Clinical Manifestations and Molecular Characterization of Pertactin-Deficient and Pertactin-Producing<i>Bordetella pertussis</i>in Children, Philadelphia 2007–2014

Vodzak, Jennifer; Queenan, Anne Marie; Souder, Emily; Evangelista, Alan T.; Long, Sarah S.

doi:10.1093/cid/ciw632

Cited by 14 publications

(4 citation statements)

References 35 publications

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“…The highest incidence of pertussis has been observed in infants < 1 year of age since the 1990s, with second increase in incidence in adolescents [ 2 ]. Based on original descriptions of pertussis, the paroxysmal coughing fits, which may last for weeks or months, were considered so typical of pertussis that they were deemed sufficient for diagnosis [ 3 ]. However, more recently, pneumonia has been reported as a common complication of pertussis, particularly with younger patients [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors and prediction model of severe pertussis in infants < 12 months of age in Tianjin, China

et al. 2022

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Background To identify risk factors associated with the prognosis of pertussis in infants (< 12 months). Methods A retrospective study on infants hospitalized with pertussis January 2017 to June 2019. The infants were divided into two groups according to the severity of disease: severe pertussis and non-severe pertussis groups. We collected all case data from medical records including socio-demographics, clinical manifestations, and auxiliary examinations. Univariate analysis and Logistic regression were used. Results Finally, a total of 84 infants with severe pertussis and 586 infants with non-severe pertussis were admitted. The data of 75% of the cases (severe pertussis group, n = 63; non-severe pertussis group, n = 189) were randomly selected for univariate and multivariate logistic regression analysis. The results showed rural area [P = 0.002, OR = 6.831, 95% CI (2.013–23.175)], hospital stay (days) [P = 0.002, OR = 1.304, 95% CI (1.107–1.536)], fever [P = 0.040, OR = 2.965, 95% CI (1.050–8.375)], cyanosis [P = 0.008, OR = 3.799, 95% CI (1.419–10.174)], pulmonary rales [P = 0.021, OR = 4.022, 95% CI (1.228–13.168)], breathing heavily [P = 0.001, OR = 58.811, 95% CI (5.503–628.507)] and abnormal liver function [P < 0.001, OR = 9.164, 95% CI (2.840–29.565)] were independent risk factors, and higher birth weight [P = 0.006, OR = 0.380, 95% CI (0.191–0.755)] was protective factor for severe pertussis in infants. The sensitivity and specificity of logistic regression model for remaining 25% data of severe group and common group were 76.2% and 81.0%, respectively, and the consistency rate was 79.8%. Conclusions The findings indicated risk factor prediction models may be useful for the early identification of severe pertussis in infants.

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Section: Introductionmentioning

confidence: 99%

Risk factors and prediction model of severe pertussis in infants < 12 months of age in Tianjin, China

et al. 2022

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“…PRN(−) B.pertussis strains were shown to be almost as pathogenic as those producing PRN in animal models contrary to PT(−) isolates [ 21 , 41 , 42 ] despite a higher fitness than PRN(+) isolates. They were also shown to be almost as pathogenic in infants [ 34 , 48 , 49 ]. It has been hypothesized that the increase of the prevalence of PRN(−) isolates might decrease the aPV efficacy [ 45 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Can vaccines control bacterial virulence and pathogenicity? Bordetella pertussis: the advantage of fitness over virulence

Guiso

Soubeyrand²,

Macina

2022

Evolution, Medicine, and Public Health

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Some vaccines, such as diphtheria toxoid and acellular pertussis vaccines (aPVs), may favor the emergence of less pathogenic strains of the respective bacteria they target. This review discusses the impact of the wide use of aPV on Bordetella pertussis phenotype evolutions and their beneficial consequences in the light of the diphtheria toxoid immunization program experience and structuring evidence review in a causal analysis following Bradford Hill’s causality criteria. All aPVs contain the pertussis toxin (PT), the main virulence factor of B. pertussis, alone or with one adhesin (Filamentous hemagglutinin (FHA)), two adhesins (FHA and pertactin (PRN)) or four adhesins (FHA, PRN and two fimbriae (Fim 2/3)). In countries where the coverage of aPVs containing PRN is high, PRN negative B. pertussis isolates are increasing in prevalence, but isolates non-producing the other antigens are rarely reported. We hypothesize that the selective pressure at play with PRN should exist against all aVP antigens, although detection biases may hinder its detection for other antigens, especially PT. PT being responsible for clinically frank cases of the disease, the opportunity to collect PT negative isolates is far lower than to collect PRN negative isolates which have a limited clinical impact. The replacement of current B. pertussis by far less pathogenic isolates no longer producing the factors contained in aPVs should be expected as a consequence of the wide aPV use. LAY SUMMARY Reviewing the existing evidence, we hypothesize that acellular whooping cough vaccines induced selective pressure on the bacteria causing whooping cough. To survive the bacteria must stop the production of virulence factors targeted by the vaccine that should decrease the severity of the disease and jeopardise the detection of the bacteria.

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“…Despite the enhanced proinflammatory moDC activation by Prn-deficient strains, they do not appear to induce enhanced disease compared to the Prn-expressing strains [ 40 ]. Yet, whether the enhanced immune activation by these strains is beneficial for bacterial survival in vivo remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

Naturally circulating pertactin-deficient Bordetella pertussis strains induce distinct gene expression and inflammatory signatures in human dendritic cells

Kroes

Miranda-Bedate

Hovingh

et al. 2021

Emerging Microbes & Infections

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Respiratory infections caused by Bordetella pertussis are reemerging despite high pertussis vaccination coverage. Since the introduction of the acellular pertussis vaccine in the late twentieth century, circulating B. pertussis strains increasingly lack expression of the vaccine component pertactin (Prn). In some countries, up to 90% of the circulating B. pertussis strains are deficient in Prn. To better understand the resurgence of pertussis, we investigated the response of human monocyte-derived dendritic cells (moDCs) to naturally circulating Prn-expressing (Prn-Pos) and Prn-deficient (Prn-Neg) B. pertussis strains from 2016 in the Netherlands. Transcriptome analysis of moDC showed enriched IFNα response-associated gene expression after exposure to Prn-Pos B. pertussis strains, whereas the Prn-Neg strains induced enriched expression of interleukin- and TNF-signaling genes, as well as other genes involved in immune activation. Multiplex immune assays confirmed enhanced proinflammatory cytokine secretion by Prn-Neg stimulated moDC. Comparison of the proteomes from the Prn-Pos and Prn-Neg strains revealed, next to the difference in Prn, differential expression of a number of other proteins including several proteins involved in metabolic processes. Our findings indicate that Prn-deficient B. pertussis strains induce a distinct and stronger immune activation of moDCs than the Prn-Pos strains. These findings highlight the role of pathogen adaptation in the resurgence of pertussis as well as the effects that vaccine pressure can have on a bacterial population.

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Clinical Manifestations and Molecular Characterization of Pertactin-Deficient and Pertactin-ProducingBordetella pertussisin Children, Philadelphia 2007–2014

Cited by 14 publications

References 35 publications

Risk factors and prediction model of severe pertussis in infants < 12 months of age in Tianjin, China

Risk factors and prediction model of severe pertussis in infants < 12 months of age in Tianjin, China

Can vaccines control bacterial virulence and pathogenicity? Bordetella pertussis: the advantage of fitness over virulence

Naturally circulating pertactin-deficient Bordetella pertussis strains induce distinct gene expression and inflammatory signatures in human dendritic cells

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