The international occurrence of ptxP3 genotype macrolide resistant Bordetella pertussis; a call for updating of clinical practice guidelines

As we had previously expected, a concerning pathogen characteristic change in the recent pertussis upsurge is the international occurrence of macrolideresistant Bordetella pertussis (MRBP). 1 These isolates from multiple countries were homologous to the ptxP3 genotype MRBP strains (ptxP3-MRBP) first widely identified in China. 2,3In response to this epidemiological shift, experts usually emphasize the 1 These authors contributed equally to this work.