Isolation of High Level Macrolide Resistant Bordetella Pertussis Without Transition Mutation at Domain V in Iran

Mirzaei, Bahman; Bameri, Zakaria; Babaei, Ryhane; Shahcheraghi, Fereshteh

doi:10.5812/jjm.8(5)2015.18190

Cited by 7 publications

(9 citation statements)

References 14 publications

(27 reference statements)

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“…The possible reason to explain this could be that antigens in the vaccine strain used in Iran are different from the circulating pertussis strains in the community. Interestingly, studies by Shahcheraghi et al show that 48% of B. pertussis strains isolated from Iranian patients had allelic differences in ptxP3, ptxA1, prn2, fim 2-1, fim3-2, and cya2 antigens [25,26]. In conclusion, we believe that the prevalence of the disease in children under one year of age can be due to inadequate or incomplete vaccination in this age group.…”

Section: Discussionmentioning

confidence: 61%

Seroepidemiology of pertussis in a set of under one year old Iranian children

Badamchi

Siadat

Shahcheraghi

2019

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Introduction: Pertussis or whooping cough is one of the vaccine preventable diseases. The purpose of this study was to evaluate the seroepidemiology of pertussis in two groups of children (i.e. under 2 months and 2-12 months old) who had been admitted to Tehran Children Hospital. Methods: Sampling from the children was done along with completing a questionnaire including demographic information, clinical symptoms and the history of the parents coughing. The levels of IgG-Ptx antibody were then measured using the children's sera. Results: Overall, 10.8% of the children were not immune, 78.3% were immune, and 10.9% had recent pertussis infections. Moreover, 19.4% of the female and 13.1% of the male subjects had the infection. In the age group less than two months, 16.6% were infected. The likelihood of new infection among the children less than 2 months old was 1.2 times higher than the control group (P < 0.004). Fifty percent of the children who were diagnosed with cyanosis in their clinical examinations had a recent infection (P <0.001). Conclusion: Pertussis appears to be endemic in Iran with children under one year old being at high risk of the infection. In this regard, maternal vaccination against pertussis for conferring passive immunity to the newborns could be considered as a protection measure.

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Section: Discussionmentioning

confidence: 61%

Seroepidemiology of pertussis in a set of under one year old Iranian children

Badamchi

Siadat

Shahcheraghi

2019

vacres

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“…Seven virulence-related genes ( ptxA , ptxC , ptxP , prn , fim2 , fim3 , and tcfA2 ) and the 23S rRNA gene of B. pertussis were amplified and sequenced following procedures published previously ( Yang et al, 2015 ; Mooi et al, 2000 ). The mutation A2047G in domain V of the 23S rRNA gene was responsible for ER ( Bartkus et al, 2003 ; Guillot et al, 2012 ; Mirzaei et al, 2015 ; Xu et al, 2019 ), and genotypes were determined as described previously ( Li et al, 2019 ).…”

Section: Methodsmentioning

confidence: 99%

“…One study collecting 256 isolates from nine European countries between 2012 and 2015 showed that the alleles ptxA1 , ptxP3 , and prn2 account for 100, 95.5, and 96.2%, respectively, whereas 24.9% (66/265) of isolates exhibit prn deficiency ( Barkoff et al, 2018 ). Although the macrolides have been the first-choice antibiotics to treat pertussis for more than 50 years worldwide, a few countries other than China (e.g., the United States, France, and Iran) have reported occasional erythromycin-resistant (ER) strains that do not exhibit epidemic trends ( Bartkus et al, 2003 ; Guillot et al, 2012 ; Mirzaei et al, 2015 ). However, previous studies revealed the unique molecular characteristics and common ER phenotype of circulating B. pertussis strains in China ( Fu et al, 2019 ; Li et al, 2019 ; Xu et al, 2019 ; Zhang et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

A Cross-Sectional Study Revealing the Emergence of Erythromycin-Resistant Bordetella pertussis Carrying ptxP3 Alleles in China

et al. 2022

Front. Microbiol.

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BackgroundPrevious 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.MethodsThe 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.ResultsA 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.ConclusionThe 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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“…There have only been two reports (Iran and China) where the A2047G SNP has not been the mechanism behind the macrolide resistance in B. pertussis [ 22 , 43 ]. However, these two studies did not perform erm gene or mexAB-oprM operon identification, and the reason for the resistance remains unknown.…”

Section: Mechanisms Behind Macrolide Resistance In B Pertussismentioning

confidence: 99%

Macrolide Resistance in Bordetella pertussis: Current Situation and Future Challenges

et al. 2022

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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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Isolation of High Level Macrolide Resistant Bordetella Pertussis Without Transition Mutation at Domain V in Iran

Cited by 7 publications

References 14 publications

Seroepidemiology of pertussis in a set of under one year old Iranian children

Seroepidemiology of pertussis in a set of under one year old Iranian children

A Cross-Sectional Study Revealing the Emergence of Erythromycin-Resistant Bordetella pertussis Carrying ptxP3 Alleles in China

Macrolide Resistance in Bordetella pertussis: Current Situation and Future Challenges

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