RESUMEN
Many countries have reported antigenic divergence among circulating Bordetella pertussis strains, mainly in those countries which introduced the acellular pertussis (aP) vaccine. This phenomenon can be seen, for example, with the recent rise of pertactin (Prn)-deficient B. pertussis strains, one of the antigens included in aP vaccine formulas. The whole cell pertussis (wP) vaccine has been used in Brazil since 1977 for the primary pertussis, diphtheria and tetanus immunization series. In 2014, the aP vaccine was recommended for women during pregnancy to protect infants in the first months of life. Our objective was to determine the prevalence of Prn-deficiency in 511 isolates of B. pertussis collected in Brazil during 2010-2016. All isolates were characterized, through PFGE and serotyping, and screened for the loss of Prn by ELISA. Prn-deficiency was confirmed by immunoblotting, and identification of the possible genetic markers was performed with PCR and Sanger sequencing. Results indicate that 110 PFGE profiles are currently circulating, with five profiles representing the majority, and the predominant serotype 3, has been gradually replaced by serotype 2 and serotype 2,3. ELISA screening and immunoblotting identified three Prn-deficient isolates. Genotypic characterization by PCR and sequencing indicated that one isolate had a promoter mutation in prn, while the other two did not have an obvious genetic explanation for their deficiency. While the lack of Prn was identified in a few isolates, this study did not detect a relevant occurrence of Prn-deficiency, until 2016, confirming previous observations that Prn-deficiency is likely aP vaccine-driven.
RESUMEN
Many countries have reported antigenic divergence among circulating Bordetella pertussis strains, mainly in those countries which introduced the acellular pertussis (aP) vaccine. This phenomenon can be seen, for example, with the recent rise of pertactin (Prn)-deficient B. pertussis strains, one of the antigens included in aP vaccine formulas. The whole cell pertussis (wP) vaccine has been used in Brazil since 1977 for the primary pertussis, diphtheria and tetanus immunization series. In 2014, the aP vaccine was recommended for women during pregnancy to protect infants in the first months of life. Our objective was to determine the prevalence of Prn-deficiency in 511 isolates of B. pertussis collected in Brazil during 20102016. All isolates were characterized, through PFGE and serotyping, and screened for the loss of Prn by ELISA. Prn-deficiency was confirmed by immunoblotting, and identification of the possible genetic markers was performed with PCR and Sanger sequencing. Results indicate that 110 PFGE profiles are currently circulating, with five profiles representing the majority, and the predominant serotype 3, has been gradually replaced by serotype 2 and serotype 2,3. ELISA screening and immunoblotting identified three Prn-deficient isolates. Genotypic characterization by PCR and sequencing indicated that one isolate had a promoter mutation in prn, while the other two did not have an obvious genetic explanation for their deficiency. While the lack of Prn was identified in a few isolates, this study did not detect a relevant occurrence of Prn-deficiency, until 2016, confirming previous observations that Prn-deficiency is likely aP vaccine-driven. (AU)
Asunto(s)
Bordetella pertussis , Brasil , Serotipificación , Tos Ferina , Vacunación , Tipificación MolecularRESUMEN
BACKGROUND: Maternal Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination provides antibody transfer to newborn infants and may affect their antibody response to the primary vaccination series. This study aimed to assess the effect of Tdap vaccination during pregnancy on infant antibody response to the whole cell pertussis (DTwP) primary series. METHODS: Plasma from 318 pregnant women (243 Tdap-vaccinated and 75 unvaccinated) and their infants (cord blood) was collected at delivery; infant blood was again collected at 2 and 7 months, before and after their primary DTwP series. Anti-pertussis toxin (PT), pertactin (PRN), filamentous hemagglutinin (FHA), fimbriae 2/3 (FIM) and adenylate cyclase toxin (ACT) IgG antibodies were quantified by a microsphere-based multiplex antibody capture assay and anti-PT neutralizing antibodies by the Real Time Cell analysis system. RESULTS: Infant geometric mean concentrations (GMCs) of IgG anti-Tdap antigens were significantly higher (p < 0.001) among the Tdap-vaccinated (PT: 57.22 IU/mL; PRN: 464.86 IU/mL; FHA: 424.0 IU/mL), versus the unvaccinated group (4 IU/mL, 15.43 IU/mL, 31.99 IU/mL, respectively) at delivery. Anti-FIM and ACT GMCs were similar between the two groups. At 2 months of age, anti-PT, PRN, and FHA GMCs remained higher (p < 0.001) in the Tdap-vaccinated group (12.64 IU/mL; 108.76 IU/mL; 87.41 IU/mL, respectively) than the unvaccinated group (1.02 IU/mL; 4.46 IU/mL; 6.89 IU/mL). However, at 7 months, after receiving the third DTwP dose, the anti-PT GMC was higher (p = 0.016) in the unvaccinated group (7.91 IU/mL) compared to the vaccinated group (2.27 IU/mL), but without differences for anti-PRN, FHA, FIM and ACT GMCs. CONCLUSION: Elevated antibody levels suggest that maternal Tdap vaccination might protect infants until 2 months of age. Reduced anti-PT levels at 7 months indicate potential blunting of immune response in infants. Surveillance would help determine if blunting alters vaccine immunity and impacts pertussis prevention in infants.
