Article Publish Status: FREE
Abstract Title:

Pertactin-deficientisolates: evidence of increased circulation in Europe, 1998 to 2015.

Abstract Source:

Euro Surveill. 2019 Feb ;24(7). PMID: 30782265

Abstract Author(s):

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

Article Affiliation:

Alex-Mikael Barkoff


IntroductionPertussis outbreaks have occurred in several industrialised countries using acellular pertussis vaccines (ACVs) since the 1990s. High prevalence of pertactin (PRN)-deficientisolates has been found in these countries.AimsTo evaluate in Europe: (i) whether proportions of PRN-deficient strains increased in consecutive collections ofclinical 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.Methodsclinical 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.ResultsIn each period 1.0% (1/102), 1.9% (3/154), 6.4% (9/140) and24.9% (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.ConclusionResults suggest that the longer the period since the introduction of ACVs containing PRN, the higher the frequency of circulating PRN-deficient isolates.

Study Type : Meta Analysis

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