title: Rapid spread of drug-resistant influenza A viruses in the Basque Country, northern Spain, 2000-1 to 2008-9.
abstract: A worldwide increase of adamantane-resistant influenza A(H3N2) and oseltamivir-resistant influenza A(H1N1) viruses has been observed in recent years. The aim of this study was to analyse the prevalence of antiviral drug-resistant influenza A in a region of northern Spain. Resistance to adamantanes was detected in 45.3% (68/150) of influenza AH3 viruses analysed for the period from 2000-1 to 2008-9. Adamantane-resistance was absent in our region during the 2000-1 to 2002-3 influenza seasons. However, after the first adamantane-resistant virus (characterised as A/Fujian/411/2002) was detected in the 2003-4 season, a rapid increase in the proportion of resistant strains was observed (4.9% [2/41], 80% [8/10] and 100% [53/53] in the 2004-5, 2006-7 and 2008-9 seasons, respectively). Four of the first five adamantane-resistant AH3 viruses detected were isolated from adult patients, but the subsequent spread was observed mainly among children. No resistance to adamantanes was detected among the 65 influenza AH1 viruses analysed throughout the study period. Among the 172 influenza A (76 AH1 and 96 AH3) viruses analysed, five strains (AH1 with mutation H274Y) showed oseltamivir resistance, and all were detected in the last season. Amantadine use was very scarce in our region, and oseltamivir was not used at all; therefore the increase of resistance was attributed to imported drug-resistant influenza viruses.
authors.affiliation: Microbiology Service and Reference Laboratory for Influenza Infections of the Basque Country, Hospital Donostia, San Sebastián, Spain. mikrobiol@terra.es
authors.forename: D
authors.initials: D
authors.lastname: Vicente
authors.forename: G
authors.initials: G
authors.lastname: Cilla
authors.forename: M
authors.initials: M
authors.lastname: Montes
authors.forename: J
authors.initials: J
authors.lastname: Mendiola
authors.forename: E
authors.initials: E
authors.lastname: Pérez-Trallero
mesh_terms: D000218:Adamantane / Q000627:therapeutic use; D024882:Drug Resistance, Viral / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects* / Q000235:genetics; D053122:Influenza A Virus, H3N2 Subtype / Q000187:drug effects* / Q000235:genetics; D007251:Influenza, Human / Q000453:epidemiology*; D008826:Microbial Sensitivity Tests; D009154:Mutation / Q000187:drug effects / Q000235:genetics; D053139:Oseltamivir / Q000627:therapeutic use; D013030:Spain / Q000453:epidemiology
chemical_list: D053139:Oseltamivir; D000218:Adamantane