Emergence of macrolide-resistant Bordetella pertussis in France, 2024: out of China
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Pertussis is a highly contagious vaccine-preventable respiratory disease, primarily caused by Bordetella pertussis (Bp) . Macrolides constitute the first-line treatment for pertussis, reducing bacterial carriage and transmission. Macrolide-resistant Bp (MRBP) isolates have been reported in China since 2011. Here, we report 14 MRBP cases from France collected between February and November 2024. Phylogenetic analysis based on whole-genome single nucleotide polymorphisms revealed that the 14 isolates belong to a cluster of 349 MRBP isolates, of genotype ptxP3 , and form three separate branches nested within the diversity of isolates from China. These data suggest three independent introductions into France. Two of these branches were detected across several French administrative regions, suggesting forward transmission and spatial dissemination. The ptxP3- MRBP clade emerged in China only around 2016 and became predominant after 2020. Its dissemination in France in 2024 is consistent with a high predicted fitness of the ptxP3 genotype in countries using acellular vaccines.
