Pertactin-deficient Bordetella pertussis isolates: evidence of increased circulation in Europe, 1998 to 2015

Alex-Mikael Barkoff1, Jussi Mertsola2, Denis Pierard3

  • 1Institute of Biomedicine, Department of Microbiology, Virology and Immunology, University of Turku, Turku, Finland.

Insights

Pertussis outbreaks are linked to pertactin (PRN)-deficient Bordetella pertussis strains. Longer use of acellular pertussis vaccines (ACVs) containing PRN correlates with a higher frequency of these deficient strains in Europe.

Area of Science:

  • Microbiology
  • Vaccinology
  • Epidemiology

Background:

  • Pertussis outbreaks have been observed in industrialized nations utilizing acellular pertussis vaccines (ACVs).
  • A high prevalence of pertactin (PRN)-deficient Bordetella pertussis isolates has been noted in these countries, raising concerns about vaccine effectiveness and bacterial evolution.

Purpose of the Study:

  • To investigate the increasing proportion of PRN-deficient Bordetella pertussis strains in Europe over time.
  • To determine if the frequency of PRN-deficient strains correlates with the duration of acellular pertussis vaccine (ACV) use in different countries.
  • To assess the prevalence of isolates deficient in other vaccine components, such as pertussis toxin (PT), filamentous hemagglutinin (FHA), or fimbriae (Fim).

Main Methods:

  • Analysis of Bordetella pertussis clinical isolates collected across Europe during four study periods (1998-2015).
  • Quantification of pertactin (PRN)-deficient strains using ELISA to assess PRN, PT, FHA, and Fim2/Fim3 expression.
  • Correlation analysis between the frequency of PRN-deficient strains and the time since the introduction of acellular pertussis vaccines (ACVs) containing PRN.

Main Results:

  • The proportion of PRN-deficient Bordetella pertussis isolates significantly increased from 1.0% in 1998-2001 to 24.9% in 2012-2015.
  • Countries with longer histories of using acellular pertussis vaccines (ACVs) containing PRN exhibited higher frequencies of PRN-deficient strains.
  • No pertussis toxin (PT)- or filamentous hemagglutinin (FHA)-deficient isolates were detected; only one fimbriae (Fim)-deficient isolate was found.

Conclusions:

  • The findings suggest an evolutionary adaptation of Bordetella pertussis, leading to an increased circulation of PRN-deficient strains.
  • The duration of acellular pertussis vaccine (ACV) use, particularly those containing pertactin (PRN), appears to be a driving factor in the selection of PRN-deficient isolates.
  • Further research is needed to understand the implications of PRN-deficient strains on pertussis vaccine efficacy and public health strategies.

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