determine which countries experienced statistically significant trends in incidence over the past two decades and to map changes in incidence during this period. These data reveal that pertussis resurgence is not a universal phenomenon. The heterogeneity in incidence trends, even in countries with superficially similar demography, socioeconomic conditions and vaccination programmes, is striking and requires explanation. In this opinion piece, we review and assess the multifaceted proposed explanations incorporating evolution, population dynamics, and the details of immunization programmes. While we do not solve the riddle that is pertussis epidemiology, we highlight critical aspects that are likely to hold the key to understanding its worldwide epidemiology.
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Bottero D, Gaillard ME, Basile LA, Fritz M, Hozbor DF. Genotypic and phenotypic characterization of Bordetella pertussis strains used in different vaccine formulations in Latin America. J Appl Microbiol 2012; 112:1266-76. [PMID: 22471652 DOI: 10.1111/j.1365-2672.2012.05299.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To characterize Bordetella pertussis vaccine strains in comparison with current circulating bacteria. METHODS AND RESULTS Genomic and proteomic analyses of Bp137 were performed in comparison with other vaccine strains used in Latin America (Bp509 and Bp10536) and with the clinical Argentinean isolate Bp106. Tohama I strain was used as reference strain. Pulse-field gel electrophoresis (PFGE) and pertussis toxin promoter (ptxP) sequence analysis revealed that Bp137 groups with Bp509 in PFGE group III and contains ptxP2 sequence. Tohama I (group II) and Bp10536 (group I) contain ptxP1 sequence, while Bp106 belongs to a different PFGE cluster and contains ptxP3. Surface protein profiles diverged in at least 24 peptide subunits among the studied strains. From these 24 differential proteins, Bp10536 shared the expression of ten proteins with Tohama I and Bp509, but only three with Bp137. In contrast, seven proteins were detected exclusively in Bp137 and Bp106. CONCLUSIONS Bp137 showed more features in common with the clinical isolate Bp106 than the other vaccine strains here included. SIGNIFICANCE AND IMPACT OF THE STUDY The results presented show that the old strains included in vaccines are not all equal among them. These findings together with the data of circulating bacteria should be taken into account to select the best vaccine to be included in a national immunization programme.
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Affiliation(s)
- D Bottero
- Laboratorio VacSal, Instituto de Biotecnología y Biología Molecular, CONICET - Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
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van Gent M, Bart MJ, van der Heide HGJ, Heuvelman KJ, Kallonen T, He Q, Mertsola J, Advani A, Hallander HO, Janssens K, Hermans PW, Mooi FR. SNP-based typing: a useful tool to study Bordetella pertussis populations. PLoS One 2011; 6:e20340. [PMID: 21647370 PMCID: PMC3103551 DOI: 10.1371/journal.pone.0020340] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 04/29/2011] [Indexed: 11/19/2022] Open
Abstract
To monitor changes in Bordetella pertussis populations, mainly two typing methods are used; Pulsed-Field Gel Electrophoresis (PFGE) and Multiple-Locus Variable-Number Tandem Repeat Analysis (MLVA). In this study, a single nucleotide polymorphism (SNP) typing method, based on 87 SNPs, was developed and compared with PFGE and MLVA. The discriminatory indices of SNP typing, PFGE and MLVA were found to be 0.85, 0.95 and 0.83, respectively. Phylogenetic analysis, using SNP typing as Gold Standard, revealed false homoplasies in the PFGE and MLVA trees. Further, in contrast to the SNP-based tree, the PFGE- and MLVA-based trees did not reveal a positive correlation between root-to-tip distance and the isolation year of strains. Thus PFGE and MLVA do not allow an estimation of the relative age of the selected strains. In conclusion, SNP typing was found to be phylogenetically more informative than PFGE and more discriminative than MLVA. Further, in contrast to PFGE, it is readily standardized allowing interlaboratory comparisons. We applied SNP typing to study strains with a novel allele for the pertussis toxin promoter, ptxP3, which have a worldwide distribution and which have replaced the resident ptxP1 strains in the last 20 years. Previously, we showed that ptxP3 strains showed increased pertussis toxin expression and that their emergence was associated with increased notification in the Netherlands. SNP typing showed that the ptxP3 strains isolated in the Americas, Asia, Australia and Europe formed a monophyletic branch which recently diverged from ptxP1 strains. Two predominant ptxP3 SNP types were identified which spread worldwide. The widespread use of SNP typing will enhance our understanding of the evolution and global epidemiology of B. pertussis.