RESUMEN
Background: Maternal Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination provides antibodytransfer to newborn infants and may affect their antibody response to the primary vaccination series. This study aimed to assess the effect of Tdap vaccination during pregnancy on infant antibody response to the whole cell pertussis (DTwP) primary series. Methods: Plasma from 318 pregnant women (243 Tdap-vaccinated and 75 unvaccinated) and their infants (cord blood) was collected at delivery; infant blood was again collected at 2 and 7 months, before and after their primary DTwP series. Anti-pertussis toxin (PT), pertactin (PRN), filamentous hemagglutinin (FHA), fimbriae 2/3 (FIM) and adenylate cyclase toxin (ACT) IgG antibodies were quantified by a microsphere-based multiplex antibody capture assay and anti-PT neutralizing antibodies by the Real Time Cell analysis system. Results: Infant geometric mean concentrations (GMCs) of IgG anti-Tdap antigens were significantly higher (p < 0.001) among the Tdap-vaccinated (PT: 57.22 IU/mL; PRN: 464.86 IU/mL; FHA: 424.0 IU/mL), versus the unvaccinated group (4 IU/mL, 15.43 IU/mL, 31.99 IU/mL, respectively) at delivery. Anti-FIM and ACT GMCs were similar between the two groups. At 2 months of age, anti-PT, PRN, and FHA GMCs remained higher (p < 0.001) in the Tdap-vaccinated group (12.64 IU/mL; 108.76 IU/mL; 87.41 IU/mL, respectively) than the unvaccinated group (1.02 IU/mL; 4.46 IU/mL; 6.89 IU/mL). However, at 7 months, after receiving the third DTwP dose, the anti-PT GMC was higher (p = 0.016) in the unvaccinated group (7.91 IU/mL) compared to the vaccinated group (2.27 IU/mL), but without differences for anti-PRN, FHA, FIM and ACT GMCs. Conclusion: Elevated antibody levels suggest that maternal Tdap vaccination might protect infants until 2 months of age. Reduced anti-PT levels at 7 months indicate potential blunting of immune response in infants. Surveillance would help determine if blunting alters vaccine immunity and impacts pertussis prevention in infants. (AU)
Asunto(s)
Brasil , Vacuna contra Difteria, Tétanos y Tos Ferina , Tos Ferina , Vacunación , Programas de Inmunización , AnticuerposRESUMEN
Pertussis remains an important public health problem in many countries despite extensive immunization. Cultures and real-time PCR (RT-PCR) assays are the recommended pertussis diagnostic tests, but they lack sensitivity at the later stage of the disease. This study introduces the IgG anti-pertussis toxin enzyme-linked immunosorbent assay (PT ELISA) in our routine diagnosis to improve disease burden estimation. Serum samples and nasopharyngeal swabs (n = 503) were collected at the same time from patients presenting with cough illness suspected of being pertussis and tested by the PT ELISA and culture and/or RT-PCR, respectively. Patients were separated into three age groups: group 1, <1 year (n = 260; mean age, 3 months), group 2, 1 to 6 years (n = 81; mean age, 3 years), and group 3, ≥7 years (n = 162; mean age, 26 years). The times (means) from cough onset to specimen collection were 16, 24, and 26 days, respectively. In group 1, 83 (82.2%) of 101 positive cases were positive for pertussis by culture/RT-PCR, while 40 (39.6%) tested positive by PT ELISA. In group 2, 6 (19.4%) of 31 positive cases were culture/RT-PCR positive, and 29 (93.6%) were seropositive. In group 3, 13 (13.8%) of 94 positive cases were positive by culture/RT-PCR and 91 (96.8%) were positive by serology. Culture/RT-PCR detected more cases of pertussis in infants (P < 0.0001), whereas the PT ELISA detected more cases in adolescents and adults (P < 0.0001). The timing between cough onset and specimen collection or recent vaccination may have partially affected our results. Serology is a suitable, cost-effective, and complementary pertussis diagnostic tool, especially among older children, adolescents, and adults during the later disease phase.
