Pertactin-deficient Bordetella pertussis isolates: Evidence of increased circulation in Europe, 1998 to 2015

Alex Mikael Barkoff, Jussi Mertsola, Denis Pierard, Tine Dalby, Silje Vermedal Hoegh, Sophie Guillot, Paola Stefanelli, Marjolein van Gent, Guy Berbers, Didrik Vestrheim, Margrethe Greve-Isdahl, Lena Wehlin, Margaretha Ljungman, Norman K. Fry, Kevin Markey, Qiushui He*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)

Abstract

Introduction: Pertussis outbreaks have occurred in several industrialised countries using acellular pertussis vaccines (ACVs) since the 1990s. High prevalence of pertactin (PRN)-deficient Bordetella pertussis isolates has been found in these countries. Aims: To evaluate in Europe: (i) whether proportions of PRN-deficient strains increased in consecutive collections of B. pertussis 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: B. pertussis 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.

Original languageEnglish
JournalEurosurveillance
Volume24
Issue number7
DOIs
Publication statusPublished - 14 Feb 2019

Bibliographical note

Funding Information:
Financial support: The EUpertstrain II, III and IV studies were jointly funded by GlaxoSmithKline Biologicals (GSK study identifier: 201328), Wavre, Belgium and Sanofi Pasteur MSD, Lyon, France. Both GlaxoSmithKline Biologicals SA and Sanofi Pasteur were provided the opportunity to review a preliminary version of this manuscript for factual accuracy but the authors are solely responsible for final content and interpretation. The study has been registered in ClinicalTrials.gov (Identifier: NCT03197597).

Funding Information:
We thank Päivi Haaranen and Mari Virta for their great help in the laboratory work. Randi Føns Petersen, Kirsten Olsson and Lene Berthelsen for their help with strain collections. Financial support: The EUpertstrain II, III and IV studies were jointly funded by GlaxoSmithKline Biologicals (GSK study identifier: 201328), Wavre, Belgium and Sanofi Pasteur MSD, Lyon, France. Both GlaxoSmithKline Biologicals SA and Sanofi Pasteur were provided the opportunity to review a preliminary version of this manuscript for factual accuracy but the authors are solely responsible for final content and interpretation. The study has been registered in ClinicalTrials.gov (Identifier: NCT03197597).

Publisher Copyright:
© 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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