{"title":"Severe macrolide-resistant Bordetella pertussis (ptxP3) infection in Japanese Infants: first report of cases requiring intensive care.","authors":"Haruka Tsukahara, Kotaro Araki, Yoshiaki Cho, Naoki Fujiwara, Takashi Matsuoka, Tetsuya Kakita, Shogo Morichika, Makoto Ohnishi","doi":"10.1016/j.ijid.2025.107960","DOIUrl":null,"url":null,"abstract":"<p><p>In November 2024, two unvaccinated infants with ptxP3 allele-carrying macrolide-resistant Bordetella pertussis (MRBP) infection were admitted to a hospital in Okinawa, Japan, and required intensive care. These represent the first reported severe MRBP cases in Japan. Both tested positive via LAMP and failed initial macrolide therapy, requiring mechanical ventilation and a switch to trimethoprim-sulfamethoxazole. Whole-genome sequencing identified ptxP3-positive MRBP strains with high virulence potential. Phylogenetic analysis showed relatedness to the MT28-ptxP3 lineage from China; however, 8-11 SNP differences among strains suggest independent introductions and possible prolonged circulation in Okinawa. These findings raise public health concerns and highlight the need for enhanced surveillance and prevention.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"107960"},"PeriodicalIF":4.8000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ijid.2025.107960","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
In November 2024, two unvaccinated infants with ptxP3 allele-carrying macrolide-resistant Bordetella pertussis (MRBP) infection were admitted to a hospital in Okinawa, Japan, and required intensive care. These represent the first reported severe MRBP cases in Japan. Both tested positive via LAMP and failed initial macrolide therapy, requiring mechanical ventilation and a switch to trimethoprim-sulfamethoxazole. Whole-genome sequencing identified ptxP3-positive MRBP strains with high virulence potential. Phylogenetic analysis showed relatedness to the MT28-ptxP3 lineage from China; however, 8-11 SNP differences among strains suggest independent introductions and possible prolonged circulation in Okinawa. These findings raise public health concerns and highlight the need for enhanced surveillance and prevention.
期刊介绍：
International Journal of Infectious Diseases (IJID)
Publisher: International Society for Infectious Diseases
Publication Frequency: Monthly
Type: Peer-reviewed, Open Access
Scope:
Publishes original clinical and laboratory-based research.
Reports clinical trials, reviews, and some case reports.
Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases.
Emphasizes diseases common in under-resourced countries.
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