Macrolide-Resistant Bordetella pertussis Infection in Newborn Girl, France

Sophie Guillot, Ghislaine Descours, Yves Gillet, Jérome Etienne, Daniel Floret, and Nicole Guiso

Author affiliations: Institut Pasteur, Paris, France (S. Guillot, N. Guiso); Hospices Civils de Lyon, Bron, France (G. Descours, J. Etienne, Y. Gillet, D. Floret); University Claude Bernard, Lyon, France (G. Descours, J. Etienne, D. Floret)

Abstract

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.

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.