title: Investigations into the emergence of pertactin-deficient Bordetella pertussis isolates in six European countries, 1996 to 2012.
abstract: Pathogen adaptation has been proposed to contribute to the resurgence of pertussis. A striking recent example is the emergence of isolates deficient in the vaccine component pertactin (Prn). This study explores the emergence of such Prn-deficient isolates in six European countries. During 2007 to 2009, 0/83 isolates from the Netherlands, 0/18 from the United Kingdom, 0/17 Finland, 0/23 Denmark, 4/99 Sweden and 5/20 from Norway of the isolates collected were Prn-deficient. In the Netherlands and Sweden, respectively 4/146 and 1/8 were observed in a later period (2010–12). The Prn-deficient isolates were genetically diverse and different mutations were found to inactivate the prn gene. These are indications that Prn-deficiency is subject to positive selective pressure. We hypothesise that the switch from whole cell to acellular pertussis vaccines has affected the balance between ‘costs and benefits’ of Prn production by Bordetella pertussis to the extent that isolates that do not produce Prn are able to expand. The absence of Prn-deficient isolates in some countries may point to ways to prevent or delay the spread of Prn-deficient strains. In order to substantiate this hypothesis, trends in the European B. pertussis population should be monitored continuously.
authors.affiliation: Centre for Infectious Diseases Research, Diagnostics and Screening (IDS), Centre for Infectious Diseases Control (CIb), National Institute of Public Health and the Environment (RIVM), the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Zeddeman
authors.forename: M
authors.initials: M
authors.lastname: van Gent
authors.forename: C J
authors.initials: CJ
authors.lastname: Heuvelman
authors.forename: H G
authors.initials: HG
authors.lastname: van der Heide
authors.forename: M J
authors.initials: MJ
authors.lastname: Bart
authors.forename: A
authors.initials: A
authors.lastname: Advani
authors.forename: H O
authors.initials: HO
authors.lastname: Hallander
authors.forename: C H
authors.initials: CH
authors.lastname: Wirsing von Konig
authors.forename: M
authors.initials: M
authors.lastname: Riffelman
authors.forename: J
authors.initials: J
authors.lastname: Storsaeter
authors.forename: D F
authors.initials: DF
authors.lastname: Vestrheim
authors.forename: T
authors.initials: T
authors.lastname: Dalby
authors.forename: K A
authors.initials: KA
authors.lastname: Krogfelt
authors.forename: N K
authors.initials: NK
authors.lastname: Fry
authors.forename: A M
authors.initials: AM
authors.lastname: Barkoff
authors.forename: J
authors.initials: J
authors.lastname: Mertsola
authors.forename: Q
authors.initials: Q
authors.lastname: He
authors.forename: F
authors.initials: F
authors.lastname: Mooi
mesh_terms: D000595:Amino Acid Sequence; D001425:Bacterial Outer Membrane Proteins / Q000032:analysis* / Q000235:genetics*; D001483:Base Sequence; D001886:Bordetella pertussis / Q000235:genetics / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D021821:Communicable Diseases, Emerging / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D005060:Europe; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D058889:Molecular Typing; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide; D017422:Sequence Analysis, DNA; D010566:Virulence Factors, Bordetella / Q000032:analysis* / Q000235:genetics*; D014917:Whooping Cough / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D001425:Bacterial Outer Membrane Proteins; D004269:DNA, Bacterial; D010566:Virulence Factors, Bordetella; C068929:pertactin