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Affiliation(s)
- Marjolein van Gent
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Marieke J. Bart
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Han G. J. van der Heide
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Kees J. Heuvelman
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Teemu Kallonen
- Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Turku, Finland
- Turku Graduate School for Biomedical Sciences, University of Turku, Turku, Finland
| | - Qiushui He
- Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Turku, Finland
| | - Jussi Mertsola
- Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Turku, Finland
| | - Abdolreza Advani
- Department of Bacteriology, Swedish Institute for Infectious Disease Control, Solna, Sweden
| | - Hans O. Hallander
- Department of Bacteriology, Swedish Institute for Infectious Disease Control, Solna, Sweden
| | | | - Peter W. Hermans
- Laboratory of Pediatric Infectious Diseases, Radboud University Nijmegen Medical Center, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Frits R. Mooi
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- * E-mail:
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Nakamura Y, Kamachi K, Toyoizumi-Ajisaka H, Otsuka N, Saito R, Tsuruoka J, Katsuta T, Nakajima N, Okada K, Kato T, Arakawa Y. Marked difference between adults and children in Bordetella pertussis DNA load in nasopharyngeal swabs. Clin Microbiol Infect 2011; 17:365-70. [PMID: 20456454 DOI: 10.1111/j.1469-0691.2010.03255.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Bordetella pertussis is the aetiologic agent of whooping cough, a common cause of severe respiratory illness in children and prolonged mild cough in adults. To understand some of the reasons for differences in clinical symptoms between adults and children, we measured B. pertussis DNA loads in nasopharyngeal swabs (NPS) from 19 adults and 40 children (including 14 infants) by quantitative IS481 real-time PCR. All cases had been pre-diagnosed with the B. pertussis-specific loop-mediated isothermal amplification method. The mean PCR threshold cycles for adult and child NPS were 34.9 and 27.1, respectively, indicating a significantly lower B. pertussis DNA load in adults than in children (p <0.001). Moreover, adults had very low DNA loads during both early and later stages of the disease. When corresponding bacterial loads in NPS were calculated for B. pertussis Tohama cells using a standard curve, the mean number of bacterial cells taken with a rayon-tipped swab from an adult, older child and infant was estimated to be 320 (95% CI 120-910), 2.1 × 10⁴(95% CI 5.3 × 10³ to 8.3 × 10⁴) and 1.1 × 10⁶ cells (95% CI 1.2 × 10⁵ to 8.9 × 10⁶), respectively. This indicates that the B. pertussis load in NPS is closely correlated with patient age. Our observations suggest that adult pertussis is characterized by a lower bacterial load in the nasopharynx, resulting in milder symptoms and negative cultures.
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Affiliation(s)
- Y Nakamura
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan.
