Abstract:
OBJECTIVE:To describe clinical and laboratory findings from the 2012 southeastern Minnesota pertussis outbreak. PATIENTS AND METHODS:Patients were selected for 2 parts of the study. In the first part, nasopharyngeal swabs from a convenience sample of 265 unique patients were used for both the clinician-requested polymerase chain reaction (PCR) test and culture. B pertussis isolates were tested for macrolide susceptibility and typed using whole genome sequencing and pulsed-field gel electrophoresis. Pertactin gene sequences were analyzed to identify pertactin-deficient B pertussis. In the second part, all patients seen at Mayo Clinic in Rochester, Minnesota, who had PCR results positive for Bordetella pertussis or Bordetella parapertussis between January 1, 2012, and December 31, 2012, were analyzed for patient demographic features and vaccination records. RESULTS:One hundred sixty patients had results positive for B pertussis, and 21 patients had results positive for B parapertussis. Among the 265 swabs cultured, B pertussis was detected by both culture and PCR in 11. One swab was positive for B pertussis by culture alone, and 13 were positive by PCR alone. Polymerase chain reaction detected B pertussis more frequently than did culture (P=.001). No macrolide resistance was detected. All 12 isolates tested had an altered pertactin gene, including 9 with a signal sequence deletion, 2 with insertion sequence disruptions, and 1 with a premature stop codon. Nine and 3 isolates were pertactin types prn1 and prn2, respectively. Whole genome sequencing and pulsed-field gel electrophoresis detected the presence of multiple B pertussis strains. The mean age of patients with pertussis was younger than that of those without pertussis (15.6 and 25.5 years, respectively; P=.002). Compared with those whose test results were negative for B pertussis, fewer patients with positive results had received whole-cell pertussis vaccine (P=.02). In the subgroup who had received acellular vaccine exclusively, the time since the most recent pertussis vaccination in those with results positive for B pertussis was longer than that in those with negative results (1363 vs 1010 days; P=.004). CONCLUSION:The 2012 pertussis outbreak in southeastern Minnesota included multiple strains of B pertussis, all putatively lacking pertactin. Our findings may indicate decreased efficacy of (and waning immunity from) acellular vaccines as contributors to the outbreak.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Theofiles AG,Cunningham SA,Chia N,Jeraldo PR,Quest DJ,Mandrekar JN,Patel Rdoi
10.1016/j.mayocp.2014.08.004subject
Has Abstractpub_date
2014-10-01 00:00:00pages
1378-88issue
10eissn
0025-6196issn
1942-5546pii
S0025-6196(14)00720-4journal_volume
89pub_type
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
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abstract:OBJECTIVE:To determine whether blood type affects the risk of thromboembolic complications in patients with atrial fibrillation (AF). PATIENTS AND METHODS:The Mayo Clinic electronic medical record was searched (between January 1, 2004, and December 31, 2010) to identify all patients with AF with blood group assessment...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
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journal_title:Mayo Clinic proceedings
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journal_title:Mayo Clinic proceedings
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abstract:OBJECTIVE:To describe lymphoma associated with human immunodeficiency virus (HIV) infection. DESIGN:A review of HIV-related lymphoma and its associated epidemiology, etiopathogenesis, and clinicopathologic characteristics is presented. Major studies of therapeutic regimens for HIV-related lymphoma are discussed. Facto...
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)60828-3
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abstract::We have observed the effects of concussion on nonanesthetized rats and humans. We believe the phenomenon in both to be identical. There are four obvious stages to concussion and the recovery therefrom: fourth stage--visceral (respiratory) and somatic immobility; third stage--return of irregular visceral (respiratory) ...
journal_title:Mayo Clinic proceedings
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doi:
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doi:10.1016/s0025-6196(12)60660-0
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pub_type: 杂志文章
doi:
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-04-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,评审
doi:10.1016/s0025-6196(12)65345-2
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journal_title:Mayo Clinic proceedings
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doi:10.1016/j.mayocp.2015.07.013
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pub_type: 杂志文章,评审
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更新日期:2015-05-01 00:00:00
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journal_title:Mayo Clinic proceedings
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更新日期:2019-03-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,评审
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更新日期:2019-11-01 00:00:00