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Guo S, Zhu Y, Guo Q, Wan C. Severe pertussis in infants: a scoping review. Ann Med 2024; 56:2352606. [PMID: 38728617 PMCID: PMC11089926 DOI: 10.1080/07853890.2024.2352606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Pertussis (Whooping Cough) is a respiratory infection caused by Bordetella pertussis. Pertussis usually occurs in childhood; severe infections are most common in infants. It can be fatal with severe complications such as pulmonary hypertension, heart failure, and encephalitis. OBJECTIVES We sought to synthesize the existing literature on severe pertussis in infants and inform further study. METHODS A scoping review was performed based on the methodological framework developed by Arksey & O'Malley. Search in Pubmed and Embase databases, with no restrictions on the language and date of publication. RESULTS Of the 1299 articles retrieved, 64 were finally included. The selected articles were published between 1979 and 2022, with 90.6% (58/64) of the studies in the last two decades. The studies covered epidemiology, pathology, clinical characteristics, risk factors, treatments, and burden of disease. CONCLUSION The literature reviewed suggests that studies on severe pertussis in infants covered a variety of clinical concerns. However, these studies were observational, and experimental studies are needed to provide high-quality evidence.
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Affiliation(s)
- Shuai Guo
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- National Health Commission Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
| | - Yu Zhu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- National Health Commission Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
| | - Qin Guo
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- National Health Commission Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
| | - Chaomin Wan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- National Health Commission Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
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Li J, Liu L, Zhang H, Guo J, Wei X, Xue M, Ma X. Severe problem of macrolides resistance to common pathogens in China. Front Cell Infect Microbiol 2023; 13:1181633. [PMID: 37637457 PMCID: PMC10448830 DOI: 10.3389/fcimb.2023.1181633] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/18/2023] [Indexed: 08/29/2023] Open
Abstract
With the widespread use of macrolide antibiotics in China, common pathogens causing children's infections, such as Streptococcus pneumoniae, Streptococcus (including Group A streptococcus, Group B streptococcus), Staphylococcus aureus, Bordetella pertussis, and Mycoplasma pneumoniae, have shown varying degrees of drug resistance. In order to provide such problem and related evidence for rational use of antibiotics in clinic, we reviewed the drug resistance of common bacteria to macrolides in children recent 20 years.
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Affiliation(s)
- Jialin Li
- Department of Respiratory Disease, Children's Hospital Affiliated to Shandong University, Jinan, Shandong, China
- Jinan Key Laboratory of Pediatric Respiratory Diseases, Jinan Children’s Hospital, Jinan, China
| | - Lesen Liu
- Surgical Department, Huaiyin People’s Hospital, Jinan, China
| | - Hua Zhang
- Department of Respiratory Disease, Children's Hospital Affiliated to Shandong University, Jinan, Shandong, China
- Jinan Key Laboratory of Pediatric Respiratory Diseases, Jinan Children’s Hospital, Jinan, China
| | - Jing Guo
- Department of Respiratory Disease, Children's Hospital Affiliated to Shandong University, Jinan, Shandong, China
- Jinan Key Laboratory of Pediatric Respiratory Diseases, Jinan Children’s Hospital, Jinan, China
| | - Xiaoling Wei
- Department of Respiratory Disease, Children's Hospital Affiliated to Shandong University, Jinan, Shandong, China
- Jinan Key Laboratory of Pediatric Respiratory Diseases, Jinan Children’s Hospital, Jinan, China
| | - Min Xue
- Department of Respiratory Disease, Children's Hospital Affiliated to Shandong University, Jinan, Shandong, China
- Jinan Key Laboratory of Pediatric Respiratory Diseases, Jinan Children’s Hospital, Jinan, China
| | - Xiang Ma
- Department of Respiratory Disease, Children's Hospital Affiliated to Shandong University, Jinan, Shandong, China
- Jinan Key Laboratory of Pediatric Respiratory Diseases, Jinan Children’s Hospital, Jinan, China
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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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Gunning CE, Rohani P, Mwananyanda L, Kwenda G, Mupila Z, Gill CJ. Young Zambian infants with symptomatic RSV and pertussis infections are frequently prescribed inappropriate antibiotics: a retrospective analysis. PeerJ 2023; 11:e15175. [PMID: 37193027 PMCID: PMC10183159 DOI: 10.7717/peerj.15175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 03/13/2023] [Indexed: 05/18/2023] Open
Abstract
