Emergence of Multidrug-Resistant Influenza A(H1N1)pdm09 Virus Variants in an Immunocompromised Child Treated With Oseltamivir and Zanamivir.
Prolonged treatment of an immunocompromised child with oseltamivir and zanamivir for A(H1N1)pdm09 virus infection led to the emergence of viruses carrying H275Y and/or E119G in the neuraminidase (NA). When phenotypically evaluated by NA inhibition, the dual H275Y-E119G substitution caused highly reduced inhibition by 4 NA inhibitors: oseltamivir, zanamivir, peramivir, and laninamivir.
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Daisuke
D
Tamura
Divisions of Pediatric Infectious Diseases Departments of Pediatrics Microbiology, Immunology and Tropical Medicine, George Washington University School of Medicine, Washington D.C.
Roberta L
RL
DeBiasi
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Margaret
M
Okomo-Adhiambo
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Vasiliy P
VP
Mishin
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Angela P
AP
Campbell
Blood and Marrow Transplantation, Children's National Medical Center Departments of Pediatrics.
Brett
B
Loechelt
Divisions of Pediatric Infectious Diseases Departments of Pediatrics.
Bernhard L
BL
Wiedermann
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Alicia M
AM
Fry
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Larisa V
LV
Gubareva
D000146:Acids, Carbocyclic; D019943:Amino Acid Substitution; D000998:Antiviral Agents / Q000627:therapeutic use*; D003517:Cyclopentanes / Q000627:therapeutic use; D024882:Drug Resistance, Viral / Q000235:genetics*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006146:Guanidines / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects / Q000235:genetics*; D007251:Influenza, Human / Q000188:drug therapy / Q000821:virology*; D008297:Male; D020125:Mutation, Missense; D009439:Neuraminidase / Q000235:genetics*; D053139:Oseltamivir / Q000627:therapeutic use; D011714:Pyrans; D012794:Sialic Acids; D014764:Viral Proteins / Q000235:genetics; D053243:Zanamivir / Q000031:analogs & derivatives / Q000627:therapeutic use
D000146:Acids, Carbocyclic; D000998:Antiviral Agents; D003517:Cyclopentanes; D004791:Enzyme Inhibitors; D006146:Guanidines; D011714:Pyrans; D012794:Sialic Acids; D014764:Viral Proteins; D053139:Oseltamivir; C546918:laninamivir; D009439:Neuraminidase; D053243:Zanamivir; C414210:peramivir
drug resistance; neuraminidase; oseltamivir; pyrosequencing; zanamivir