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Journal of Clinical Microbiology, August 2002, p. 2942-2944, Vol. 40, No. 8
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.8.2942-2944.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Bordetella pertussis Isolates with a Heterogeneous Phenotype for Erythromycin Resistance

K. E. Wilson, P. K. Cassiday, T. Popovic, and G. N. Sanden*

Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

Received 15 March 2002/ Returned for modification 12 April 2002/ Accepted 3 May 2002

Erythromycin is currently being used for both prophylaxis and treatment of pertussis infections. Erythromycin resistance was first recognized in Bordetella pertussis in Arizona in 1994, and since then, three additional resistant isolates have been identified in the United States. To better assess the potential public health impact of erythromycin-resistant B. pertussis, we used the disk diffusion assay to evaluate the frequency of erythromycin resistance among 1,030 recently circulating U.S. isolates and found the rate of occurrence to be <1%. We also describe a novel heterogeneous phenotype, with erythromycin-resistant colonies appearing only after a 7-day incubation period. To optimize patient management, we recommend that clinicians be alert to potential treatment failures and that laboratorians use a 7-day incubation period when screening for resistance. Our ongoing national surveillance will continue to monitor for resistant B. pertussis isolates and their potential association with changing pertussis epidemiology.

* Corresponding author. Mailing address: Epidemiologic Investigations Laboratory, Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., MSD11, Atlanta, GA 30333. Phone: (404) 639-1373. Fax: (404) 639-4421. E-mail: gnsl{at}cdc.gov.

Journal of Clinical Microbiology, August 2002, p. 2942-2944, Vol. 40, No. 8
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.8.2942-2944.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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