Pediatric community-acquired pneumonia (CAP) remains a pressing global health concern, particularly in low-resource settings where diagnosis and treatment rely on empiric, symptoms-based guidelines such as the WHO's Integrated Management of Childhood Illness (IMCI). This study details the delivery of IMCI-based health care to 1,320 young infants and their mothers in a low-resource urban community in Lusaka, Zambia during 2015. Our Southern Africa Mother Infant Pertussis Study (SAMIPS) prospectively monitored a cohort of mother/infant pairs across infants' first four months of life, recording symptoms of respiratory infection and antibiotics prescriptions (predominantly penicillins), and tested nasopharyngeal (NP) samples for respiratory syncytial virus (RSV) and Bordetella pertussis. Our retrospective analysis of the SAMIPS cohort found that symptoms and antibiotics use were more common in infants (43% and 15.7%) than in mothers (16.6% and 8%), while RSV and B. pertussis were observed at similar rates in infants (2.7% and 32.5%) and mothers (2% and 35.5%), albeit frequently at very low levels. In infants, we observed strong associations between symptoms, pathogen detection, and antibiotics use. Critically, we demonstrate that non-macrolide antibiotics were commonly prescribed for pertussis infections, some of which persisted across many weeks. We speculate that improved diagnostic specificity and/or clinician education paired with timely, appropriate treatment of pertussis could substantially reduce the burden of this disease while reducing the off-target use of penicillins.
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Affiliation(s)
- Christian E. Gunning
- Odum School of Ecology, University of Georgia, Athens, GA, United States of America
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, GA, United States of America
- Center for the Ecology of Infectious Diseases; Department of Infectious Diseases, University of Georgia, Athens, GA, United States of America
- Department of Infectious Diseases, University of Georgia, Athens, GA, United States of America
| | - Lawrence Mwananyanda
- School of Public Health, Department of Global Health, Boston University, Boston, MA, United States of America
- Right to Care Zambia, Lusaka, Zambia
| | - Geoffrey Kwenda
- School of Health Sciences, Department of Biomedical Science, University of Zambia, Lusaka, Zambia
| | | | - Christopher J. Gill
- School of Public Health, Department of Global Health, Boston University, Boston, MA, United States of America
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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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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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Complete Genome Sequence of a Macrolide-Resistant Bordetella pertussis Isolated in Japan. Microbiol Resour Announc 2022; 11:e0071822. [PMID: 36129277 PMCID: PMC9584335 DOI: 10.1128/mra.00718-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We report the complete genome sequence of macrolide-resistant Bordetella pertussis BP616, which was first isolated in 2018 in Japan. The BP616 genome can serve as a valuable specific reference for genomic and epidemiological studies of this resistant bacterium.
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Fong W, Timms V, Sim E, Pey K, Nguyen T, Sintchenko V. Genomic and transcriptomic variation in Bordetella spp. following induction of erythromycin resistance. J Antimicrob Chemother 2022; 77:3016-3025. [PMID: 35971665 PMCID: PMC9616548 DOI: 10.1093/jac/dkac272] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background The emergence of macrolide resistance in Bordetella pertussis, the causative agent of pertussis, due to mutations in the 23S rRNA gene has been recently recognized. However, resistance mechanisms to macrolides in Bordetella parapertussis and Bordetella holmesii remain unknown. Objectives This study investigated genomic changes induced by in vitro exposure to erythromycin in these three main pathogens responsible for pertussis-like disease. Methods A set of 10 clinical and reference strains of B. pertussis, B. parapertussis and B. holmesii was exposed to erythromycin for 15 weeks or 30 subculture passages. Antibiotic pressure was achieved by growth on the selective media with erythromycin Etest strips or impregnated discs. Genome polymorphisms and transcriptomic profiles were examined by short- and long-read sequencing of passaged isolates. Results B. parapertussis and B. holmesii isolates developed significant in vitro resistance to erythromycin (MIC >256 mg/L) within 2 to 7 weeks and at 5 to 12 weeks, respectively. B. pertussis remained phenotypically susceptible to the antibiotic following 15 weeks of exposure, with the MIC between 0.032 to 0.38 mg/L. Genomic analysis revealed that B. holmesii developed resistance due to mutations in the 23S rRNA gene. The resistance mechanism in B. parapertussis was hypothesized as being due to upregulation of an efflux pump mechanism. Conclusions These findings indicate that both B. holmesii and B. parapertussis can be more prone to induced resistance following exposure to treatment with erythromycin than B. pertussis. The surveillance of macrolide resistance in Bordetella isolates recovered from patients with pertussis, especially persistent disease, is warranted.
