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

Emerg Infect Dis. 2019 Dec;25(12):2205-2214. doi: 10.3201/eid2512.181836.

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.

Keywords: Bordetella pertussis; China; antibiotic sensitivity; antimicrobial resistance; antimicrobial sensitivity; bacteria; macrolide resistance; ptxP1; virulence-related genotype.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bordetella pertussis / drug effects*
  • Bordetella pertussis / genetics*
  • Child
  • Child, Preschool
  • China / epidemiology
  • Drug Resistance, Bacterial*
  • Female
  • Genotype*
  • Geography, Medical
  • History, 21st Century
  • Humans
  • Infant
  • Infant, Newborn
  • Macrolides / pharmacology*
  • Male
  • Multilocus Sequence Typing
  • Mutation
  • Pertussis Vaccine / administration & dosage
  • Prevalence
  • Public Health Surveillance
  • RNA, Ribosomal, 23S
  • Virulence
  • Whooping Cough / epidemiology*
  • Whooping Cough / history
  • Whooping Cough / microbiology*
  • Whooping Cough / prevention & control

Substances

  • Anti-Bacterial Agents
  • Macrolides
  • Pertussis Vaccine
  • RNA, Ribosomal, 23S