The relationship between Bordetella pertussis genotype and clinical severity in Australian children with pertussis - 29/01/16

Doi : 10.1016/j.jinf.2015.11.004

Michelle Clarke ^a,^b,^c, Peter B. McIntyre ^d,^e,^f, Christopher C. Blyth ^g,^h,^i,^j, Nick Wood ^d,^e,^f, Sophie Octavia ^k, Vitali Sintchenko ^l,^m, Lynne Giles ^a,ⁿ, Helen Quinn ^d,^e, Verity Hill ^b, Gabrielle Hanly ^g, Ruiting Lan ^k,^⁎ , Helen S. Marshall ^a,^b,^c,^n,^⁎
^a School of Public Health, University of Adelaide, Adelaide, SA 5000, Australia
^b Discipline of Paediatrics, Women's and Children's Hospital, North Adelaide, SA 5006, Australia
^c School of Medicine, University of Adelaide, Adelaide, SA 5000, Australia
^d National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia
^e Discipline of Paediatrics and Child Health, University of Sydney, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia
^f Department of Microbiology and Infectious Diseases, The Children's Hospital at Westmead, NSW, Australia
^g School of Paediatrics and Child Health, University of Western Australia, WA, Australia
^h Department of Infectious Diseases, Princess Margaret Hospital for Children, WA, Australia
ⁱ Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, WA, Australia
^j Department of Microbiology, Princess Margaret Hospital, PathWest Laboratory Medicine, WA, Australia
^k School of Biotechnology and Biomolecular Sciences, University of New South Wales, NSW, Australia
^l Sydney Emerging Infectious Diseases and Biosecurity Institute, The University of Sydney, NSW, Australia
^m Centre for Infectious Diseases and Microbiology (CIDM) Public Health, Sydney West LHD and Pathology West, NSW, Australia
ⁿ Robinson Research Institute, University of Adelaide, SA 5000, Australia

^∗Corresponding author. 72 King William Road, North Adelaide, SA 5006, Australia. Tel.: +61 8 81618115; fax: +61 8 8161 7031.^∗∗Corresponding author.

Summary

Objectives

Changes in circulating Bordetella pertussis genotypes, including a novel pertussis toxin promoter ptxP3 allele and absence of pertactin (Prn) antigen, have been reported from several countries but limited data on relative severity are available. We compared markers of disease severity in children with B. pertussis infection due to strains of differing genotype.

Methods

Culture confirmed cases presenting to tertiary paediatric hospitals in three Australian states between 2008 and 2012 were classified as severe if they required a hospital stay greater than seven days, were admitted to intensive care, or if death occurred. Associations between age, vaccination, genotype and severity were assessed.

Results

Of 199 pertussis cases, 81 (41%) were <3 months, including 32/39 (82%) of severe cases. The proportion of isolates from these cases that were Prn deficient increased markedly between 2008 and 2012. Of B. pertussis isolates, the proportion considered severe was similar for Prn positive (27/128, 21%) and Prn deficient (12/71, 17%) cases but only 1/22 (4.5%) of non ptxP3 cases were severe versus 38/177 (21.4%) ptxP3 positive. Adjusting for ptxP type, vaccination status and age, disease severity was not significantly associated with Prn status (RRA: 0.95, [0.57–1.56]; p = 0.83).

Conclusions

In children, we found no relationship between Prn status and markers of severe pertussis. An increased proportion of severe disease in isolates with the ptxP3 allele was observed.

Le texte complet de cet article est disponible en PDF.

Highlights

•	Prn deficient isolates were not associated with pertussis severity.
•	Almost all isolates from severe pertussis cases carried the ptxP3 allele.
•	The majority of severe pertussis occurred in infants <3 months of age.
•	Young age and absence of prior vaccination were related to severe pertussis.

Le texte complet de cet article est disponible en PDF.

Keywords : Pertussis, Hospitalization, Children, Pertactin, Severity

Plan

Introduction

Methods

Results

Identified cohort and antigen expression

Demographic comparisons between Prn deficient and Prn positive cases

Clinical comparisons between Prn deficient and Prn positive cases

Associations with severe pertussis

Discussion

Funding

Conflict of interest statement

Contribution statement

☆	Conference presentation: This research has been presented in part at the Communicable Diseases Control Conference, Brisbane Australia, 01 Jun 2015. Abstract ID #137.

Export

Vol 72 - N° 2

P. 171-178 - février 2016 Retour au numéro

Article précédent

Molecular diagnosis of Legionella infections – Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm
Naomi J. Gadsby, Kristjan O. Helgason, Elizabeth M. Dickson, Jonathan M. Mills, Diane S.J. Lindsay, Giles F. Edwards, Mary F. Hanson, Kate E. Templeton, ESCMID Study Group for Molecular Diagnostics and the ESCMID Study Group for Legionella Infections, Basel, Switzerland

| Article suivant

Population tailored modification of tuberculosis specific interferon-gamma release assay
Kata Horvati, Szilvia B?sze, Hannah P. Gideon, Bernadett Bacsa, Tamás G. Szabó, Rene Goliath, Molebogeng X. Rangaka, Ferenc Hudecz, Robert J. Wilkinson, Katalin A. Wilkinson

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

connectez-vous ou créez un compte

The relationship between Bordetella pertussis genotype and clinical severity in Australian children with pertussis - 29/01/16

Summary

Objectives

Methods

Results

Conclusions

Highlights

Plan

Export citations

Fichier

Contenu

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL