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Frequency of drug-resistant viruses and virus shedding in pediatric influenza patients treated with neuraminidase inhibitors.

Abstract

BACKGROUND

Although influenza virus resistance to the neuraminidase inhibitor zanamivir is reported less frequently than is resistance to the neuraminidase inhibitor oseltamivir in clinical settings, it is unknown whether this difference is due to the limited use of zanamivir or to an inherent property of the drug. We therefore compared the prevalence of drug-resistant viruses and virus shedding in seasonal influenza virus-infected children treated with either oseltamivir or zanamivir.

METHODS

Clinical specimens (throat or nasal swab) were collected from a total of 144 pediatric influenza patients during the 2005-2006, 2006-2007, 2007-2008, and 2008-2009 influenza seasons. Neuraminidase inhibitor-resistant mutants were detected among the isolated viruses by sequencing the viral hemagglutinin and neuraminidase genes. Sensitivity of the viruses to neuraminidase inhibitors was tested by neuraminidase inhibition assay.

RESULTS

In oseltamivir- or zanamivir-treated influenza patients who were statistically comparable in their age distribution, vaccination history, and type or subtype of virus isolates, the virus-shedding period in zanamivir-treated patients was significantly shorter than that in oseltamivir-treated patients. Furthermore, the frequency of zanamivir-resistant viruses was significantly lower than that of oseltamivir-resistant viruses.

CONCLUSION

In comparison with treatment with oseltamivir, treatment of pediatric patients with zanamivir resulted in the emergence of fewer drug-resistant influenza viruses and a shorter virus-shedding period. We conclude that zanamivir shows promise as a better therapy for pediatric influenza patients.

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  • Authors+Show Affiliations

    ,

    Division of Virology, Department of Microbiology and Immunology, Institute of MedicalScience, University of Tokyo, Shirokanedai, Minato-ku, Tokyo, Japan.

    , , , , , , , , , , ,

    Source

    MeSH

    Adolescent
    Antiviral Agents
    Child
    Child, Preschool
    Drug Resistance, Viral
    Female
    Humans
    Influenza, Human
    Male
    Microbial Sensitivity Tests
    Nasal Mucosa
    Neuraminidase
    Orthomyxoviridae
    Oseltamivir
    Pharynx
    RNA, Viral
    Sequence Analysis, DNA
    Treatment Outcome
    Virus Shedding
    Zanamivir

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    21248368

    Citation

    Tamura, Daisuke, et al. "Frequency of Drug-resistant Viruses and Virus Shedding in Pediatric Influenza Patients Treated With Neuraminidase Inhibitors." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 52, no. 4, 2011, pp. 432-7.
    Tamura D, Sugaya N, Ozawa M, et al. Frequency of drug-resistant viruses and virus shedding in pediatric influenza patients treated with neuraminidase inhibitors. Clin Infect Dis. 2011;52(4):432-7.
    Tamura, D., Sugaya, N., Ozawa, M., Takano, R., Ichikawa, M., Yamazaki, M., ... Kawaoka, Y. (2011). Frequency of drug-resistant viruses and virus shedding in pediatric influenza patients treated with neuraminidase inhibitors. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 52(4), pp. 432-7. doi:10.1093/cid/ciq183.
    Tamura D, et al. Frequency of Drug-resistant Viruses and Virus Shedding in Pediatric Influenza Patients Treated With Neuraminidase Inhibitors. Clin Infect Dis. 2011 Feb 15;52(4):432-7. PubMed PMID: 21248368.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Frequency of drug-resistant viruses and virus shedding in pediatric influenza patients treated with neuraminidase inhibitors. AU - Tamura,Daisuke, AU - Sugaya,Norio, AU - Ozawa,Makoto, AU - Takano,Ryo, AU - Ichikawa,Masataka, AU - Yamazaki,Masahiko, AU - Kawakami,Chiharu, AU - Shimizu,Hideaki, AU - Uehara,Ritei, AU - Kiso,Maki, AU - Kawakami,Eiryo, AU - Mitamura,Keiko, AU - Kawaoka,Yoshihiro, Y1 - 2011/01/19/ PY - 2011/1/21/entrez PY - 2011/1/21/pubmed PY - 2011/4/27/medline SP - 432 EP - 7 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 52 IS - 4 N2 - BACKGROUND: Although influenza virus resistance to the neuraminidase inhibitor zanamivir is reported less frequently than is resistance to the neuraminidase inhibitor oseltamivir in clinical settings, it is unknown whether this difference is due to the limited use of zanamivir or to an inherent property of the drug. We therefore compared the prevalence of drug-resistant viruses and virus shedding in seasonal influenza virus-infected children treated with either oseltamivir or zanamivir. METHODS: Clinical specimens (throat or nasal swab) were collected from a total of 144 pediatric influenza patients during the 2005-2006, 2006-2007, 2007-2008, and 2008-2009 influenza seasons. Neuraminidase inhibitor-resistant mutants were detected among the isolated viruses by sequencing the viral hemagglutinin and neuraminidase genes. Sensitivity of the viruses to neuraminidase inhibitors was tested by neuraminidase inhibition assay. RESULTS: In oseltamivir- or zanamivir-treated influenza patients who were statistically comparable in their age distribution, vaccination history, and type or subtype of virus isolates, the virus-shedding period in zanamivir-treated patients was significantly shorter than that in oseltamivir-treated patients. Furthermore, the frequency of zanamivir-resistant viruses was significantly lower than that of oseltamivir-resistant viruses. CONCLUSION: In comparison with treatment with oseltamivir, treatment of pediatric patients with zanamivir resulted in the emergence of fewer drug-resistant influenza viruses and a shorter virus-shedding period. We conclude that zanamivir shows promise as a better therapy for pediatric influenza patients. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/21248368/Frequency_of_drug_resistant_viruses_and_virus_shedding_in_pediatric_influenza_patients_treated_with_neuraminidase_inhibitors_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciq183 DB - PRIME DP - Unbound Medicine ER -