title: Oseltamivir resistance mutation N294S in human influenza A(H5N1) virus in Egypt.
abstract: In December 2006, three human specimens were received that were suspected positive for influenza A(H5N1). The specimens were tested using real time PCR. And the presence of A(H5N1) virus was confirmed in 2 patients (16F and 26M), The NA sequence from A(H5N1) positive specimens collected before and after antiviral therapy revealed a mutation (N294S) (N295S according to N1 numbering), previously associated with resistance to oseltamivir. When tested with NA inhibition assays, the two N294S viruses from Egypt exhibited from 57 to 138-fold reduction in susceptibility to oseltamivir, depending on the assay. To our knowledge, this is the first time oseltamivir resistance has been detected in A(H5N1) infecting a human prior to treatment.
authors.affiliation: U.S. Naval Medical Research Unit No. 3 (NAMRU-3), Cairo, Egypt. kenneth.earhart@med.navy.mil
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Earhart
authors.forename: Nasr M
authors.initials: NM
authors.lastname: Elsayed
authors.forename: Magdi D
authors.initials: MD
authors.lastname: Saad
authors.forename: Larisa V
authors.initials: LV
authors.lastname: Gubareva
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nayel
authors.forename: Varough M
authors.initials: VM
authors.lastname: Deyde
authors.forename: Ali
authors.initials: A
authors.lastname: Abdelsattar
authors.forename: Ahmad S
authors.initials: AS
authors.lastname: Abdelghani
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Boynton
authors.forename: Moustafa M
authors.initials: MM
authors.lastname: Mansour
authors.forename: Hala M
authors.initials: HM
authors.lastname: Essmat
authors.forename: Alexander
authors.initials: A
authors.lastname: Klimov
authors.forename: Deidra
authors.initials: D
authors.lastname: Shuck-Lee
authors.forename: M R
authors.initials: MR
authors.lastname: Monteville
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Tjaden
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000494:pharmacology*; D001483:Base Sequence; D024882:Drug Resistance, Viral / Q000187:drug effects / Q000235:genetics*; D004534:Egypt; D005260:Female; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D007251:Influenza, Human / Q000188:drug therapy* / Q000235:genetics / Q000821:virology; D020128:Inhibitory Concentration 50; D008297:Male; D008826:Microbial Sensitivity Tests; D009154:Mutation / Q000235:genetics; D009439:Neuraminidase / Q000037:antagonists & inhibitors* / Q000235:genetics / Q000378:metabolism; D053139:Oseltamivir / Q000494:pharmacology*; D010641:Phenotype; D016133:Polymerase Chain Reaction; D012367:RNA, Viral; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D053139:Oseltamivir; D009439:Neuraminidase