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1. Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus Infection in England and Scotland, 2009–2010

Author

Laurence Calatayud, Angie Lackenby, Arlene Reynolds, Jim McMenamin, Nick F. Phin, Maria Zambon, and Richard G. Pebody

Subjects
swine-origin influenza A H1N1 virus, subtype H1N1, virus, antiviral drug resistance, drug resistance, antimicrobial resistance, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Oseltamivir has been widely used for pandemic (H1N1) 2009 virus infection, and by April 30, 2010, a total of 285 resistant cases were reported worldwide, including 45 in the United Kingdom. To determine risk factors for emergence of oseltamivir resistance and severe infection, a case–control study was conducted in the United Kingdom. Study participants were hospitalized in England or Scotland during January 4, 2009–April 30, 2010. Controls had confirmed oseltamivir-sensitive pandemic (H1N1) 2009 virus infections, and case-patients had confirmed oseltamivir-resistant infections. Of 28 case-patients with available information, 21 (75%) were immunocompromised; 31 of 33 case-patients (94%) received antiviral drugs before a sample was obtained. After adjusting for confounders, case-patients remained significantly more likely than controls to be immunocompromised and at higher risk for showing development of respiratory complications. Selective drug pressure likely explains the development of oseltamivir resistance, especially among immunocompromised patients. Monitoring of antiviral resistance is strongly recommended in this group.

Published
2011
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2. Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus Infection in England and Scotland, 2009–2010

Author

Nick Phin, Angie Lackenby, Laurence Calatayud, Jim McMenamin, Maria Zambon, Richard Pebody, and Arlene Reynolds

Subjects
Male, swine-origin influenza A H1N1 virus, Epidemiology, viruses, lcsh:Medicine, Drug resistance, medicine.disease_cause, chemistry.chemical_compound, Influenza A Virus, H1N1 Subtype, Risk Factors, Pandemic, Influenza A virus, Medicine, Young adult, expedited, Child, Aged, 80 and over, immunocompromised patient, antiviral drug resistance, virus diseases, Middle Aged, Infectious Diseases, England, Child, Preschool, Female, influenza, Microbiology (medical), Adult, medicine.medical_specialty, Oseltamivir, Adolescent, pandemic (H1N1) 2009 virus, Neuraminidase, virus, Virus, lcsh:Infectious and parasitic diseases, subtype H1N1, Young Adult, Antibiotic resistance, H1N1 influenza virus, Internal medicine, Drug Resistance, Viral, Influenza, Human, influenza A virus, Humans, lcsh:RC109-216, antimicrobial resistance, Pandemics, immunocompromised host, Aged, drug resistance, business.industry, Research, lcsh:R, Case-control study, Infant, Virology, respiratory tract diseases, chemistry, Scotland, Case-Control Studies, Mutation, business
Abstract

Monitoring of antiviral resistance is strongly recommended for immunocompromised patients., Oseltamivir has been widely used for pandemic (H1N1) 2009 virus infection, and by April 30, 2010, a total of 285 resistant cases were reported worldwide, including 45 in the United Kingdom. To determine risk factors for emergence of oseltamivir resistance and severe infection, a case–control study was conducted in the United Kingdom. Study participants were hospitalized in England or Scotland during January 4, 2009–April 30, 2010. Controls had confirmed oseltamivir-sensitive pandemic (H1N1) 2009 virus infections, and case-patients had confirmed oseltamivir-resistant infections. Of 28 case-patients with available information, 21 (75%) were immunocompromised; 31 of 33 case-patients (94%) received antiviral drugs before a sample was obtained. After adjusting for confounders, case-patients remained significantly more likely than controls to be immunocompromised and at higher risk for showing development of respiratory complications. Selective drug pressure likely explains the development of oseltamivir resistance, especially among immunocompromised patients. Monitoring of antiviral resistance is strongly recommended in this group.

Published
2011

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