title: Oseltamivir resistance in an influenza A (H3N2) virus isolated from an immunocompromised patient during the 2014-2015 influenza season in Alberta, Canada.
abstract: This manuscript describes the identification of an oseltamivir-resistant influenza A (H3N2) virus in a respiratory specimen collected from an immunocompromised patient in Alberta, Canada, during the 2014-2015 influenza season. Following treatment with oseltamivir, neuraminidase (NA) gene sequencing indicated the presence of an R292K mutation. Phenotypic susceptibility testing by the NA-Star assay indicated a highly reduced inhibition by oseltamivir and normal inhibition by zanamivir. The use of zanamivir following identification of the oseltamivir-resistant strain, combined with a partial immune reconstitution, was followed by a suggested decrease in the nasopharyngeal viral load in the nasopharynx and clinical improvement of the patient.
authors.affiliation: Departments of Oncology and Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Ahsan
authors.initials: A
authors.lastname: Chaudhry
authors.affiliation: National Microbiology Laboratory, Winnipeg, MB, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bastien
authors.affiliation: National Microbiology Laboratory, Winnipeg, MB, Canada.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Surveillance and Assessment, Accountability and Performance, Edmonton, AB, Canada.
authors.forename: Allison
authors.initials: A
authors.lastname: Scott
authors.affiliation: ProvLab Alberta (Calgary), Calgary, AB, Canada.
authors.forename: Kanti
authors.initials: K
authors.lastname: Pabbaraju
authors.affiliation: Departments of Oncology and Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Douglas
authors.initials: D
authors.lastname: Stewart
authors.affiliation: ProvLab Alberta (Calgary), Calgary, AB, Canada.
authors.forename: Sallene
authors.initials: S
authors.lastname: Wong
authors.affiliation: ProvLab Alberta (Edmonton), Edmonton, AB, Canada. Steven.Drews@albertahealthservices.ca.|Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada. Steven.Drews@albertahealthservices.ca.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Drews
mesh_terms: D000416:Alberta / Q000453:epidemiology; D000998:Antiviral Agents / Q000494:pharmacology* / Q000627:therapeutic use; D024882:Drug Resistance, Viral; D006801:Humans; D016867:Immunocompromised Host; D053122:Influenza A Virus, H3N2 Subtype / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009305:Nasopharynx / Q000821:virology; D009439:Neuraminidase / Q000235:genetics; D053139:Oseltamivir / Q000494:pharmacology* / Q000627:therapeutic use; D012621:Seasons; D019562:Viral Load / Q000187:drug effects; D053243:Zanamivir / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir; D009439:Neuraminidase; D053243:Zanamivir
keywords: H3N2; influenza; neuraminidase inhibitors; reduced susceptibility; resistance; sequence analysis