Macrolide-Resistant Bordetella pertussis Infection in Newborn Girl, France - Vol. 18 No. 6 - June 2012 - Emerging Infectious Disease journal - CDC
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Respiratory infections articles
Volume 18, Number 6–June 2012
Volume 18, Number 6—June 2012
Macrolide-Resistant Bordetella pertussis Infection in Newborn Girl, France
Bordetella pertussis, the causative agent of whooping cough, continues to circulate among children and adolescents even in regions with high vaccine coverage. Antimicrobial drug treatment contributes substantially to controlling transmission of the disease. In France, the treatment of choice is clarithromycin or azithromycin, which eliminate the bacterium from the respiratory tract of the infected patient and their close contacts (1). To date, erythromycin resistance in B. pertussis has been described only in the United States (2–4). The erythromycin-resistant B. pertussis isolates in the United States carry an A-to-G transition at nucleotide position 2047 of the 23S rRNA gene, in a region critical for erythromycin binding.
A macrolide antimicrobial drug was administered to a newborn with cough. On day 23 of hospitalization, macrolide-resistant Bordetella pertussis was isolated from nasopharyngeal aspirates. DNA sequencing and PCR–restriction fragment length polymorphism showed a 2047 A-to-G mutation in the 3 copies of the 23S rRNA gene. Monitoring for macrolide resistance is essential in infants <6 months of age.