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Affiliation(s)
- Winkie Fong
- Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, New South Wales, Australia
| | - Verlaine Timms
- Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, New South Wales, Australia.,Neilan Laboratory of Microbial and Molecular Diversity, College of Engineering, Science and Environment, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Eby Sim
- Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, New South Wales, Australia.,Microbial Genomics Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead, New South Wales, Australia
| | - Keenan Pey
- Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, New South Wales, Australia.,Sydney Institute of Infectious Diseases, The University of Sydney, Camperdown, New South Wales, Australia
| | - Trang Nguyen
- Microbial Genomics Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead, New South Wales, Australia
| | - Vitali Sintchenko
- Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, New South Wales, Australia.,Microbial Genomics Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead, New South Wales, Australia.,Sydney Institute of Infectious Diseases, The University of Sydney, Camperdown, New South Wales, Australia
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9
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Wu X, Du Q, Li D, Yuan L, Meng Q, Fu Z, Xu H, Yao K, Zhao R. A Cross-Sectional Study Revealing the Emergence of Erythromycin-Resistant Bordetella pertussis Carrying ptxP3 Alleles in China. Front Microbiol 2022; 13:901617. [PMID: 35923401 PMCID: PMC9342848 DOI: 10.3389/fmicb.2022.901617] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous limited studies have identified that Bordetella pertussis (B. pertussis) isolates circulating in China possess distinct molecular features and high rates of erythromycin-resistance (ER). Their evolution and potential impact on the prevention and control of global pertussis are worthy of attention. Methods The present cross-sectional study involved 311 non-duplicate and unrelated B. pertussis strains isolated from Chinese children from 2017 to 2019. Their antimicrobial susceptibilities were assessed using both E-test strips and Kirby-Bauer (KB) disk diffusion methods. Seven virulence-related genes (ptxA, ptxC, ptxP, prn, fim2, fim3, and tcfA2) and the A2047G mutation in the 23S rRNA gene were detected by PCR. Based on the susceptibilities and genotypes, 50 isolates were selected for multi-locus variable-number tandem-repeat analysis (MLVA) typing and whole-genome sequencing. Results A total of 311 B. pertussis strains were isolated from children with a median age of 4 months (interquartile range: 2–9 months). Strains carrying the ptxP1 allele were more frequent (84.9%, 264/311), were always ER (except for one strain), and were mainly related to ptxA1/ptxC1/prn1 alleles (99.6%, 263/264). The remaining 47 (15.1%) strains carried the ptxP3 allele, mainly harboring the ptxA1/ptxC2/prn2 alleles (93.6%, 44/47), and were sensitive to erythromycin (except for two strains). The two ER-ptxP3 isolates were first identified in China, belonged to MT27 and MT28 according to MLVA, and were classified into sub-lineage IVd by phylogenetic analysis of their genome sequences. This sub-lineage also includes many strains carrying the ptxP3 allele spreading in developed countries. For each tested antimicrobial, the susceptibilities judged by KB disks were consistent with those determined by E-test strips. Conclusion The present results reveal that B. pertussis strains with the ptxP1-ER profile still dominate in China, and a few strains carrying the ptxP3 allele have acquired the A2047G mutation in the 23S rRNA gene and the ER phenotype. The surveillance of the drug susceptibility of B. pertussis is necessary for all countries, and the KB disk method can be adopted as a screening test.
