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Macrolide-resistant Bordetella pertussis strain identified during an ongoing epidemic, Finland, January to October

Milja Miettinen1,2,3, Alex-Mikael Barkoff1,3, Aino Nyqvist4

  • 1Finnish Reference Laboratory for Diphtheria and Pertussis, Institute of Biomedicine, University of Turku, Turku, Finland.

Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin
|December 6, 2024
PubMed

Insights

Finland is experiencing a pertussis epidemic, with a concerning rise in cases among adolescents. A macrolide-resistant Bordetella pertussis strain has been identified, highlighting the need for rapid detection and surveillance.

Area of Science:

  • Microbiology
  • Epidemiology
  • Public Health

Background:

  • A pertussis epidemic has been ongoing in Finland since April 2024, with a significant number of cases reported.
  • Adolescents aged 10-14 years represent a substantial proportion of the affected population.

Purpose of the Study:

  • To report the emergence of macrolide-resistant *Bordetella pertussis* during the ongoing pertussis epidemic in Finland.
  • To characterize the genetic and phenotypic features of the identified resistant strain.

Main Methods:

  • Surveillance of pertussis cases in Finland from April to October 2024.
  • Isolation and characterization of *Bordetella pertussis* from clinical samples.
  • Macrolide resistance testing using minimum inhibitory concentration (MIC) assays.
  • Serotyping and genotypic analysis (including *ptxP* allele and pertactin deficiency) of isolates.

Main Results:

  • A total of 2,215 pertussis cases were notified by the end of October 2024.
  • 30.1% of cases were in the 10-14 years age group.
  • One out of 462 *Bordetella pertussis* isolates exhibited macrolide resistance (MIC > 256 μg/mL for erythromycin, azithromycin, and clarithromycin).
  • The resistant isolate was identified as serotype FIM2, was pertactin-deficient, and harbored the *ptxP3* allele.

Conclusions:

  • The identification of a macrolide-resistant *Bordetella pertussis* strain in Europe is a significant public health concern.
  • Rapid identification and surveillance of macrolide-resistant strains are crucial for effective pertussis control and treatment strategies.
Keywords:
Bordetella pertussismacrolide resistancepertactin expressionpertussispost-COVID-19 resurgencewhooping cough

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