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Abstract

Introduction

Pertussis outbreaks have occurred in several industrialised countries using acellular pertussis vaccines (ACVs) since the 1990s. High prevalence of pertactin (PRN)-deficient isolates has been found in these countries.

Aims

To evaluate in Europe: (i) whether proportions of PRN-deficient strains increased in consecutive collections of clinical isolates; (ii) if the frequency of PRN-deficient strains in countries correlated with the time since ACV introduction; (iii) the presence of pertussis toxin (PT)-, filamentous haemagglutinin (FHA)- or fimbriae (Fim)-deficient isolates.

Methods

clinical isolates were obtained from different European countries during four periods (EUpert I–IV studies): 1998 to 2001 (n = 102), 2004 to 2005 (n = 154), 2007 to 2009 (n = 140) and 2012 to 2015 (n = 265). The isolates’ selection criteria remained unchanged in all periods. PRN, PT, FHA and Fim2 and Fim3 expression were assessed by ELISA.

Results

In each period 1.0% (1/102), 1.9% (3/154), 6.4% (9/140) and 24.9% (66/265) of isolates were PRN-deficient. In EUpert IV, PRN-deficient isolates occurred in all countries sampled and in six countries their frequency was higher than in EUpert III (for Sweden and the United Kingdom, p < 0.0001 and p = 0.0155, respectively). Sweden and Italy which used ACVs since the mid 1990s had the highest frequencies (69%; 20/29 and 55%; 11/20, respectively) while Finland, where primary immunisations with ACV containing PRN dated from 2009 had the lowest (3.6%). Throughout the study, no PT- or FHA-deficient isolate and one Fim2/3-deficient was detected.

Conclusion

Results suggest that the longer the period since the introduction of ACVs containing PRN, the higher the frequency of circulating PRN-deficient isolates.

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2019-02-14
2024-12-26
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Pertactin-deficient Bordetella pertussis isolates: evidence of increased circulation in Europe, 1998 to 2015
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Alex-Mikael+Barkoff&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Barkoff Alex-Mikael</a>, <a href="/search?value1=Jussi+Mertsola&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mertsola Jussi</a>, <a href="/search?value1=Denis+Pierard&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pierard Denis</a>, <a href="/search?value1=Tine+Dalby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dalby Tine</a>, <a href="/search?value1=Silje+Vermedal+Hoegh&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hoegh Silje Vermedal</a>, <a href="/search?value1=Sophie+Guillot&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guillot Sophie</a>, <a href="/search?value1=Paola+Stefanelli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stefanelli Paola</a>, <a href="/search?value1=Marjolein+van+Gent&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Gent Marjolein</a>, <a href="/search?value1=Guy+Berbers&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Berbers Guy</a>, <a href="/search?value1=Didrik+Vestrheim&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vestrheim Didrik</a>, <a href="/search?value1=Margrethe+Greve-Isdahl&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Greve-Isdahl Margrethe</a>, <a href="/search?value1=Lena+Wehlin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wehlin Lena</a>, <a href="/search?value1=Margaretha+Ljungman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ljungman Margaretha</a>, <a href="/search?value1=Norman+K.+Fry&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fry Norman K.</a>, <a href="/search?value1=Kevin+Markey&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Markey Kevin</a>, <a href="/search?value1=Qiushui+He&option1=author&noRedirect=true" class="nonDisambigAuthorLink">He Qiushui</a></span>. Pertactin-deficient Bordetella pertussis isolates: evidence of increased circulation in Europe, 1998 to 2015. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(7):pii=1700832. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.7.1700832" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.7.1700832</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 12 Dec 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 06 Jul 2018 </span> </p>
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