title: Surveillance of antiviral resistance markers in Argentina: detection of E119V neuraminidase mutation in a post-treatment immunocompromised patient.
abstract: Although vaccines are the best means of protection against influenza, neuraminidase inhibitors are currently the main antiviral treatment available to control severe influenza cases. One of the most frequent substitutions in the neuraminidase (NA) protein of influenza A(H3N2) viruses during or soon after oseltamivir administration is E119V mutation. We describe the emergence of a mixed viral population with the E119E/V mutation in the NA protein sequence in a post-treatment influenza sample collected from an immunocompromised patient in Argentina. This substitution was identified by a real-time reverse transcriptase polymerase chain reaction (RT-PCR) protocol and was confirmed by direct Sanger sequencing of the original sample. In 2014, out of 1140 influenza samples received at the National Influenza Centre, 888 samples (78%) were A(H3N2) strains, 244 (21.3%) were type B strains, and 8 (0.7%) were A(H1N1)pdm09 strains. Out of 888 A(H3N2) samples, 842 were tested for the E119V substitution by quantitative RT-PCR: 841 A(H3N2) samples had the wild-type E119 genotype and in one sample, a mixture of viral E119/ V119 subpopulations was detected. Influenza virus surveillance and antiviral resistance studies can lead to better decisions in health policies and help in medical treatment planning, especially for severe cases and immunocompromised patients.
authors.affiliation: National Influenza Centre PAHO/WHO, National Reference Laboratory, Respiratory Viral Diseases Service, Department of Virology, National Institute of Infectious Diseases, National Agency of Laboratories and Institutes of Health Dr Carlos G Malbrán, Ciudad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pontoriero
authors.affiliation: National Influenza Centre PAHO/WHO, National Reference Laboratory, Respiratory Viral Diseases Service, Department of Virology, National Institute of Infectious Diseases, National Agency of Laboratories and Institutes of Health Dr Carlos G Malbrán, Ciudad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Martín
authors.initials: M
authors.lastname: Avaro
authors.affiliation: National Influenza Centre PAHO/WHO, National Reference Laboratory, Respiratory Viral Diseases Service, Department of Virology, National Institute of Infectious Diseases, National Agency of Laboratories and Institutes of Health Dr Carlos G Malbrán, Ciudad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Estefania
authors.initials: E
authors.lastname: Benedetti
authors.affiliation: National Influenza Centre PAHO/WHO, National Reference Laboratory, Respiratory Viral Diseases Service, Department of Virology, National Institute of Infectious Diseases, National Agency of Laboratories and Institutes of Health Dr Carlos G Malbrán, Ciudad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Mara
authors.initials: M
authors.lastname: Russo
authors.affiliation: National Influenza Centre PAHO/WHO, National Reference Laboratory, Respiratory Viral Diseases Service, Department of Virology, National Institute of Infectious Diseases, National Agency of Laboratories and Institutes of Health Dr Carlos G Malbrán, Ciudad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Andrea
authors.initials: A
authors.lastname: Czech
authors.affiliation: National Influenza Centre PAHO/WHO, National Reference Laboratory, Respiratory Viral Diseases Service, Department of Virology, National Institute of Infectious Diseases, National Agency of Laboratories and Institutes of Health Dr Carlos G Malbrán, Ciudad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Natalia
authors.initials: N
authors.lastname: Periolo
authors.affiliation: National Influenza Centre PAHO/WHO, National Reference Laboratory, Respiratory Viral Diseases Service, Department of Virology, National Institute of Infectious Diseases, National Agency of Laboratories and Institutes of Health Dr Carlos G Malbrán, Ciudad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Ana
authors.initials: A
authors.lastname: Campos
authors.affiliation: University of Tucuman, School of Pharmacy and Biochemistry, Microbiology Institute, Tucuman, Argentina.
authors.forename: Ana
authors.initials: A
authors.lastname: Zamora
authors.affiliation: National Influenza Centre PAHO/WHO, National Reference Laboratory, Respiratory Viral Diseases Service, Department of Virology, National Institute of Infectious Diseases, National Agency of Laboratories and Institutes of Health Dr Carlos G Malbrán, Ciudad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Elsa
authors.initials: E
authors.lastname: Baumeister
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D001118:Argentina / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D053122:Influenza A Virus, H3N2 Subtype / Q000187:drug effects / Q000235:genetics*; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009439:Neuraminidase / Q000235:genetics*; D053139:Oseltamivir / Q000627:therapeutic use*; D060888:Real-Time Polymerase Chain Reaction; D014764:Viral Proteins / Q000235:genetics*; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D014764:Viral Proteins; D053139:Oseltamivir; C487630:NA protein, influenza A virus; D009439:Neuraminidase