{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:56:35Z","timestamp":1787028995634,"version":"build-2736575974"},"reference-count":59,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Pathology, Queen Elizabeth Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>A post-COVID surge of Bordetella pertussis was observed globally. China has reported a high level of macrolide-resistant Bordetella pertussis (MRBP) in recent years; however, the epidemiology of MRBP in Hong Kong remains unknown. We retrieved archived B. pertussis isolates from respiratory samples collected at five regional public hospitals in Hong Kong between 2015 and 2024 and tested their minimum inhibitory concentration (MIC) for macrolides and other non-macrolide antibiotics using the Etest method. All isolates were also subjected to whole genome sequencing for genotypic resistance, Multi-locus Antigen Sequence Typing (MLST) and Multi-locus Variable Number of Tandem Repeat Analysis (MLVA) typing. Twenty-nine isolates of B. pertussis were included in the study. All isolates demonstrating phenotypic macrolide resistance harbored the A2047G mutation while showing low MIC to trimethoprim-sulfamethoxazole, doxycycline, levofloxacin, piperacillin-tazobactam and meropenem. In 2023 and 2024, 100% were MRBP and all belonged to the MT28 clone with the ptxP3 antigenic type. The MRBP isolates in Hong Kong were phylogenetically related to those from mainland China during the same period. There was no obvious correlation between macrolide resistance and clinical presentation, laboratory findings, management and outcome. Phylogenetic analysis suggests that MRBP isolates in Hong Kong and mainland China are closely related.<\/jats:p>","DOI":"10.3390\/microorganisms13081947","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T15:53:37Z","timestamp":1755705217000},"page":"1947","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Macrolide-Resistant Bordetella pertussis in Hong Kong: Evidence for Post-COVID-19 Emergence of ptxP3-Lineage MT28 Clone from a Hospital-Based Surveillance Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6990-906X","authenticated-orcid":false,"given":"Tsz-Yung","family":"Hui","sequence":"first","affiliation":[{"name":"Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China"},{"name":"Department of Pathology, Hong Kong Children\u2019s Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9831-2912","authenticated-orcid":false,"given":"Hayes Kam-Hei","family":"Luk","sequence":"additional","affiliation":[{"name":"Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garnet Kwan-Yue","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hong Kong Children\u2019s Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy Ka-Yee","family":"Chau","sequence":"additional","affiliation":[{"name":"Department of Pathology, United Christian Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lok-Man","family":"Tsang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kwong Wah Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy Wing-Sze","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kwong Wah Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka-Kin","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy Yiu-Wing","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho-Leung","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Tuen Mun Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6476-4697","authenticated-orcid":false,"given":"Tommy Hing-Cheung","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China"},{"name":"Quality & Safety Division, Hospital Authority Head Office, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3071-6256","authenticated-orcid":false,"given":"Edmond Siu-Keung","family":"Ma","sequence":"additional","affiliation":[{"name":"Infection Control Branch, Centre for Health Protection, Department of Health, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Khoo Teck Puat Hospital, Singapore 768828, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2126-6484","authenticated-orcid":false,"given":"Sally Cheuk-Ying","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China"},{"name":"Department of Pathology, Hong Kong Children\u2019s Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivien Wai-Man","family":"Chuang","sequence":"additional","affiliation":[{"name":"Quality & Safety Division, Hospital Authority Head Office, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6047-9744","authenticated-orcid":false,"given":"David Christopher","family":"Lung","sequence":"additional","affiliation":[{"name":"Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China"},{"name":"Department of Pathology, Hong Kong Children\u2019s Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref_1","unstructured":"Ho, F.W. 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