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Bordetella pertussis

Background:

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Gram-Negative Cocci & Coccobacilli   
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>Aggregatibacter aphrophilus (formally known as Haemophilus aphrophilus)
>Bordetella pertussis (Causative agent of pertussis or whooping cough. )led
>Brucella species:
     1] Brucella abortus
     2] Brucella canis
     3] Brucella melitensis
     4] Brucella suis
>Eikenella corrodens
>Haemophilus species:
     1] Haemophilus influenzae
     2] Haemophilus ducreyi
     3] Haemophilus avium
>Moraxella catarrhalis (formerly known as Branhamella catarrhalis)
>Neisseria species:  (frequently colonize mucosal surfaces.)
     1] Neisseria gonorrhoeae
     2] Neisseria meningitidis
>Pasteurella multocida

Bordetella pertussis

  • Gram-negative, nonmotile, aerobic coccobacillus capsulate of the genus Bordetella, and the causative agent of pertussis or whooping cough.
  • Virulence factors include pertussis toxin, filamentous hæmagglutinin, pertactin, fimbria, and tracheal cytotoxin.  Humans are its only host.
  • Spread by airborne droplets; its incubation period is seven to 14 days.
  • Pertussis: infection of the respiratory system characterized by a “whooping” sound when the person breathes in. In the US, it killed between 10,000 and 20,000 people per year before a vaccine was available.
  • Bordetella pertussis infects its host by colonizing lung epithelial cells.
  • The bacterium contains a surface protein, filamentous haemagglutinin adhesin, which binds to the sulfatides found on cilia of epithelial cells.

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Therapy:

Important considerations:  The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions.   Generally, the most common agents/regimens are listed first.  Listed dosages may need to be adjusted for renal dysfunction.  

  1. Azithromycin 500mg orally x 1 then 250mg  once daily for 4 days
  2. Clarithromycin 500mg po q12h  or Biaxin XL ®: 1000mg po qd x 7 days
  3. Bactrim DS (TMP-SMX) 160/800mg po bid x 14 days.  Mild-moderate infection:  5 to 10 mg/kg/day (based on trimethoprim component) IV/oral divided in 2-4 doses.   

Bordetella pertussis