title: Pandemic influenza A(H1N1) 2009: molecular characterisation and duration of viral shedding in intensive care patients in Bordeaux, south-west France, May 2009 to January 2010.
abstract: From May 2009 to January 2010, the Virology Laboratory at the University Hospital of Bordeaux received more than 4,000 nasopharyngeal samples from the Aquitaine region (south-west France) for the diagnosis of pandemic influenza A(H1N1)2009. Eighty-three infected patients deteriorated and were admitted to intensive care units. Our study focused on 24 of these patients. Positivity for influenza A(H1N1)2009 was monitored by realtime PCR and duration of viral shedding was determined. The first available sample of each patient was analysed for bacterial, fungal and viral co-infection. We observed six bacterial (or bacterial/fungal) co-infections and one viral co-infection with respiratory syncytial virus. The samples were analysed for the presence of the neuraminidase H275Y (N1 numbering) mutation, which confers resistance to oseltamivir, by realtime PCR of the neuraminidase gene. No H275Y mutation was observed in any of the viral strains screened in this study. In parallel, a fragment of the haemagglutinin gene encoding amino acid residues 173 to 362 was sequenced to detect mutations that had been reported to increase the severity of the disease. Two patients were infected by strains bearing the D222G (H3 numbering) mutation. The viral shedding of A(H1N1)2009 in this study ranged from four to 28 days with a median of 11 days.
authors.affiliation: Virology laboratory, University Hospital of Bordeaux, France.
authors.forename: L
authors.initials: L
authors.lastname: Malato
authors.forename: V
authors.initials: V
authors.lastname: Llavador
authors.forename: E
authors.initials: E
authors.lastname: Marmier
authors.forename: J
authors.initials: J
authors.lastname: Youssef
authors.forename: C
authors.initials: C
authors.lastname: Balick Weber
authors.forename: H
authors.initials: H
authors.lastname: Rozé
authors.forename: E
authors.initials: E
authors.lastname: Bessede
authors.forename: H J
authors.initials: HJ
authors.lastname: Fleury
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D019267:Hemagglutinin Glycoproteins, Influenza Virus / Q000235:genetics; D006785:Hospitals, University; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009439:Neuraminidase / Q000235:genetics*; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D016133:Polymerase Chain Reaction; D013997:Time Factors; D017201:Virus Shedding; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D019267:Hemagglutinin Glycoproteins, Influenza Virus; D053139:Oseltamivir; D009439:Neuraminidase