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Mosiej E, Augustynowicz E, Zawadka M, Dąbrowski W, Lutyńska A. Strain variation among Bordetella pertussis isolates circulating in Poland after 50 years of whole-cell pertussis vaccine use. J Clin Microbiol 2011; 49:1452-7. [PMID: 21307213 PMCID: PMC3122874 DOI: 10.1128/jcm.01487-10] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 02/01/2011] [Indexed: 11/20/2022] Open
Abstract
In the present study, clinical isolates of Bordetella pertussis collected in Poland from 1960 to 2005 were analyzed by pulsed-field gel electrophoresis (PFGE) according to protocols recommended in previous studies. Among the 110 isolates from 1995 to 2005, 59 PFGE patterns were found, most of which were different from those currently circulating in other European Union (EU) countries for which data are available. The PFGE patterns of currently disseminating B. pertussis clones were found within PFGE groups III and IV, as elsewhere in the EU, and in newly identified clusters A and C. Up to 70, 26, and 4%, respectively, of the currently isolated strains in Poland harbored ptxA1-prn1, ptxA1-prn2, and ptxA1-prn3 allele combinations, and most (82%) were found to be of the Fim2 phenotype. Differences in the extent of heterogeneity estimated by PFGE typing in B. pertussis populations circulating in Poland in comparison to other EU countries may be due to the different vaccine composition strategy, since routine pertussis vaccination was initiated in Poland in 1960.
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Affiliation(s)
- Ewa Mosiej
- Department of Sera and Vaccines Evaluation, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
| | - Ewa Augustynowicz
- Department of Sera and Vaccines Evaluation, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
| | - Monika Zawadka
- Department of Sera and Vaccines Evaluation, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
| | - Waldemar Dąbrowski
- Department of Food Microbiology, West Pomeranian University, Szczecin, Poland
| | - Anna Lutyńska
- Department of Sera and Vaccines Evaluation, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
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Studies on Prn variation in the mouse model and comparison with epidemiological data. PLoS One 2011; 6:e18014. [PMID: 21464955 PMCID: PMC3064647 DOI: 10.1371/journal.pone.0018014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 02/21/2011] [Indexed: 11/19/2022] Open
Abstract
The virulence factor pertactin (Prn) is a component of pertussis vaccines and one
of the most polymorphic Bordetella pertussis antigens. After
the introduction of vaccination shifts in predominant Prn types were observed
and strains with the Prn vaccine type (Prn1) were replaced by strains carrying
non-vaccine types (Prn2 and Prn3), suggesting vaccine-driven selection. The aim
of this study was to elucidate the shifts observed in Prn variants. We show
that, although Prn2 and Prn3 circulated in similar frequencies in the 1970s and
1980s, in the 1990s Prn2 strains expanded and Prn3 strains disappeared,
suggesting that in vaccinated populations Prn2 strains are fitter than Prn3
strains. We established a role for Prn in the mouse model by showing that a Prn
knock-out (Prn-ko) mutation reduced colonization in trachea and lungs.
Restoration of the mutation resulted in a significant increase in colonization
compared to the knock-out mutant. The ability of clinical isolates with
different Prn variants to colonize the mouse lung was compared. Although these
isolates were also polymorphic at other loci, only variation in the promoter for
pertussis toxin (ptxP) and Prn were found to contribute
significantly to differences in colonization. Analysis of a subset of strains
with the same ptxP allele revealed that the ability to colonize
mice decreased in the order Prn1>Prn2 and Prn3. Our results are consistent
with the predominance of Prn1 strains in unvaccinated populations. Our results
show that ability to colonize mice is practically the same for Prn2 and Prn3.
Therefore other factors may have contributed to the predominance of Prn2 in
vaccinated populations. The mouse model may be useful to assess and predict
changes in the B. pertussis population due to vaccination.