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Affiliation(s)
- Xiaoying Wu
- Department of Infectious Diseases, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, China
| | - Qianqian Du
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Dongfang Li
- BGI Pathogenesis Pharmaceutical Technology, BGI-Shenzhen, Shenzhen, China
| | - Lin Yuan
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Qinghong Meng
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Zhou Fu
- Department of Respiratory Diseases, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hongmei Xu
- Department of Infectious Diseases, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, China
| | - Kaihu Yao
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
- *Correspondence: Kaihu Yao,
| | - Ruiqiu Zhao
- Department of Infectious Diseases, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, China
- Ruiqiu Zhao,
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Thuy Nga DT, Thi Bich Thuy P, Ainai A, Takayama I, Huong DT, Saitoh A, Nakagawa S, Minh Dien T, Nakajima N, Saitoh A. Association Between Real-time Polymerase Chain Reaction Cycle Threshold Value and Clinical Severity in Neonates and Infants Infected With Bordetella pertussis. Pediatr Infect Dis J 2022; 41:388-393. [PMID: 35093999 DOI: 10.1097/inf.0000000000003471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Polymerase chain reaction (PCR) is highly sensitive and is thus the standard method for diagnosing pertussis. Real-time PCR is widely used because of its accuracy and the simplicity of the simultaneous cycle threshold (Ct) value, which represents the copy numbers of the target gene. Little is known of the association of Ct value with pertussis severity in neonates and infants. METHODS This study determined Ct values in neonates and infants diagnosed with pertussis by real-time PCR using nasopharyngeal samples at Vietnam National Children's Hospital in Hanoi in 2017 and 2019. The association of disease severity and clinical parameters were analyzed using univariate and multivariate analyses. RESULTS We evaluated 108 patients with pertussis [median age: 63 days, interquartile range (IQR): 41-92 days]. Only 6/108 (6%) received at least 1 dose of a pertussis-containing vaccine. Among them, 24 (22.2%) had severe disease requiring care in a pediatric intensive care unit, 16 (13.8%) required mechanical ventilation, and 3 (2.6%) died. The median Ct value was lower in patients with severe disease (19.0, IQR: 16.5-22.0, n = 24) than in those without severe disease (25.5, IQR: 20.0-30.0, n = 84) (P = 0.002). Logistic regression analyses demonstrated that PCR Ct value [odds ratio (OR): 1.783, 95% confidence interval (CI): 1.013-3.138, P = 0.045], age (OR: 3.118, 95% CI: 1.643-5.920, P = 0.001), and white blood cell counts (OR: 0.446, 95% CI: 0.261-0.763, P = 0.003) remained significantly associated with severe disease. CONCLUSIONS Real-time PCR Ct values for pertussis might be useful as a predictor of severe disease in neonates and infants.
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Affiliation(s)
- Do Thi Thuy Nga
- From the Division of General Internal Medicine, The Center for Tropical Diseases, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Phung Thi Bich Thuy
- Department of Molecular Biology for Infectious Disease, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Akira Ainai
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ikuyo Takayama
- Center for Influenza and Respiratory Virus Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Do Thu Huong
- Department of Molecular Biology for Infectious Disease, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Aya Saitoh
- Department of Nursing, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Satoshi Nakagawa
- Division of Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Tran Minh Dien
- Surgical Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Noriko Nakajima
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Akihiko Saitoh
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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11
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Wakimoto Y, Otsuka N, Yanagawa Y, Koide K, Kamachi K, Shibayama K, Teruya K, Kikuchi Y, Oka S. The First Reported Case of Bordetella pertussis Bacteremia in a Patient With Human Immunodeficiency Virus Infection. Open Forum Infect Dis 2022; 9:ofac020. [PMID: 35146052 PMCID: PMC8825563 DOI: 10.1093/ofid/ofac020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/11/2022] [Indexed: 11/25/2022] Open
Abstract
We describe a case of bacteremia in a human immunodeficiency virus–infected patient caused by a Bordetella pertussis strain lacking 2 major virulence factors, filamentous hemagglutinin and fimbriae. Although B pertussis bacteremia is uncommon, physicians should be aware that even attenuated B pertussis strains can cause invasive infection in immunocompromised patients. Bordetella pertussis is a gram-negative coccobacillus that causes a severe paroxysmal coughing disease known as whooping cough or pertussis. Bordetella pertussis colonizes the epithelial cells of the human respiratory tract, and the organisms are typically isolated from nasopharynx. We describe a case of B pertussis bacteremia in a patient with human immunodeficiency virus (HIV) infection. Interestingly, the isolate recovered from blood culture did not produce the major virulence factors, filamentous hemagglutinin (FHA) and fimbriae (FIM). Previously, 3 cases of B pertussis bacteremia were reported in the literature. We discuss the features of B pertussis bacteremia.
