High Prevalence of Macrolide-Resistant Bordetella pertussis and ptxP1 Genotype, Mainland China, 2014–2016

Abstract

According to the government of China, reported cases of pertussis have increased remarkably and are still increasing. To determine the genetic relatedness of Bordetella pertussis strains, we compared multilocus variable-number tandem-repeat analysis (MLVA) results for isolates from China with those from Western countries. Among 335 isolates from China, the most common virulence-associated genotype was ptxA1/ptxC1/ptxP1/prn1/fim2–1/fim3A/tcfA2, which was more frequent among isolates from northern than southern China. Isolates of this genotype were highly resistant to erythromycin. We identified 36 ptxP3 strains mainly harboring ptxA1 and prn2 (35/36); ptxP3 strains were sensitive to erythromycin and were less frequently from northern China. For all isolates, the sulfamethoxazole/trimethoprim MIC was low, indicating that this drug should be recommended for patients infected with erythromycin-resistant B. pertussis. MLVA of 150 clinical isolates identified 13 MLVA types, including 3 predominant types. Our results show that isolates circulating in China differ from those in Western countries.

Development and Standardization of a High-Throughput Bordetella pertussis Growth-Inhibition Assay

“…While antibiotic-resistant B. pertussis strains were rare in the past, resistance to the drugs routinely used to treat pertussis has emerged in recent decades. The first erythromycin-resistant strains were isolated in the United States (Lewis et al, 1995;Korgenski and Daly, 1997) in the 1990s and outbreaks of macrolide-resistant strains were reported with increased frequency in China (Wang et al, 2014;Yang et al, 2015;Liu et al, 2018;Li et al, 2019). A few erythromycin-resistant strains were also isolated in Iran (Shahcheraghi et al, 2014) and France (Guillot et al, 2012).…”

“…Substantial vaccine pressure has led to genetic remodeling of strains circulating since the introduction of aPV, particularly of the pertactin gene (Bart et al, 2014). In addition, the emergence of macrolides-resistant strains in China (Wang et al, 2014;Liu et al, 2018;Li et al, 2019) has raised new concerns for transmission and resurgence of pertussis.…”

The First Report of Macrolide-Resistant <i>Bordetella pertussis</i> Isolation in Japan

“…However, the clinical outcome is actually unknown. From the result of the E-test, trimethoprim/sulfamethoxazole was also thought to be effective for the treatment of the infection with macrolide-resistant B. pertussis as previously reported (7).…”

Macrolide-Resistant Bordetella pertussis, Vietnam, 2016−2017

“…Genotyping assays revealed that MRBP strains in Vietnam were closely related to an MRBP strain identified in China. The major MLVA types reported recently in China are MT55, MT104, and MT195 (8,9). These types are closely related; they have only 1 difference at 1 VNTR locus.…”

“…Of the 10 MRBP DNA samples, 9 yielded a complete profile of virulence-associated allelic genes, 8 were ptxP1/ ptxA1/prn1/fim3A, and 1 was ptxP1/ptxA1/prn1/fim3B (Table). The allelic profile ptxP1/ptxA1/prn1 is common in MRBP strains prevalent in China (8). In addition, 9 of the MRBP DNA samples exhibited the C5330T mutation in fhaB3, which is frequently observed in MRBP in China (9) (Appendix Table).…”