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[Antimicrobial susceptibility and antigen genotypes of Bordetella pertussis strains isolated from neonates]

Li-Jun Li1, Ying Liu, Ju Jia

  • 1National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/National Clinical Research Center for Respiratory Diseases/Key Laboratory of Major Diseases in Children, Ministry of Education/Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing 100045, China. jiuhu2655@sina.com.

Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics
|March 26, 2019
PubMed
Abstract

Insights

Neonatal pertussis strains show high resistance to macrolides. Sulfamethoxazole-trimethoprim (SMZ) offers a reliable alternative treatment for these drug-resistant Bordetella pertussis infections.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Neonatal pertussis poses a significant health risk.
  • Increasing antimicrobial resistance in Bordetella pertussis complicates treatment.
  • Understanding resistance mechanisms and identifying alternative drugs is crucial.

Purpose of the Study:

  • To evaluate alternative antimicrobial drugs for treating neonatal pertussis.
  • To determine the antigen genotypes of Bordetella pertussis strains causing neonatal infections.

Main Methods:

  • Minimal inhibitory concentrations (MICs) of 18 antimicrobials were tested against 32 Bordetella pertussis strains.
  • 23S rRNA gene sequencing identified mutations associated with erythromycin resistance.
  • Seven key antigen genotypes (ptxA, ptxC, ptxP, prn, fim2, fim3, tcfA2) were analyzed.

Main Results:

  • 78% of strains were resistant to macrolides (erythromycin, azithromycin, etc.) with A2047G mutation in 23S rRNA gene.
  • All strains remained susceptible to sulfamethoxazole-trimethoprim (SMZ) with low MICs.
  • Macrolide-resistant strains exhibited a specific antigen genotype profile (ptxA1/ptxC1/ptxP1/prn1/fim2-1/fim3-1/tcfA2).

Conclusions:

  • Neonatal Bordetella pertussis frequently exhibits macrolide resistance.
  • Sulfonamides (SMZ) show promise as an effective off-label treatment for macrolide-resistant pertussis in neonates.
  • The rise of drug-resistant strains highlights the critical need for robust immunoprophylaxis strategies.

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