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Analysis of Macrolide Resistance in Bordetella pertussis Isolated from Japanese Children in 2025 Using Test Kit and

Tomohiro Oishi1, Takashi Nakano2

  • 1Department of Clinical Infectious Diseases, Kawasaki Medical School, 577, Matsushima, Kurashiki 701-0192, Okayama, Japan.

Biomedicines
|January 28, 2026
PubMed

Insights

Pertussis (whooping cough) is resurging in Japan post-pandemic, with most Bordetella pertussis isolates showing macrolide resistance. This highlights the urgent need for ongoing surveillance of pertussis and antibiotic resistance.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genetics

Background:

  • Pertussis, caused by Bordetella pertussis, is a significant respiratory illness.
  • Vaccine coverage has not prevented a post-COVID-19 pandemic resurgence of pertussis.
  • Increasing macrolide resistance in Bordetella pertussis isolates is a growing global concern, particularly in Japan.

Purpose of the Study:

  • To investigate the prevalence of macrolide-resistant Bordetella pertussis in children in Japan.
  • To assess the feasibility of using residual clinical samples for resistance detection.

Main Methods:

  • Nasopharyngeal samples were collected from 54 children (aged 0-15) with suspected pertussis between March and August 2025.
  • Bordetella pertussis was identified using PCR, and isolates were sequenced to detect macrolide resistance mutations.
  • Gene-amplification kits were utilized for rapid detection in participating clinics.

Main Results:

  • Of 54 Bordetella pertussis isolates, 43 out of 52 (82.7%) harbored the A2047G mutation conferring macrolide resistance.
  • Reported macrolide resistance rates varied significantly across different clinics, ranging from 40% to 96%.

Conclusions:

  • A significant increase in macrolide-resistant Bordetella pertussis strains has been observed in Japan following the pandemic.
  • Continuous surveillance for antibiotic resistance in Bordetella pertussis is crucial.
  • Repurposing residual clinical samples offers a viable solution for resistance monitoring due to challenges in culturing and detection.
Keywords:
Bordetella pertussisgene amplificationmacrolide resistancepediatric infectionssequencing

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