The relationship between Bordetella pertussis genotype and clinical severity in Australian children with pertussis

M. Clarke, P.B. Mcintyre, Christopher Blyth, N. Wood, S. Octavia, V. Sintchenko, L. Giles, H. Quinn, V. Hill, Gabrielle Hanly, R. Lan, H.S. Marshall

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    Abstract

    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 ptxP3allele was observed.© 2015 The British Infection Association.
    Original languageEnglish
    Pages (from-to)171-178
    Number of pages8
    JournalJournal of Infection
    Volume72
    Issue number2
    Early online date8 Dec 2015
    DOIs
    Publication statusPublished - Feb 2016

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    Bordetella pertussis
    Whooping Cough
    Genotype
    Vaccination
    Pediatric Hospitals
    Pertussis Toxin
    Critical Care
    Infection
    Tertiary Care Centers
    pertactin
    Length of Stay
    Alleles
    Antigens

    Cite this

    Clarke, M. ; Mcintyre, P.B. ; Blyth, Christopher ; Wood, N. ; Octavia, S. ; Sintchenko, V. ; Giles, L. ; Quinn, H. ; Hill, V. ; Hanly, Gabrielle ; Lan, R. ; Marshall, H.S. / The relationship between Bordetella pertussis genotype and clinical severity in Australian children with pertussis. In: Journal of Infection. 2016 ; Vol. 72, No. 2. pp. 171-178.
    @article{0aa106ac30984a6e85ceed2c6d554b65,
    title = "The relationship between Bordetella pertussis genotype and clinical severity in Australian children with pertussis",
    abstract = "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 ptxP3allele was observed.{\circledC} 2015 The British Infection Association.",
    author = "M. Clarke and P.B. Mcintyre and Christopher Blyth and N. Wood and S. Octavia and V. Sintchenko and L. Giles and H. Quinn and V. Hill and Gabrielle Hanly and R. Lan and H.S. Marshall",
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    Clarke, M, Mcintyre, PB, Blyth, C, Wood, N, Octavia, S, Sintchenko, V, Giles, L, Quinn, H, Hill, V, Hanly, G, Lan, R & Marshall, HS 2016, 'The relationship between Bordetella pertussis genotype and clinical severity in Australian children with pertussis' Journal of Infection, vol. 72, no. 2, pp. 171-178. https://doi.org/10.1016/j.jinf.2015.11.004

    The relationship between Bordetella pertussis genotype and clinical severity in Australian children with pertussis. / Clarke, M.; Mcintyre, P.B.; Blyth, Christopher; Wood, N.; Octavia, S.; Sintchenko, V.; Giles, L.; Quinn, H.; Hill, V.; Hanly, Gabrielle; Lan, R.; Marshall, H.S.

    In: Journal of Infection, Vol. 72, No. 2, 02.2016, p. 171-178.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - The relationship between Bordetella pertussis genotype and clinical severity in Australian children with pertussis

    AU - Clarke, M.

    AU - Mcintyre, P.B.

    AU - Blyth, Christopher

    AU - Wood, N.

    AU - Octavia, S.

    AU - Sintchenko, V.

    AU - Giles, L.

    AU - Quinn, H.

    AU - Hill, V.

    AU - Hanly, Gabrielle

    AU - Lan, R.

    AU - Marshall, H.S.

    PY - 2016/2

    Y1 - 2016/2

    N2 - 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 ptxP3allele was observed.© 2015 The British Infection Association.

    AB - 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 ptxP3allele was observed.© 2015 The British Infection Association.

    U2 - 10.1016/j.jinf.2015.11.004

    DO - 10.1016/j.jinf.2015.11.004

    M3 - Article

    VL - 72

    SP - 171

    EP - 178

    JO - Journal of Infection.

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    SN - 0163-4453

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