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Affiliation(s)
- Yuji Wakimoto
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nao Otsuka
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yasuaki Yanagawa
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kentaro Koide
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunari Kamachi
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Katsuji Teruya
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshimi Kikuchi
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
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12
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Fry NK, Campbell H, Amirthalingam G. JMM Profile: Bordetella pertussis and whooping cough (pertussis): still a significant cause of infant morbidity and mortality, but vaccine-preventable. J Med Microbiol 2021; 70. [PMID: 34668853 PMCID: PMC8604168 DOI: 10.1099/jmm.0.001442] [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: 12/26/2022] Open
Abstract
Whooping cough (pertussis) is a highly contagious respiratory bacterial infection caused by Bordetella pertussis and is an important cause of morbidity and mortality worldwide, particularly in infants. Bordetella parapertussis can cause a similar, but usually less severe pertussis-like disease. Bordetella pertussis has a number of virulence factors including adhesins and toxins which allow the organism to bind to ciliated epithelial cells in the upper respiratory tract and interfere with host clearance mechanisms. Typical symptoms of pertussis include paroxysmal cough with characteristic whoop and vomiting. Severe complications and deaths occur mostly in infants. Laboratory confirmation can be performed by isolation, detection of genomic DNA or specific antibodies. Childhood vaccination is safe, effective and remains the best control method available. Many countries have replaced whole-cell pertussis vaccines (wP) with acellular pertussis vaccines (aP). Waning protection following immunisation with aP is considered to be more rapid than that from wP. Deployed by resource-rich countries to date, maternal immunisation programmes have also demonstrated high efficacy in preventing hospitalisation and death in infants by passive immunisation through transplacental transfer of maternal antibodies.
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Affiliation(s)
- Norman K Fry
- Immunisation and Countermeasures Division, Public Health England - National Infection Service, London, UK.,Vaccine Preventable Bacteria Section, Public Health England - National Infection Service, London, UK
| | - Helen Campbell
- Immunisation and Countermeasures Division, Public Health England - National Infection Service, London, UK
| | - Gayatri Amirthalingam
- Immunisation and Countermeasures Division, Public Health England - National Infection Service, London, UK
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13
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Walkowski W, Bassett J, Bhalla M, Pfeifer BA, Ghanem ENB. Intranasal Vaccine Delivery Technology for Respiratory Tract Disease Application with a Special Emphasis on Pneumococcal Disease. Vaccines (Basel) 2021; 9:vaccines9060589. [PMID: 34199398 PMCID: PMC8230341 DOI: 10.3390/vaccines9060589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/17/2021] [Accepted: 05/22/2021] [Indexed: 12/17/2022] Open
Abstract
This mini-review will cover recent trends in intranasal (IN) vaccine delivery as it relates to applications for respiratory tract diseases. The logic and rationale for IN vaccine delivery will be compared to methods and applications accompanying this particular administration route. In addition, we will focus extended discussion on the potential role of IN vaccination in the context of respiratory tract diseases, with a special emphasis on pneumococcal disease. Here, elements of this disease, including its prevalence and impact upon the elderly population, will be viewed from the standpoint of improving health outcomes through vaccine design and delivery technology and how IN administration can play a role in such efforts.