Asunto(s)
Anticuerpos Antibacterianos/sangre , Pruebas Diagnósticas de Rutina/métodos , Tos Ferina/diagnóstico , Adolescente , Adulto , Anciano , Técnicas Bacteriológicas/métodos , Bordetella pertussis/genética , Bordetella pertussis/crecimiento & desarrollo , Bordetella pertussis/inmunología , Bordetella pertussis/aislamiento & purificación , Brasil , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática/métodos , Femenino , Humanos , Inmunoglobulina G/sangre , Lactante , Masculino , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular/métodos , Nasofaringe/microbiología , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Sensibilidad y Especificidad , Pruebas Serológicas/métodos , Adulto JovenRESUMEN
OBJETIVO: O conhecimento de Bordetella pertussis circulante na América Latina é limitado. Portanto, o objetivo deste estudo foi usar a técnica da eletroforese em campo pulsado e a sorotipagem para caracterizar cepas de B. pertussis isoladas na cidade de São Paulo (SP). MÉTODOS: Este estudo, conduzido entre 2006 e 2008, analisou 652 swabs de nasofaringe coletados de casos suspeitos e comunicantes de coqueluche, provenientes de 37 hospitais sentinela de São Paulo. Foram realizadas as técnicas da eletroforese em campo pulsado e sorotipagem em 91 (70%) cepas de B. pertussis, escolhidas aleatoriamente. RESULTADOS: Noventa e sete por cento das cepas de São Paulo foram sorotipadas como Fim3. Foram identificados 14 perfis genéticos pela eletroforese em campo pulsado; o mais prevalente (57%) também é o mais prevalente nos EUA. CONCLUSÕES: Esses dados, em conjunto com ações da vigilância, podem ter um impacto nas estratégias de prevenção e controle de coqueluche na região, oferecendo informações úteis para a introdução de estratégias novas de vacinação e redução do risco de transmissão para bebês menores de 6 meses de idade.
OBJECTIVE: Knowledge of Bordetella pertussis circulating in Latin America is limited. Therefore, the goal of this study was to use pulsed-field gel electrophoresis and serotyping to characterize B. pertussis strains isolated in the city of São Paulo, Brazil. METHODS: This study, conducted between 2006 and 2008, analyzed 652 nasopharyngeal swabs from suspected pertussis cases and contacts, collected from 37 sentinel hospitals in São Paulo. Randomized samples of 91 (70%) strains of B. pertussis were subtyped by pulsed-field gel electrophoresis and serotyping. RESULTS: Ninety-seven percent of strains from São Paulo were serotyped as Fim3. Fourteen pulsed-field gel electrophoresis profiles were identified; the most prevalent (57%) is also the most prevalent in the USA. CONCLUSIONS: These data, in conjunction with surveillance activities, may impact strategies regarding prevention and control of pertussis in the region, providing useful information for introduction of new vaccination strategies and reduction of risk of transmission to infants less than 6 months of age.
Asunto(s)
Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Adulto Joven , Bordetella pertussis/clasificación , Tos Ferina/microbiología , Factores de Edad , Bordetella pertussis/genética , Bordetella pertussis/aislamiento & purificación , Brasil/epidemiología , Electroforesis en Gel de Campo Pulsado , Vacuna contra la Tos Ferina/uso terapéutico , Serotipificación , Vacunación , Tos Ferina/prevención & controlRESUMEN
OBJECTIVE: Knowledge of Bordetella pertussis circulating in Latin America is limited. Therefore, the goal of this study was to use pulsed-field gel electrophoresis and serotyping to characterize B. pertussis strains isolated in the city of São Paulo, Brazil. METHODS: This study, conducted between 2006 and 2008, analyzed 652 nasopharyngeal swabs from suspected pertussis cases and contacts, collected from 37 sentinel hospitals in São Paulo. Randomized samples of 91 (70%) strains of B. pertussis were subtyped by pulsed-field gel electrophoresis and serotyping. RESULTS: Ninety-seven percent of strains from São Paulo were serotyped as Fim3. Fourteen pulsed-field gel electrophoresis profiles were identified; the most prevalent (57%) is also the most prevalent in the USA. CONCLUSIONS: These data, in conjunction with surveillance activities, may impact strategies regarding prevention and control of pertussis in the region, providing useful information for introduction of new vaccination strategies and reduction of risk of transmission to infants less than 6 months of age.
