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Fu P, Zhou J, Yang C, Nijiati Y, Zhou L, Yan G, Lu G, Zhai X, Wang C. Molecular Evolution and Increasing Macrolide Resistance of Bordetella pertussis, Shanghai, China, 2016-2022. Emerg Infect Dis 2023; 30:29-38. [PMID: 38146984 PMCID: PMC10756392 DOI: 10.3201/eid3001.221588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Resurgence and spread of macrolide-resistant Bordetella pertussis (MRBP) threaten global public health. We collected 283 B. pertussis isolates during 2016-2022 in Shanghai, China, and conducted 23S rRNA gene A2047G mutation detection, multilocus variable-number tandem-repeat analysis, and virulence genotyping analysis. We performed whole-genome sequencing on representative strains. We detected pertussis primarily in infants (0-1 years of age) before 2020 and older children (>5-10 years of age) after 2020. The major genotypes were ptxP1/prn1/fhaB3/ptxA1/ptxC1/fim2-1/fim3-1 (48.7%) and ptxP3/prn2/fhaB1/ptxA1/ptxC2/fim2-1/fim3-1 (47.7%). MRBP increased remarkably from 2016 (36.4%) to 2022 (97.2%). All MRBPs before 2020 harbored ptxP1, and 51.4% belonged to multilocus variable-number tandem-repeat analysis type (MT) 195, whereas ptxP3-MRBP increased from 0% before 2020 to 66.7% after 2020, and all belonged to MT28. MT28 ptxP3-MRBP emerged only after 2020 and replaced the resident MT195 ptxP1-MRBP, revealing that 2020 was a watershed in the transformation of MRBP.
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Affiliation(s)
| | | | - Chao Yang
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Yaxier Nijiati
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Lijun Zhou
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Gangfen Yan
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Guoping Lu
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Xiaowen Zhai
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Chuanqing Wang
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
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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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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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Zhang J, Lin C, Chang L, Wang X, Wei X, Li H. Genotypes of Bordetella pertussis isolated from infants in Xi'an and Shanghai. Zhejiang Da Xue Xue Bao Yi Xue Ban 2022; 51:47-52. [PMID: 35462464 PMCID: PMC9109763 DOI: 10.3724/zdxbyxb-2021-0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare the genotypes of Bordetella pertussis isolated from infants in Xi'an and Shanghai. METHODS Samples were collected by nasopharyngeal swab from infants aged <1 year hospitalized with suspected pertussis in Xi'an and Shanghai during 2018 and 2019. Bordetella pertussis was isolated, and multilocus antigen sequence typing (MAST) and multilocus variable-number tandem repeat analysis (MLVA) were used to analyse the genotypes. RESULTS A total of 1200 samples were collected from infants suspected of pertussis and 60 strains of Bordetella pertussis were isolated, including 34 strains in Xi'an and 26 strains in Shanghai. There were significant differences in the MAST types between Xi'an and Shanghai ( χ 2=18.642, P<0.01); the prn1/ ptxP1/ ptxA1/ fim3-1/ fim2-1 strains dominated in Xi'an (32/34, 94.12%), while the dominated MAST types in Shanghai were prn1/ ptxP1/ ptxA1/ fim3-1/ fim2-1 (13/26, 50.00%) and prn2/ ptxP3/ ptxA1/ fim3-1/ fim2-1 (11/26, 42.31%). The composition of MLVA type of pertussis strains was also significantly different between Xi'an and Shanghai ( χ 2=15.866, P<0.01); the MT195 (13/34, 38.24%), MT55 (10/34, 29.41%) and MT104 (9/34, 26.47%) strains dominated in Xi'an, while the MT27 (12/26, 46.15%) strain was most common in Shanghai. CONCLUSION There are differences in molecular types of Bordetella pertussis isolated from infants with suspected persussis in Xi'an and Shanghai, indicating that further monitoring of Bordetella pertussis is necessary for better understanding the pathogen evolution in China.
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Affiliation(s)
- Juansheng Zhang
- 1. Xi'an Center for Disease Control and Prevention, Xi'an 710054, China
| | - Chen Lin
- 2. Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China
| | - Ling Chang
- 1. Xi'an Center for Disease Control and Prevention, Xi'an 710054, China
| | - Xiaoqiang Wang
- 1. Xi'an Center for Disease Control and Prevention, Xi'an 710054, China
| | - Xiaoguang Wei
- 1. Xi'an Center for Disease Control and Prevention, Xi'an 710054, China
| | - Hao Li
- 1. Xi'an Center for Disease Control and Prevention, Xi'an 710054, China
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