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Han HJ, Kuwae A, Abe A, Arakawa Y, Kamachi K. Differential expression of type III effector BteA protein due to IS481 insertion in Bordetella pertussis. PLoS One 2011; 6:e17797. [PMID: 21423776 PMCID: PMC3053399 DOI: 10.1371/journal.pone.0017797] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 02/11/2011] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Bordetella pertussis is the primary etiologic agent of the disease pertussis. Universal immunization programs have contributed to a significant reduction in morbidity and mortality of pertussis; however, incidence of the disease, especially in adolescents and adults, has increased in several countries despite high vaccination coverage. During the last three decades, strains of Bordetella pertussis in circulation have shifted from the vaccine-type to the nonvaccine-type in many countries. A comparative proteomic analysis of the strains was performed to identify protein(s) involved in the type shift. METHODOLOGY/PRINCIPAL FINDING Proteomic analysis identified one differentially expressed protein in the B. pertussis strains: the type III cytotoxic effector protein BteA, which is responsible for host cell death in Bordetella bronchiseptica infections. Immunoblot analysis confirmed the prominent expression of BteA protein in the nonvaccine-type strains but not in the vaccine-type strains. Sequence analysis of the vaccine-type strains revealed an IS481 insertion in the 5' untranslated region of bteA, -136 bp upstream of the bteA start codon. A high level of bteA transcripts from the IS481 promoter was detected in the vaccine-type strains, indicating that the transcript might be an untranslatable form. Furthermore, BteA mutant studies demonstrated that BteA expression in the vaccine-type strains is down-regulated by the IS481 insertion. CONCLUSION/SIGNIFICANCE The cytotoxic effector BteA protein is expressed at higher levels in B. pertussis nonvaccine-type strains than in vaccine-type strains. This type-dependent expression is due to an insertion of IS481 in B. pertussis clinical strains, suggesting that augmented expression of BteA protein might play a key role in the type shift of B. pertussis.
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Affiliation(s)
- Hyun-Ja Han
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Asaomi Kuwae
- Laboratory of Bacterial Infection, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Akio Abe
- Laboratory of Bacterial Infection, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Yoshichika Arakawa
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunari Kamachi
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail:
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Immunoproteomic analysis of human serological antibody responses to vaccination with whole-cell pertussis vaccine (WCV). PLoS One 2010; 5:e13915. [PMID: 21170113 PMCID: PMC2976700 DOI: 10.1371/journal.pone.0013915] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 10/18/2010] [Indexed: 11/29/2022] Open
Abstract
Background Pertussis (whooping cough) caused by Bordetella pertussis
(B.p), continues to be a serious public health threat.
Vaccination is the most economical and effective strategy for preventing and
controlling pertussis. However, few systematic investigations of actual
human immune responses to pertussis vaccines have been performed. Therefore,
we utilized a combination of two-dimensional electrophoresis (2-DE),
immunoblotting, and mass spectrometry to reveal the entire antigenic
proteome of whole-cell pertussis vaccine (WCV) targeted by the human immune
system as a first step toward evaluating the repertoire of human humoral
immune responses against WCV. Methodology/Principal Findings Immunoproteomic profiling of total membrane enriched proteins and
extracellular proteins of Chinese WCV strain 58003 identified a total of 30
immunoreactive proteins. Seven are known pertussis antigens including
Pertactin, Serum resistance protein, chaperonin GroEL and two OMP porins.
Sixteen have been documented to be immunogenic in other pathogens but not in
B.p, and the immunogenicity of the last seven proteins
was found for the first time. Furthermore, by comparison of the human and
murine immunoproteomes of B.p, with the exception of four
human immunoreactive proteins that were also reactive with mouse immune
sera, a unique group of antigens including more than 20 novel immunoreactive
proteins that uniquely reacted with human immune serum was confirmed. Conclusions/Significance This study is the first time that the repertoire of human serum antibody
responses against WCV was comprehensively investigated, and a small number
of previously unidentified antigens of WCV were also found by means of the
classic immunoproteomic strategy. Further research on these newly identified
predominant antigens of B.p exclusively against humans will
not only remarkably accelerate the development of diagnostic biomarkers and
subunit vaccines but also provide detailed insight into human immunity
mechanisms against WCV. In particular, this work highlights the
heterogeneity of the B.p immunoreactivity patterns of the
mouse model and the human host.