Asunto(s)
Bordetella pertussis/clasificación , Tos Ferina/microbiología , Adolescente , Factores de Edad , Bordetella pertussis/genética , Bordetella pertussis/aislamiento & purificación , Brasil/epidemiología , Niño , Preescolar , Electroforesis en Gel de Campo Pulsado , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Vacuna contra la Tos Ferina/uso terapéutico , Serotipificación , Vacunación , Tos Ferina/prevención & control , Adulto JovenRESUMEN
BACKGROUND: Pertussis is among the most poorly controlled bacterial vaccine-preventable diseases in the United States. In 2006, a tetanus, reduced-dose diphtheria, and acellular pertussis (Tdap) booster was recommended for adolescents and adults. Tdap vaccines were licensed on the basis of antibody response without vaccine effectiveness data. METHODS: From 30 September 2007 through 19 December 2007, a pertussis outbreak occurred at a nursery through twelfth grade school on St. Croix, US Virgin Islands. We screened all students for cough and collected clinical history, including Tdap receipt. Coughing students were offered diagnostic testing. We defined clinical case patients as students with cough 14 days in duration plus either whoop, paroxysms, or post-tussive vomiting, and we defined confirmed case patients as students with any cough with isolation of Bordetella pertussis or those with clinical cases and polymerase chain reaction or serological evidence of pertussis; other clinical cases were classified as probable. RESULTS: There were 51 confirmed or probable cases among 499 students (attack rate, 10%). Disease clustered in grades 6-12, with a peak attack rate of 38% among 10th graders. Of 266 students aged 11 years with complete data, 31 (12%) had received Tdap. Forty-one unvaccinated students (18%) had confirmed or probable pertussis, compared with 2 (6%) of the vaccinated students (relative risk, 2.9); vaccine effectiveness was 65.6% (95% confidence interval, -35.8% to 91.3%; P = .092). CONCLUSIONS: This first evaluation of Tdap vaccine effectiveness in the outbreak setting suggests that Tdap provides protection against pertussis. Increased coverage is needed to realize the full benefit of the vaccine program. Serological testing was an important tool for case identification and should be considered for inclusion in the Council of State and Territorial Epidemiologists case definition.
Asunto(s)
Bordetella pertussis/inmunología , Bordetella pertussis/aislamiento & purificación , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/administración & dosificación , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/inmunología , Brotes de Enfermedades , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Adolescente , Adulto , Anticuerpos Antibacterianos/sangre , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Humanos , Inmunoglobulina G/sangre , Lactante , Masculino , Nasofaringe/microbiología , Reacción en Cadena de la Polimerasa , Islas Virgenes de los Estados Unidos/epidemiología , Vacunación/estadística & datos numéricos , Adulto JovenRESUMEN
No presente estudo, nos reportamos os resultados de uma analise, baseada na sorotipagem, multilocus enzimatico (MEE) e ribotipagem de N. meningitidis sorogrupo C isoladas de paciente com doenca meningococica no Rio Grande do Sul (RS) e Santa Catarina (SC), onde o Centro de Controle Epidemiologico do Ministerio da Saude detectou um aumento de casos de doenca meningococica (DM) devido a este sorogrupo nos ultimos 2 anos (1992-1993)...
