Molecular epidemiology of Bordetella pertussis in Greece, 2010–2015

Evangelia Petridou,Karen Angeliki Krogfelt,Randi Føns Petersen,Athanasios Michos,Athanasios Arvanitidis,Maria Giannaki-Psinaki,Christel Barker Jensen

doi:10.1099/jmm.0.000688

Abstract

PurposeTo determine the predominant strains of Bordetella pertussis in Greece during 2010–2015.MethodologyInfants and children (n=1150) (15 days to 14 years) of Greek, Roma and immigrant origin with different vaccination statuses were hospitalized in Athens, Greece with suspected pertussis infection. IS481/IS1001 real-time PCR confirmed Bordetella spp./B. pertussis infection in 300 samples. A subset of samples (n=153) were analysed by multi-locus variable number tandem repeat analysis (MLVA) and (n=25) by sequence-based typing of the toxin promotor region (ptxP) on DNA extracted from clinical specimens.Results/Key findingsA complete MLVA profile was determined in 66 out of 153 samples; the B. pertussis MLVA type 27 (n=55) was the dominant genotype and all tested samples (n=25) expressed the ptxP3 genotype. The vaccine coverage in the Greek population was 90 %; however, the study population expressed complete coverage in 2 out of 264 infants (0–11 months) and in 20 out of 36 children (1–14 years). Roma and immigrant minorities represent 7 % of the Greek population, but make up 50 % of the study population, indicating a low vaccine coverage among these groups.ConclusionsThe B. pertussis MT27 and ptxP3 genotype is dominant in Greek, Roma and immigrant infants and children hospitalized in Greece. Thus, the predominant MLVA genotype in Greece is similar to other countries using acellular vaccines.

Highlights

Whooping cough is a highly contagious respiratory infection caused mainly by the bacterium Bordetella pertussis (B. pertussis)
The B. pertussis MT27 and ptxP3 genotype is dominant in Greek, Roma and immigrant infants and children hospitalized in Greece
The predominant multi-locus variable number tandem repeat analysis (MLVA) genotype in Greece is similar to other countries using acellular vaccines

Summary

Introduction

Whooping cough (pertussis) is a highly contagious respiratory infection caused mainly by the bacterium Bordetella pertussis (B. pertussis). The introduction of pertussis vaccination during the 1950s and 1960s resulted in a dramatic reduction (>90 %) in the pertussis incidence and mortality in the industrialized world. This vaccine-preventable disease continues to circulate in many countries [1]. Adolescents 11–18 years of age (preferably at the age of 11–12 years) receive a single dose of a Received 15 May 2017; Accepted 20 January 2018 Author affiliations: 1Department of Clinical Microbiology, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece; 2Department of Virus and Microbiological Special Diagnostics, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark; 3Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark; 4First Department of Pediatrics, National and Kapodistrian University of Athens, ‘Aghia Sophia’ Children’s Hospital, ptxP, pertussis toxin promoter; R, Roma; Tdap, acellular combination vaccine against tetanus, diphtheria, pertussis; VNTR, variable numbers of tandem repeats

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