Detection of oseltamivir resistance during treatment of 2009 H1N1 influenza virus infection in immunocompromised patients: utility of cycle threshold values of qualitative real-time reverse transcriptase PCR.
Two immunocompromised patients with 2009 H1N1 influenza pneumonia had viral shedding for over 5 weeks despite therapy with oseltamivir. Declining or persistently low cycle threshold values noted on serial qualitative real-time reverse transcriptase PCR (rRT-PCR) of respiratory specimens implied increasing viral load and probable drug resistance. Oseltamivir resistance was later confirmed by pyrosequencing.
Mehta
Tejal
T
Division of Infectious Diseases, Beaumont Hospital, Detroit, Michigan 48201, USA.
McGrath
Eric
E
Bheemreddy
Suchitha
S
Salimnia
Hossein
H
Abdel-Haq
Nahed
N
Ang
Jocelyn Y
JY
Lum
Lawrence
L
Chandrasekar
Pranatharthi
P
Alangaden
George J
GJ
D000998:Antiviral Agents / Q000008:administration & dosage / Q000494:pharmacology*; D024882:Drug Resistance, Viral; D006801:Humans; D016867:Immunocompromised Host; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D007251:Influenza, Human / Q000188:drug therapy* / Q000821:virology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D053139:Oseltamivir / Q000008:administration & dosage / Q000494:pharmacology*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D017422:Sequence Analysis, DNA; D013183:Sputum / Q000821:virology; D013997:Time Factors; D019562:Viral Load; D017201:Virus Shedding
D000998:Antiviral Agents; D053139:Oseltamivir