Asunto(s)
Infecciones Meningocócicas/epidemiología , Neisseria meningitidis/genética , Electroforesis , Neisseria meningitidis/análisis , Sensibilidad y EspecificidadRESUMEN
De culturas de sangue foram isoladas e identificadas 267 amostras bacterianas do genero Haemophilus, na Secao de Bacteriologia do Instituto Adolfo Lutz - Sao Paulo no periodo de 1979 a 1991. H.Influenzae correspondeu a 91,0 por cento (243 cepas) da totalidade dos casos com a predominancia do biotipo I (65,9 por cento) seguido dos biotipos II(29,6 por cento), III(2,1 por cento), IV(0,8 por cento) e V(1,6 por cento). Na quase totalidade das cepas o sorotipo b prevaleceu (93,0 por cento) e apenas uma amostra bacteriana foi foi caracterizada como sorotipo f. H.Influenzae biogrupo aegyptus ocorreu em 7,5 por cento dos casos, tendo as 20 cepas isoladas apresentado as caracteristicas fenotipicas e genotipicas do agente etiologico da Febre Purpurica Brasileira. O H.parainfluenzae foi identificado em 4 amostras, 2 delas pertencendo ao biotipo I, outras aos biotipos II e V. Considerando o numero de amostras de sangue de cada paciente, pode-se observar que em 29,5 por cento dos casos o agente etiologico nao se desenvolveu na totalidade das mesmas, indicando a necessidade de amostras multiplas de sangue para o diagnostico de doencas invasivas
Asunto(s)
Bacterias/aislamiento & purificación , Sangre , Haemophilus , Haemophilus influenzaeRESUMEN
O meio de cultura NNS, constituído de púrpura de bromocresol, nitrato de potássio, sacarose e novobiocina, foi utilizado na diferenciaçäo de Staphylococcus saprophyticus isolados de urina. Na formulaçäo do meio NNS, a resistência à novobiocina, característica normalmente utilizada no diagnóstico presuntivo de Staphylococcus saprophyticus, foi associada a sua capacidade de utilizar a sacarose e à ausência da enzima nitrato-redutase, visando a diferenciaçäo deste microorganismo dos demais estafilococos coagulase negativa, inclusive os igualmente resistentes à novobiocina (STAPHYLOCOCCUS COHNII, STAPHYLOCOCCUS XYLOSUS E STAPHYLOCOCCUS SCIURI). Os Staphylococcus Cohnii näo utilizam a sacarose (88% das cepas), enquanto os Staphylococcus xylosus e Staphylococcus sciuri reduzem nitrato a nitrito em 100 e 80% das cepas, respectivamente. De 74 cepas de estafilococos coagulase negativa isoladas de urina, 49 (66,2%) cepas de Staphylococcus saprophyticus foram diferenciadas pelo meio NNs, tendo sido obtidos resultados de valor predicativo de resultado positivo de 100%, sensibilidade de 95,9%, especificidade de 100% e eficiência de 97,2%...
Asunto(s)
Staphylococcus , Novobiocina , Medios de CultivoRESUMEN
Foram analisadas as características de 386 cepas de Corynebacterium diphtheriae isoladas na Seção de Bacteriologia do Instituto Adolfo Lutz, São Paulo, no período de 1980 a 1986. Verificou-se que 58,3% destas cepas foram capazes de fermentar a sacarose. O biótipo mais frequente foi o mitis (52,2%), seguidos pelos biótipos intermedius (26,4%), gravis (9,9%) e de cepas de comportamento atípico (11,7%). Das cepas pertencentes ao biótipo intermedsus, 75,5% foram capazes de fermentar a sacarose. Com relação à produção de toxina, detectada pelo método de Elek, verificou-se que 92,8% das cepas foram poligênicas e que 97,3% das cepas fermentadoras de sacarose produziram toxina (AU).
Asunto(s)
Historia del Siglo XX , Bacteriología , Corynebacterium diphtheriaeRESUMEN
Foi isolado C. diphtheriae de 3 amostras de sangue de um paciente internado no Hospital Emílio Ribas, que não apresentava suspeita clínica de difteria. Analisou-se o aspecto morfológico, comportamento bioquímico e toxigênico destas cepas e verificou-se a presença dos biotipos intermediu8, mitis e mitis variedade belfanti. O comportamento bioquímico foi idêntico para as cepas isoladas, com exceção da presença de nitrato redutase do tipo A nos biotipos intermedius e mitis. Esses dois biotipor mostraram não ser toxigênicos quando testados pelo método de Elek, enquanto o biotipo mitis varo belfanti mostrou-se toxigênico quando empregado o mesmo método. Foi observado não haver variações na sensibilidade dos diferentes antibióticos frente aos agentes antimicrobianos testados (AU).