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Affiliation(s)
- William Walkowski
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA; (W.W.); (J.B.); (B.A.P.)
| | - Justin Bassett
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA; (W.W.); (J.B.); (B.A.P.)
| | - Manmeet Bhalla
- Department of Microbiology and Immunology, University at Buffalo, The State University of New York, Buffalo, NY 14203, USA;
| | - Blaine A. Pfeifer
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA; (W.W.); (J.B.); (B.A.P.)
| | - Elsa N. Bou Ghanem
- Department of Microbiology and Immunology, University at Buffalo, The State University of New York, Buffalo, NY 14203, USA;
- Correspondence:
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14
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Liu D, Du Q, Yuan L, Wang Q, Shi W, Meng Q, Yu D, Yao K. Retrospective analysis of bacterial culture-confirmed pertussis cases in Beijing Children's hospital from 2014 to 2019 reveals prevention and control of the grim situation in mainland China. Expert Rev Vaccines 2021; 20:577-583. [PMID: 33691571 DOI: 10.1080/14760584.2021.1899822] [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: 10/21/2022]
Abstract
BACKGROUND Our study aims to explore the epidemiological features of children with bacterial culture-confirmed pertussis visiting Beijing Children's Hospital, China. METHODS From 2014 through 2019, patients with suspected pertussis coming from mainland China provided nasopharyngeal swabs and bacterial culture that was subsequently cultivated. RESULTS During the study period, 6956 children with suspected pertussis from 30 different administrative provinces of mainland China were investigated, of which 1494 cases (21.5%) had positive B. pertussis culture. The number of pertussis cases increased year-on-year, from 122 in 2014 to 279 in 2019. Of the confirmed cases, 38.2% and 26.8% were identified in the summer and autumn, respectively. The age distribution of children with pertussis showed that 77.2% were <12 months old, including 56.0% <6 months old. Only thirteen B. parapertussis isolates and one B. bronchiseptica isolates were collected in the present samples. CONCLUSIONS The present culture-confirmed cases reveal the severe epidemic situation of pertussis spreading over the whole country and mainly affecting the infants. It is necessary to set up hospital-based surveillance with reliable laboratory methods to promote clinical awareness and to monitor the disease.
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Affiliation(s)
- Dandan Liu
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Qianqian Du
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Lin Yuan
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Qing Wang
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Wei Shi
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Qinghong Meng
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Dan Yu
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Kaihu Yao
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University) National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
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15
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Cimolai N. Pharmacotherapy for Bordetella pertussis infection. I. A synthesis of laboratory sciences. Int J Antimicrob Agents 2020; 57:106258. [PMID: 33310116 DOI: 10.1016/j.ijantimicag.2020.106258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 11/09/2020] [Accepted: 11/28/2020] [Indexed: 11/15/2022]
Abstract
There is considerable history and practice experience both with laboratory susceptibility testing for Bordetella pertussis and clinical treatment. This two-part narrative review provides a synthesis of the laboratory and clinical sciences as they apply to this bacterium and the clinical consequences of treating infection. It is generally held that antibiotic susceptibility testing for B. pertussis is not sufficiently standardised, but there has not been an urgent need to consolidate the same given the lack global experience with major resistance profiles. Experience in China, however, has provided concern for high-level macrolide resistance. The nature of and frequency of such resistance has raised the bar for reconsideration of susceptibility testing given that first-line treatment may be regionally compromised. Disk diffusion and Etest susceptibility testing can be recommended for screening resistance among individual isolates of B. pertussis and on an ad hoc manner. Disk diffusion, Etest and/or critical agar dilution testing can be recommended for large-scale studies. Standards for inoculum, growth atmosphere, timing of interpretation, preferred testing media and controls can be extrapolated from the publications to date. Such methods should be able to detect high-level resistance to several antibiotics, but especially macrolides. Concern for intermediate-susceptible categories requires consideration as well as the correlation with bacteriological and clinical outcomes. Provisional standards can be applied at this time, and modification or fine-tuning of any such standards are open to future investigation.
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Affiliation(s)
- Nevio Cimolai
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Vancouver, British Columbia, V6H3V4 Canada.
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