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Abstract

Background

is the main agent of whooping cough. Vaccination with acellular pertussis vaccines has been largely implemented in high-income countries. These vaccines contain 1 to 5 antigens: pertussis toxin (PT), filamentous haemagglutinin (FHA), pertactin (PRN) and/or fimbrial proteins (FIM2 and FIM3). Monitoring the emergence of isolates that might partially escape vaccine-induced immunity is an essential component of public health strategies to control whooping cough.

Aim

We aimed to investigate temporal trends of fimbriae serotypes and vaccine antigen-expression in over a 23-year period in France (1996–2018).

Methods

Isolates (n = 2,280) were collected through hospital surveillance, capturing one third of hospitalised paediatric pertussis cases. We assayed PT, FHA and PRN production by Western blot (n = 1,428) and fimbriae production by serotyping (n = 1,058). Molecular events underlying antigen deficiency were investigated by genomic sequencing.

Results

The proportion of PRN-deficient isolates has increased steadily from 0% (0/38) in 2003 to 48.4% (31/64) in 2018 (chi-squared test for trend, p < 0.0001), whereas only 5 PT-, 5 FHA- and 9 FIM-deficient isolates were found. Impairment of PRN production was predominantly due to IS insertion within the gene or a 22 kb genomic inversion involving the promoter sequence, indicative of convergent evolution. FIM2-expressing isolates have emerged since 2011 at the expense of FIM3.

Conclusions

is evolving through the rapid increase of PRN-deficient isolates and a recent shift from FIM3 to FIM2 expression. Excluding PRN, the loss of vaccine antigen expression by circulating isolates is epidemiologically insignificant.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2021-09-16
2024-04-25
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.37.2001213
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Evolution of Bordetella pertussis over a 23-year period in France, 1996 to 2018
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Val%C3%A9rie+Bouchez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bouchez Valérie</a>, <a href="/search?value1=Sophie+Guillot&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guillot Sophie</a>, <a href="/search?value1=Annie+Landier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Landier Annie</a>, <a href="/search?value1=Nathalie+Armatys&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Armatys Nathalie</a>, <a href="/search?value1=Soraya+Matczak&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Matczak Soraya</a>, <a href="/search?value1=the+French+pertussis+microbiology+study+group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">the French pertussis microbiology study group</a>, <a href="/search?value1=Julie+Toubiana&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Toubiana Julie</a>, <a href="/search?value1=Sylvain+Brisse&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brisse Sylvain</a></span>. Evolution of Bordetella pertussis over a 23-year period in France, 1996 to 2018. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(37):pii=2001213. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.37.2001213" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.37.2001213</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 16 Jun 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 26 Feb 2021 </span> </p>
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