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Evolution of Bordetella pertussis in the acellular vaccine era in Norway, 1996 to 2019. Eur J Clin Microbiol Infect Dis 2022; 41:913-924. [PMID: 35543837 PMCID: PMC9135841 DOI: 10.1007/s10096-022-04453-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/28/2022] [Indexed: 01/16/2023]
Abstract
We described the population structure of Bordetella pertussis (B. pertussis) in Norway from 1996 to 2019 and determined if there were evolutionary shifts and whether these correlated with changes in the childhood immunization program. We selected 180 B. pertussis isolates, 22 from the whole cell vaccine (WCV) era (1996–1997) and 158 from the acellular vaccine (ACV) era (1998–2019). We conducted whole genome sequencing and determined the distribution and frequency of allelic variants and temporal changes of ACV genes. Norwegian B. pertussis isolates were evenly distributed across a phylogenetic tree that included global strains. We identified seven different allelic profiles of ACV genes (A–F), in which profiles A1, A2, and B dominated (89%), all having pertussis toxin (ptxA) allele 1, pertussis toxin promoter (ptxP) allele 3, and pertactin (prn) allele 2 present. Isolates with ptxP1 and prn1 were not detected after 2007, whereas the prn2 allele likely emerged prior to 1972, and ptxP3 before the early 1980s. Allele conversions of ACV genes all occurred prior to the introduction of ACV. Sixteen percent of our isolates showed mutations within the prn gene. ACV and its booster doses (implemented for children in 2007 and adolescents in 2013) might have contributed to evolvement of a more uniform B. pertussis population, with recent circulating strains having ptxA1, ptxP3, and prn2 present, and an increasing number of prn mutations. These strains clearly deviate from ACV strains (ptxA1, ptxP1, prn1), and this could have implications for vaccine efficiency and, therefore, prevention and control of pertussis.
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Gabutti G, Cetin I, Conversano M, Costantino C, Durando P, Giuffrida S. Experts' Opinion for Improving Pertussis Vaccination Rates in Adolescents and Adults: A Call to Action. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074412. [PMID: 35410091 PMCID: PMC8998413 DOI: 10.3390/ijerph19074412] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 12/25/2022]
Abstract
This article highlights the importance of diphtheria-tetanus-acellular pertussis (with reduced antigen content, dTap) vaccination in preventing pertussis, a respiratory infection that is still widespread and easily transmitted. In particular, it highlights the need to receive a booster vaccination throughout life to maintain high antibody levels, which decrease through time. This document collects the opinions that emerged from the comparison between major Italian experts in the field of vaccination. This working group was created to promote a "call to action", aimed at raising awareness among all institutions, public health authorities, and health workers involved in the vaccination process, about the importance of dTap vaccine administration and with the mindset of implementing the strategic vaccination plan provided by the National Vaccine Plan (NVP). In fact, despite this vaccine being included in the NVP, there are some issues attributable to the practice of vaccination (local health authorities, vaccination centers, occupational health services, gynecology centers, societies of work). Therefore, it is necessary that the Ministry defines the vaccination coverage objectives, identifies the groups of subjects who should receive the booster vaccine (subjects exposed to greater risk of infection, subjects over 60, pregnant women), and applies all the necessary measures to encourage the implementation of this practice.
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Affiliation(s)
- Giovanni Gabutti
- Department of Medical Sciences, Section of Public Health Medicine, University of Ferrara, 44121 Ferrara, Italy
- Correspondence: ; Tel.: +39-34-7888-9342
| | - Irene Cetin
- Obstetrics and Gynecology, Department “Woman, Mother and Child”—ASST Fatebenefratelli Sacco, Buzzi Children’ Hospital, University of Milan, 20157 Milan, Italy;
| | | | - Claudio Costantino
- Department of Health Promotion, Maternal and Child Care, Internal Medicine and Excellence Specialties, University of Palermo, 90133 Palermo, Italy;
| | - Paolo Durando
- Occupational Medicine, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy;
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Sandro Giuffrida
- Department of Prevention, Azienda Sanitaria Provinciale of Reggio Calabria, 89124 Reggio Calabria, Italy;
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Cimolai N. Pharmacotherapy for Bordetella pertussis infection. I. A synthesis of laboratory sciences. Int J Antimicrob Agents 2020; 57:106258. [PMID: 33310116 DOI: 10.1016/j.ijantimicag.2020.106258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 11/09/2020] [Accepted: 11/28/2020] [Indexed: 11/15/2022]
Abstract
There is considerable history and practice experience both with laboratory susceptibility testing for Bordetella pertussis and clinical treatment. This two-part narrative review provides a synthesis of the laboratory and clinical sciences as they apply to this bacterium and the clinical consequences of treating infection. It is generally held that antibiotic susceptibility testing for B. pertussis is not sufficiently standardised, but there has not been an urgent need to consolidate the same given the lack global experience with major resistance profiles. Experience in China, however, has provided concern for high-level macrolide resistance. The nature of and frequency of such resistance has raised the bar for reconsideration of susceptibility testing given that first-line treatment may be regionally compromised. Disk diffusion and Etest susceptibility testing can be recommended for screening resistance among individual isolates of B. pertussis and on an ad hoc manner. Disk diffusion, Etest and/or critical agar dilution testing can be recommended for large-scale studies. Standards for inoculum, growth atmosphere, timing of interpretation, preferred testing media and controls can be extrapolated from the publications to date. Such methods should be able to detect high-level resistance to several antibiotics, but especially macrolides. Concern for intermediate-susceptible categories requires consideration as well as the correlation with bacteriological and clinical outcomes. Provisional standards can be applied at this time, and modification or fine-tuning of any such standards are open to future investigation.
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Affiliation(s)
- Nevio Cimolai
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Vancouver, British Columbia, V6H3V4 Canada.
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Guillot S, Mizrahi A, Armatys N, Chat L, Le Monnier A, Brisse S, Toubiana J. Low Detection Rate of Bordetella pertussis Using the BioFire FilmArray Respiratory Panel 2 plus. Open Forum Infect Dis 2020; 7:ofaa267. [PMID: 32793765 PMCID: PMC7415305 DOI: 10.1093/ofid/ofaa267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/26/2020] [Indexed: 11/13/2022] Open
Abstract
Syndromic respiratory panels are increasingly used worldwide. Their performance for detection of Bordetella pertussis needs to be evaluated. We found that the FilmArray Respiratory Panel 2plus (RP2+) assay, which uses the pertussis toxin promoter target for B. pertussis, can only detect highly charged samples. Negative RP2+ results should not be interpreted as an absence of B. pertussis in clinical samples.
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Affiliation(s)
- Sophie Guillot
- Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur, Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, Institut Pasteur, Paris, France
| | - Assaf Mizrahi
- Clinical Microbiology Laboratory, Saint Joseph Hospital, Paris, France.,Institut Micalis, UMR1319, Université Paris-Saclay, INRAe, AgroParisTech, Bactéries Pathogènes et Santé, Chatenay-Malabry, France
| | - Nathalie Armatys
- Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur, Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, Institut Pasteur, Paris, France
| | - Laureen Chat
- Clinical Microbiology Laboratory, Saint Joseph Hospital, Paris, France
| | - Alban Le Monnier
- Clinical Microbiology Laboratory, Saint Joseph Hospital, Paris, France.,Institut Micalis, UMR1319, Université Paris-Saclay, INRAe, AgroParisTech, Bactéries Pathogènes et Santé, Chatenay-Malabry, France
| | - Sylvain Brisse
- Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur, Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, Institut Pasteur, Paris, France
| | - Julie Toubiana
- Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur, Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, Institut Pasteur, Paris, France.,General Paediatrics and Paediatric Infectious Diseases Department, Hôpital Necker-Enfants Malades, APHP, Université de Paris, Paris, France
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Gestal MC, Johnson HM, Harvill ET. Immunomodulation as a Novel Strategy for Prevention and Treatment of Bordetella spp. Infections. Front Immunol 2019; 10:2869. [PMID: 31921136 PMCID: PMC6923730 DOI: 10.3389/fimmu.2019.02869] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/22/2019] [Indexed: 12/13/2022] Open
Abstract
Well-adapted pathogens have evolved to survive the many challenges of a robust immune response. Defending against all host antimicrobials simultaneously would be exceedingly difficult, if not impossible, so many co-evolved organisms utilize immunomodulatory tools to subvert, distract, and/or evade the host immune response. Bordetella spp. present many examples of the diversity of immunomodulators and an exceptional experimental system in which to study them. Recent advances in this experimental system suggest strategies for interventions that tweak immunity to disrupt bacterial immunomodulation, engaging more effective host immunity to better prevent and treat infections. Here we review advances in the understanding of respiratory pathogens, with special focus on Bordetella spp., and prospects for the use of immune-stimulatory interventions in the prevention and treatment of infection.
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Affiliation(s)
- Monica C Gestal
- Department of Infectious Diseases, College of Veterinary Sciences, University of Georgia, Athens, GA, United States
| | - Hannah M Johnson
- Department of Infectious Diseases, College of Veterinary Sciences, University of Georgia, Athens, GA, United States
| | - Eric T Harvill
- Department of Infectious Diseases, College of Veterinary Sciences, University of Georgia, Athens, GA, United States
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Brosio F, Kuhdari P, Cocchio S, Stefanati A, Baldo V, Gabutti G. Impact of Pertussis on the Italian population: Analysis of hospital discharge records in the period 2001-2014. Int J Infect Dis 2019; 91:143-148. [PMID: 31678191 DOI: 10.1016/j.ijid.2019.10.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/19/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The study aimed to analyze and update the impact of pertussis on the Italian population by evaluating pertussis-related hospital admissions in the period 2001-2014. DESIGN OR METHODS Hospital Discharge Records (HDR) were provided by the National Archive of HDR data of the Ministry of Health. Only hospitalizations included in the primary diagnosis were evaluated. Significant trends over the considered years were assessed as average annual percent changes (AAPC) applying the Joinpoint model. RESULTS A total of 7,102 hospital admissions for pertussis (main diagnosis) were registered; the trend of hospitalizations progressively decreased from >1/100,000 inhabitants in the years 2001-2004 to 0.64/100,000 inhabitants in 2014. A great part of hospitalizations (63.6%) involved subjects <1 year of life; almost 20% of cases were registered in the age class 5-14 years. The Joinpoint analysis showed a statistically significant variation in some age classes. CONCLUSIONS Even if this study shows a decreasing trend in the number of pertussis-related hospitalizations, the impact of the disease in Italy in terms of hospital admissions continues to be relevant, especially in the <1 year age class. Pertussis therefore continues to be, in Italy as well as in other European countries, an important public health issue.
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Affiliation(s)
- Federica Brosio
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64b, 44121 Ferrara, Italy.
| | - Parvanè Kuhdari
- Azienda USL of Ferrara, Via A. Cassoli 30, 44121 Ferrara, Italy.
| | - Silvia Cocchio
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Via Loredan 18, 35100 Padua, Italy.
| | - Armando Stefanati
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64b, 44121 Ferrara, Italy.
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Via Loredan 18, 35100 Padua, Italy.
| | - Giovanni Gabutti
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64b, 44121 Ferrara, Italy.
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