{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:53:43Z","timestamp":1791561223676,"version":"4.3.4"},"reference-count":71,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"InFLAMES Flagship Programme of the Academy of Finland","award":["337530"],"award-info":[{"award-number":["337530"]}]},{"name":"InFLAMES Flagship Programme of the Academy of Finland","award":["26005475"],"award-info":[{"award-number":["26005475"]}]},{"name":"Tampere Tuberculosis Foundation","award":["337530"],"award-info":[{"award-number":["337530"]}]},{"name":"Tampere Tuberculosis Foundation","award":["26005475"],"award-info":[{"award-number":["26005475"]}]},{"name":"The Foundation for Paediatric Research","award":["337530"],"award-info":[{"award-number":["337530"]}]},{"name":"The Foundation for Paediatric Research","award":["26005475"],"award-info":[{"award-number":["26005475"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Pertussis is a highly contagious respiratory infection caused by Bordetella pertussis bacterium. The mainstay of treatment is macrolide antibiotics that reduce transmissibility, shorten the duration of symptoms and decrease mortality in infants. Recently, the macrolide resistance of B. pertussis has been reported globally but is especially widespread in mainland China. In this review, we aim to summarise the current understanding of the epidemiology, resistance mechanisms and clinical implications of B. pertussis macrolide resistance. Since the first appearance of macrolide-resistant B. pertussis in Arizona, USA, in 1994, only sporadic cases have been reported outside China. In certain parts of China, on the other hand, up to 70\u2013100% of the recent clinical isolates have been found to be macrolide resistant. Reasons for macrolide resistance being centred upon China during the last decade can only be speculated on, but the dominant B. pertussis lineage is different between China and most of the high-income countries. It seems evident that efforts to increase awareness, guide molecular epidemiological surveillance and carry out systematic screening of B. pertussis positive samples for macrolide resistance should be implemented globally. In addition, practices to improve the clinical care of infants with pertussis caused by resistant strains should be studied vigorously.<\/jats:p>","DOI":"10.3390\/antibiotics11111570","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T11:31:51Z","timestamp":1667907111000},"page":"1570","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Macrolide Resistance in Bordetella pertussis: Current Situation and Future Challenges"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8935-5032","authenticated-orcid":false,"given":"Lauri","family":"Ivaska","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20521 Turku, Finland"},{"name":"InFLAMES Research Flagship Center, University of Turku, 20520 Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex-Mikael","family":"Barkoff","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, 20520 Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jussi","family":"Mertsola","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20521 Turku, Finland"},{"name":"Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, 20520 Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiushui","family":"He","sequence":"additional","affiliation":[{"name":"InFLAMES Research Flagship Center, University of Turku, 20520 Turku, Finland"},{"name":"Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, 20520 Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/S1473-3099(17)30390-0","article-title":"An Update of the Global Burden of Pertussis in Children Younger than 5 Years: A Modelling Study","volume":"17","author":"Yeung","year":"2017","journal-title":"Lancet Infect. 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