Widespread<i>Bordetella parapertussis</i>Infections—Wisconsin, 2011–2012: Clinical and Epidemiologic Features and Antibiotic Use for Treatment and Prevention

Koepke, Ruth; Bartholomew, Michael L.; Eickhoff, Jens; Ayele, Roman; Rodd, Diane; Kuennen, Joan; Rosekrans, Jean; Warshauer, David M.; Conway, James H.; Davis, Jeffrey P.

doi:10.1093/cid/civ514

Cited by 25 publications

(24 citation statements)

References 27 publications

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“…Regarding Bordetella parapertusiss, in many clinical laboratories due to the high prevalence of pertussis in order to better exploit the species responsible of pertussis disease, it is suggested to investigate at the same time RT-PCR assays by using IS481 for BP and IS 1001 specific of Bordetella parapertussis. These double check methods could represent an appropriate procedure in order to estimate the prevalence of Bordetella pertussis/ parapertussis infections, and to determinate their epidemiologic characteristics in infants [32].…”

Section: Discussionmentioning

confidence: 99%

Pertussis in infants: an underestimated disease

et al. 2016

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BackgroundThe clinical diagnosis of pertussis is not easy in early infancy since clinical manifestations can overlap with several different diseases. Many cases are often misclassified and underdiagnosed. We conducted a retrospective study on infants to assess how often physicians suspected pertussis and the actual frequency of Bordetella pertussis infections.MethodsWe analyzed all infants with age ≤90 days hospitalized from March 2011 until September 2013 for acute respiratory symptoms tested with a Real Time Polymerase Chain Reaction able to detect Bordetella pertussis and with a Real Time Polymerase Chain Reaction for a multipanel respiratory virus. Therefore, we compared patients with pertussis positive aspirate, patients with respiratory virus positive aspirate and patients with negative aspirate to identify symptoms or clinical findings predictive of pertussis.ResultsOut of 215 patients analyzed, 53 were positive for pertussis (24.7 %), 119 were positive for respiratory virus (55.3 %) and 43 had a negative aspirate (20 %). Pertussis was suspected in 22 patients at admission and 16 of them were confirmed by laboratory tests, while 37 infants with different admission diagnosis resulted positive for pertussis. The sensitivity of clinical diagnosis was 30.2 % and the specificity 96.3 %. Infants with pertussis had more often paroxysmal cough, absence of fever and a higher absolute lymphocyte count than infants without pertussis.ConclusionsPertussis is a serious disease in infants and it is often unrecognized; some features should help pediatricians to suspect pertussis, but clinical suspicion has a low sensitivity. We suggest a systematic use of Real Time Polymerase Chain Reaction to support the clinical suspicion of pertussis in patients with less than 3 months of age hospitalized with acute respiratory symptoms.

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Section: Discussionmentioning

confidence: 99%

Pertussis in infants: an underestimated disease

et al. 2016

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“…holmesii and B. parapertussis cause similar cough illnesses in humans that, while generally regarded as less severe, can be clinically indistinguishable from B. pertussis infection and meet the pertussis clinical case definition (17)(18)(19)(20)(21)(22)(23)(24). Cocirculation and coinfection have been reported with no discernible difference in symptomology between etiologies (23)(24)(25)(26)(27)(28). It is unclear whether increased detection of B. holmesii or B. parapertussis respiratory infection results from recent genetic changes or, rather, heightened awareness and improved diagnostics (24,29,30).…”

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confidence: 99%

“…Cocirculation and coinfection have been reported with no discernible difference in symptomology between etiologies (23)(24)(25)(26)(27)(28). It is unclear whether increased detection of B. holmesii or B. parapertussis respiratory infection results from recent genetic changes or, rather, heightened awareness and improved diagnostics (24,29,30). Nonetheless, many diagnostic PCR assays cannot differentiate B. pertussis and B. holmesii, and retrospective testing of specimens sometimes reveals misdiagnosed cases of B. holmesii (26,27,(31)(32)(33).…”

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confidence: 99%

Conserved Patterns of Symmetric Inversion in the Genome Evolution of Bordetella Respiratory Pathogens