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Mooi FR. Bordetella pertussis and vaccination: the persistence of a genetically monomorphic pathogen. INFECTION GENETICS AND EVOLUTION 2009; 10:36-49. [PMID: 19879977 DOI: 10.1016/j.meegid.2009.10.007] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 10/11/2009] [Accepted: 10/20/2009] [Indexed: 01/08/2023]
Abstract
Before childhood vaccination was introduced in the 1950s, pertussis or whooping cough was a major cause of infant death worldwide. Widespread vaccination of children was successful in significantly reducing morbidity and mortality. However, despite vaccination, pertussis has persisted and, in the 1990s, resurged in a number of countries with highly vaccinated populations. Indeed, pertussis has become the most prevalent vaccine-preventable disease in developed countries with estimated infection frequencies of 1-6%. Recently vaccinated children are well protected against pertussis disease and its increase is mainly seen in adolescents and adults in which disease symptoms are often mild. The etiologic agent of pertussis, Bordetella pertussis, is extremely monomorphic and its ability to persist in the face of intensive vaccination is intriguing. Numerous studies have shown that B. pertussis populations changed after the introduction of vaccination suggesting adaptation. These adaptations did not involve the acquisition of novel genes but small genetic changes, mainly SNPs, and occurred in successive steps in a period of 40 years. The earliest adaptations resulted in antigenic divergence with vaccine strains. More recently, strains emerged with increased pertussis toxin (Ptx) production. Here I argue that the resurgence of pertussis is the compound effect of pathogen adaptation and waning immunity. I propose that the removal by vaccination of naïve infants as the major source for transmission was the crucial event which has driven the changes in B. pertussis populations. This has selected for strains which are more efficiently transmitted by primed hosts in which immunity has waned. The adaptation of B. pertussis to primed hosts involved delaying an effective immune response by antigenic divergence with vaccine strains and by increasing immune suppression through higher levels of Ptx production. Higher levels of Ptx may also benefit transmission by enhancing clinical symptoms. The study of B. pertussis populations has not only increased our understanding of pathogen evolution, but also suggests way to improve pertussis vaccines, underlining the public health significance of population-based studies of pathogens.
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Affiliation(s)
- Frits R Mooi
- Lab for Infectious Diseases and Screening, Netherlands Centre for Infectious Diseases Control, Natl Institute for Public Health and the Environment, RIVM, PO Box 1, 3720 BA Bilthoven, Netherlands.
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van Gent M, de Greeff SC, van der Heide HGJ, Mooi FR. An investigation into the cause of the 1983 whooping cough epidemic in the Netherlands. Vaccine 2009; 27:1898-903. [PMID: 19368769 DOI: 10.1016/j.vaccine.2009.01.111] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Revised: 01/13/2009] [Accepted: 01/22/2009] [Indexed: 10/21/2022]
Abstract
Despite more than 50 years of vaccination, whooping cough is still an endemic disease in the Netherlands with regular epidemic outbreaks. In the last 20 years, two periods of increased notifications were observed. The causes of the increased notifications in the first period, from 1983 to 1987, are contentious. At the time it was suggested to be a surveillance artifact, caused by changes in diagnostic procedures and increased awareness. An alternative explanation, a reduction in the vaccine dose, was downplayed at the time. The aim of this study was to reinvestigate the causes of the increased notifications by identifying changes in the Bordetella pertussis population. B. pertussis strains, isolated from 1965 to 1992, were characterized by means of fimbrial serotyping, multiple-locus sequence typing of virulence genes (MLST) and multiple-locus variable-number tandem repeat analysis (MLVA). Shifts in fimbrial serotypes and MLVA types were associated with changes in vaccine dose and increased number of notifications. One to three years after lowering of the vaccine dose, the predominant fimbrial serotype changed from Fim3 to Fim2, and the reverse trend was observed when the vaccine dose was increased. Significantly, changes in fimbrial serotypes were evident at least seven years before the increase in notifications. Our results provide evidence that the change in vaccine dose affected host immunity and, consequently, contributed to an increase in pertussis morbidity. Further, we show that MLVA and fimbrial serotyping of strains can be used as early warning for pertussis epidemics.
