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Molecular Evolution and Increasing Macrolide Resistance of Bordetella pertussis, Shanghai, China, 2016-2022
Abstract:
Resurgence and spread of macrolide-resistant Bordetella pertussis (MRBP) threaten global public health. We collected 283 B. pertussis isolates during 2016-2022 in Shanghai, China, and conducted 23S rRNA gene A2047G mutation detection, multilocus variable-number tandem-repeat analysis, and virulence genotyping analysis. We performed whole-genome sequencing on representative strains. We detected pertussis primarily in infants (0-1 years of age) before 2020 and older children (>5-10 years of age) after 2020. The major genotypes were ptxP1/prn1/fhaB3/ptxA1/ptxC1/fim2-1/fim3-1 (48.7%) and ptxP3/prn2/fhaB1/ptxA1/ptxC2/fim2-1/fim3-1 (47.7%). MRBP increased remarkably from 2016 (36.4%) to 2022 (97.2%). All MRBPs before 2020 harbored ptxP1, and 51.4% belonged to multilocus variable-number tandem-repeat analysis type (MT) 195, whereas ptxP3-MRBP increased from 0% before 2020 to 66.7% after 2020, and all belonged to MT28. MT28 ptxP3-MRBP emerged only after 2020 and replaced the resident MT195 ptxP1-MRBP, revealing that 2020 was a watershed in the transformation of MRBP.
Insights
Macrolide-resistant Bordetella pertussis (MRBP) is spreading globally. A study in Shanghai found that MRBP dramatically increased from 2016 to 2022, with a significant genetic shift occurring around 2020.
Area of Science:
- Microbiology
- Genetics
- Epidemiology
Background:
- Macrolide-resistant Bordetella pertussis (MRBP) poses a significant global public health threat.
- Pertussis outbreaks have been observed in various age groups, necessitating ongoing surveillance.
Purpose of the Study:
- To investigate the genetic characteristics and epidemiological trends of Bordetella pertussis isolates in Shanghai.
- To identify the emergence and spread of macrolide resistance in Bordetella pertussis.
Main Methods:
- Collection and analysis of 283 Bordetella pertussis isolates from 2016-2022.
- Detection of 23S rRNA gene A2047G mutation for macrolide resistance.
- Multilocus variable-number tandem-repeat analysis (MLVA) and virulence genotyping.
- Whole-genome sequencing of representative strains.
Main Results:
- Pertussis cases shifted from infants to older children after 2020.
- Macrolide resistance in Bordetella pertussis increased significantly from 36.4% in 2016 to 97.2% in 2022.
- A genetic shift was observed around 2020, with ptxP3-MRBP strains belonging to MLVA type 28 replacing ptxP1-MRBP strains of MLVA type 195.
Conclusions:
- The year 2020 marked a critical turning point in the evolution of macrolide-resistant Bordetella pertussis in Shanghai.
- The emergence of specific genotypes (ptxP3/MT28) is driving the recent spread of MRBP.
- Continuous genomic and epidemiological surveillance is crucial for controlling pertussis resurgence.