et al. 2019

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Whooping cough (pertussis), primarily caused by Bordetella pertussis, has resurged in the United States, and circulating strains exhibit considerable chromosome structural fluidity in the form of rearrangement and deletion. The genus Bordetella includes additional pathogenic species infecting various animals, some even causing pertussis-like respiratory disease in humans; however, investigation of their genome evolution has been limited. We studied chromosome structure in complete genome sequences from 167 Bordetella species isolates, as well as 469 B. pertussis isolates, to gain a generalized understanding of rearrangement patterns among these related pathogens. Observed changes in gene order primarily resulted from large inversions and were only detected in species with genomes harboring multicopy insertion sequence (IS) elements, most notably B. holmesii and B. parapertussis. While genomes of B. pertussis contain >240 copies of IS481, IS elements appear less numerous in other species and yield less chromosome structural diversity through rearrangement. These data were further used to predict all possible rearrangements between IS element copies present in Bordetella genomes, revealing that only a subset is observed among circulating strains. Therefore, while it appears that rearrangement occurs less frequently in other species than in B. pertussis, these clinically relevant respiratory pathogens likely experience similar mutation of gene order. The resulting chromosome structural fluidity presents both challenges and opportunity for the study of Bordetella respiratory pathogens. IMPORTANCE Bordetella pertussis is the primary agent of whooping cough (pertussis). The Bordetella genus includes additional pathogens of animals and humans, including some that cause pertussis-like respiratory illness. The chromosome of B. pertussis has previously been shown to exhibit considerable structural rearrangement, but insufficient data have prevented comparable investigation in related species. In this study, we analyze chromosome structure variation in several Bordetella species to gain a generalized understanding of rearrangement patterns in this genus. Just as in B. pertussis, we observed inversions in other species that likely result from common mutational processes. We used these data to further predict additional, unobserved inversions, suggesting that specific genome structures may be preferred in each species.

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“…Bordetella parapertussis is a species quite close to Bordetella pertussis that can infect humans causing similar symptoms to those of the respiratory disease referred to as pertussis. The detection of this pathogen in pertussis patients is relatively frequent in different countries of Europe ( 1 , 2 ) and also in the USA ( 3 – 5 ). In the latter country, the highest number of B. parapertussis infections was recorded in Wisconsin (at 443 cases) between October 2011 and December 2012 ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…The detection of this pathogen in pertussis patients is relatively frequent in different countries of Europe ( 1 , 2 ) and also in the USA ( 3 – 5 ). In the latter country, the highest number of B. parapertussis infections was recorded in Wisconsin (at 443 cases) between October 2011 and December 2012 ( 5 ). As had occurred previously, during such outbreaks 11.2% of the diagnostic specimens positive for Bordetella were also positive for B. parapertussis , probably indicating the endemnism of B. parapertussis .…”

Section: Introductionmentioning

confidence: 99%

Outer-Membrane-Vesicle–Associated O Antigen, a Crucial Component for Protecting Against Bordetella parapertussis Infection

et al. 2018

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Bordetella parapertussis is a respiratory-disease pathogen producing symptomatology similar to that of pertussis but of underestimated incidence and with no specific vaccine existing. We recently designed a vaccine candidate from B. parapertussis outer-membrane vesicles (OMVs) that proved to be safe and protective in a murine-infection model. Based on protection recently reported for the B. parapertussis O antigen in aqueous solution, we assessed here whether the B. parapertussis O-antigen-containing lipopolysaccharide (BppLPS-O+) embedded in the membranes, as present in B. parapertussis-derived OMVs (OMVs(Bpp-LPS-O+)), was the component responsible for that previously observed protection by OMVs. By performing a comparative study with OMVs from a human strain with undetectable O antigen (OMVs(Bpp-LPS-O−)), we demonstrated that the OMVs(Bpp-LPS-O+), but not the OMVs(Bpp-LPS-O−), protected mice against sublethal B. parapertussis infections. Indeed, the B. parapertussis loads were significantly reduced in the lungs of OMVs(Bpp-LPS-O+) -vaccinated animals, with the CFUs recovered being decreased by 4 log units below those detected in the non-immunized animals or in the animals treated with the OMVs(Bpp-LPS-O−), (p < 0.001). We detected that the OMVs(Bpp-LPS-O+) induced IgG antibodies against B. parapertussis whole-cell lysates, which immunocomponents recognized, among others, the O antigen and accordingly conferred protection against B. parapertussis infection, as observed in in-vivo–passive-transfer experiments. Of interest was that the OMVs(Bpp-LPS-O+) -generated sera had opsonophagocytic and bactericidal capabilities that were not detected with the OMVs(Bpp-LPS-O−)-induced sera, suggesting that those activities were involved in the clearance of B. parapertussis. Though stimulation of cultured spleen cells from immunized mice with formulations containing the O antigen resulted in gamma interferon (IFN-γ) and interleukin-17 production, spleen cells from OMVs(Bpp-LPS-O+) -immunized mice did not significantly contribute to the observed protection against B. parapertussis infection. The protective capability of the B. parapertussis O antigen was also detected in formulations containing both the OMVs derived from B. pertussis and purified BppLPS-O+. This combined formulation protected mice against B. pertussis along with B. parapertussis.

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WidespreadBordetella parapertussisInfections—Wisconsin, 2011–2012: Clinical and Epidemiologic Features and Antibiotic Use for Treatment and Prevention

Cited by 25 publications

References 27 publications

Pertussis in infants: an underestimated disease

Pertussis in infants: an underestimated disease

Conserved Patterns of Symmetric Inversion in the Genome Evolution of Bordetella Respiratory Pathogens

Outer-Membrane-Vesicle–Associated O Antigen, a Crucial Component for Protecting Against Bordetella parapertussis Infection

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