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Affiliation(s)
- Marjolein van Gent
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
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Changes in genetic diversity of the Bordetella pertussis population in the United Kingdom between 1920 and 2006 reflect vaccination coverage and emergence of a single dominant clonal type. J Clin Microbiol 2009; 47:680-8. [PMID: 19158267 DOI: 10.1128/jcm.01838-08] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pertussis (whooping cough) is a potentially fatal respiratory disease caused by the bacterium Bordetella pertussis. Despite effective vaccination programs, there has been concern in some developed countries that pertussis cases are on the increase. We characterized 703 clinical B. pertussis isolates collected in the United Kingdom between 1920 and 2006 using multilocus variable-number tandem repeat analysis (MLVA), pertactin (prnA) and pertussis toxin (ptxA) genotyping, and serotyping. The results showed that the genetic diversity of the bacterial population decreased during periods of high vaccine coverage. However, it was elevated between 1977 and 1986, when vaccine coverage in the United Kingdom was low and epidemics occurred. A high proportion of MLVA types during this epidemic period were novel, and the prnA(2) and prnA(3) alleles were seen for the first time in the United Kingdom. MLVA-27 appeared in 1982, was codominant during the 1998-to-2001 period, and comprised approximately 70% of isolates during both the 2002-to-2004 and the 2005-to-2006 periods. The United Kingdom is dominated currently by an MLVA-27 prnA(2) ptxA(1) serotype Fim3 clonal type. Even during recent periods dominated by MLVA-27, many novel types were found at low frequencies, suggesting that either there are a large number of uncommon MLVA types circulating at low frequencies or new types are constantly arising. This supports a hypothesis that MLVA-27 is under some form of positive selection conferring increased survival in a highly vaccinated population. There has been no significant change to the bacterial population in the first 2 years since the United Kingdom switched from a whole-cell to an acellular vaccine.
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Heikkinen E, Xing DK, Olander RM, Hytönen J, Viljanen MK, Mertsola J, He Q. Bordetella pertussis isolates in Finland: serotype and fimbrial expression. BMC Microbiol 2008; 8:162. [PMID: 18816412 PMCID: PMC2562373 DOI: 10.1186/1471-2180-8-162] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Accepted: 09/25/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bordetella pertussis causes whooping cough or pertussis in humans. It produces several virulence factors, of which the fimbriae are considered adhesins and elicit immune responses in the host. B. pertussis has three distinct serotypes Fim2, Fim3 or Fim2,3. Generally, B. pertussis Fim2 strains predominate in unvaccinated populations, whereas Fim3 strains are often isolated in vaccinated populations. In Finland, pertussis vaccination was introduced in 1952. The whole-cell vaccine contained two strains, 18530 (Fim3) since 1962 and strain 1772 (Fim2,3) added in 1976. After that the vaccine has remained the same until 2005 when the whole-cell vaccine was replaced by the acellular vaccine containing pertussis toxin and filamentous hemagglutinin. Our aims were to study serotypes of Finnish B. pertussis isolates from 1974 to 2006 in a population with > 90% vaccination coverage and fimbrial expression of the isolates during infection. Serotyping was done by agglutination and serotype-specific antibody responses were determined by blocking ELISA. RESULTS Altogether, 1,109 isolates were serotyped. Before 1976, serotype distributions of Fim2, Fim3 and Fim2,3 were 67%, 19% and 10%, respectively. From 1976 to 1998, 94% of the isolates were Fim2 serotype. Since 1999, the frequency of Fim3 strains started to increase and reached 83% during a nationwide epidemic in 2003. A significant increase in level of serum IgG antibodies against purified fimbriae was observed between paired sera of 37 patients. The patients infected by Fim3 strains had antibodies which blocked the binding of monoclonal antibodies to Fim3 but not to Fim2. Moreover, about one third of the Fim2 strain infected patients developed antibodies capable of blocking of binding of both anti-Fim2 and Fim3 monoclonal antibodies. CONCLUSION Despite extensive vaccinations in Finland, B. pertussis Fim2 strains were the most common serotype. Emergence of Fim3 strains started in 1999 and coincided with nationwide epidemics. Results of serotype-specific antibody responses suggest that Fim2 strains could express Fim3 during infection, showing a difference in fimbrial expression between in vivo and in vitro.
