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. 2024 Jan;30(1):29–38. doi: 10.3201/eid3001.221588

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Emerging Infectious Diseases is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.

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Changing macrolide resistance of circulating Bordetella pertussis strains, Shanghai, China, 2016–2022. A) ptxP3-strains showed very high resistance to macrolides after 2020. Resistance to macrolides was different in non-MT28 (0%) and MT28 (100%) isolates. B) Percentages of macrolide-sensitive BP, ptxP1-MRBP, and ptxP3-MRBP before and after 2020 show that ptxP1-MRBP strain was prevalent before 2020 but predominately ptxP3-MRBP spread after 2020. MRBP, macrolide-resistant Bordetella pertussis; MT, multilocus variable-number tandem-repeat analysis type.