Korean J Pediatr.
2013 Apr;56(4):165-175. 10.3345/kjp.2013.56.4.165.
Occurrence and characterization of oseltamivir-resistant influenza virus in children between 2007-2008 and 2008-2009 seasons
- Affiliations
-
- 1Department of Pediatrics, Busan St. Mary's Medical Center, Busan, Korea. ksm7090@hanmail.net
- 2Institute of Health & Environment, Busan, Korea.
- 3Department of Laboratory Medicine, Korea University Anam Hospital, Seoul, Korea.
- 4Division of Influenza Virus, Korea Centers for Disease Control and Prevention, Cheongwon, Korea.
- 5Department of Molecular Biology, Dongeui University, Busan, Korea.
- 6Office of Public Healthcare Service, Pusan National University Hospital, Busan, Korea.
- KMID: 1427933
- DOI: http://doi.org/10.3345/kjp.2013.56.4.165
Abstract
- PURPOSE
There was a global increase in the prevalence of oseltamivir-resistant influenza viruses during the 2007-2008 influenza season. This study was conducted to investigate the occurrence and characteristics of oseltamivir-resistant influenza viruses during the 2007-2008 and 2008-2009 influenza seasons among patients who were treated with oseltamivir (group A) and those that did not receive oseltamivir (group B).
METHODS
A prospective study was conducted on 321 pediatric patients who were hospitalized because of influenza during the 2007-2008 and 2008-2009 influenza seasons. Drug resistance tests were conducted on influenza viruses isolated from 91 patients.
RESULTS
There was no significant difference between the clinical characteristics of groups A and B during both seasons. Influenza A/H1N1, isolated from both groups A and B during the 2007-2008 and 2008-2009 periods, was not resistant to zanamivir. However, phenotypic analysis of the virus revealed a high oseltamivir IC50 range and that H275Y substitution of the neuraminidase (NA) gene and partial variation of the hemagglutinin (HA) gene did not affect its antigenicity to the HA vaccine even though group A had a shorter hospitalization duration and fewer lower respiratory tract complications than group B. In addition, there was no significant difference in the clinical manifestations between oseltamivir-susceptible and oseltamivir-resistant strains of influenza A/H1N1.
CONCLUSION
Establishment of guidelines to efficiently treat influenza with oseltamivir, a commonly used drug for treating influenza in Korean pediatric patients, and a treatment strategy with a new therapeutic agent is required.
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