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Affiliation(s)
- Eriikka Heikkinen
- Pertussis Reference Laboratory, National Public Health Institute, Kiinamyllynkatu 13, 20520 Turku, Finland.
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King AJ, van Gorkom T, Pennings JLA, van der Heide HGJ, He Q, Diavatopoulos D, Heuvelman K, van Gent M, van Leeuwen K, Mooi FR. Comparative genomic profiling of Dutch clinical Bordetella pertussis isolates using DNA microarrays: identification of genes absent from epidemic strains. BMC Genomics 2008; 9:311. [PMID: 18590534 PMCID: PMC2481270 DOI: 10.1186/1471-2164-9-311] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Accepted: 06/30/2008] [Indexed: 11/23/2022] Open
Abstract
Background Whooping cough caused by Bordetella pertussis in humans, is re-emerging in many countries despite vaccination. Several studies have shown that significant shifts have occurred in the B. pertussis population resulting in antigenic divergence between vaccine strains and circulating strains and suggesting pathogen adaptation. In the Netherlands, the resurgence of pertussis is associated with the rise of B. pertussis strains with an altered promoter region for pertussis toxin (ptxP3). Results We used Multi-Locus Sequence Typing (MLST), Multiple-Locus Variable Number of Tandem Repeat Analysis (MLVA) and microarray-based comparative genomic hybridization (CGH) to characterize the ptxP3 strains associated with the Dutch epidemic. For CGH analysis, we developed an oligonucleotide (70-mers) microarray consisting of 3,581 oligonucleotides representing 94% of the gene repertoire of the B. pertussis strain Tohama I. Nine different MLST profiles and 38 different MLVA types were found in the period 1993 to 2004. Forty-three Dutch clinical isolates were analyzed with CGH, 98 genes were found to be absent in at least one of the B. pertussis strains tested, these genes were clustered in 8 distinct regions of difference. Conclusion The presented MLST, MLVA and CGH-analysis identified distinctive characteristics of ptxP3 B. pertussis strains -the most prominent of which was a genomic deletion removing about 23,000 bp. We propose a model for the emergence of ptxP3 strains.
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Affiliation(s)
- Audrey J King
- Laboratory for Infectious Diseases and Screening Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
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Han HJ, Kamachi K, Okada K, Toyoizumi-Ajisaka H, Sasaki Y, Arakawa Y. Antigenic variation in Bordetella pertussis isolates recovered from adults and children in Japan. Vaccine 2008; 26:1530-4. [PMID: 18291563 DOI: 10.1016/j.vaccine.2008.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Revised: 12/26/2007] [Accepted: 01/11/2008] [Indexed: 10/22/2022]
Abstract
Recently, the incidence of reported pertussis cases of adults has dramatically increased in Japan. In the present study, we analyzed seven Bordetella pertussis isolates recovered from adults in Japan using pulsed-field gel electrophoresis (PFGE) and sequencing of their antigenic and virulence-associated proteins, compared with those from children. PFGE analysis demonstrated that the adult strains were closely related to the child strains (78-100% genetic similarity). On the other hand, the genotyping revealed that 71% (5/7) of the adult strains and 47% (25/53) of the child strains had the same combination of antigenic/virulence-associated allelic variants (ptxS1B/prn1/fim2-1/fim3A/fhaB1/tcfA2) as the Japanese vaccine strain Tohama, respectively. In comparison to the child strains, there was no apparent antigenic and genetic shift in the adult strains. Our result suggests that (i) there is no B. pertussis circulating strain specific to adults and (ii) the antigenic/virulence-associated proteins are unrelated to the rise in adult pertussis incidence in Japan.
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Affiliation(s)
- Hyun-Ja Han
- Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashimurayama, Tokyo, Japan
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