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Characteristics of a widespread community cluster of H275Y oseltamivir-resistant A(H1N1)pdm09 influenza in Australia.
J Infect Dis 2012; 206(2):148-57JI

Abstract

BACKGROUND

Oseltamivir resistance in A(H1N1)pdm09 influenza is rare, particularly in untreated community cases. Sustained community transmission has not previously been reported.

METHODS

Influenza specimens from the Asia-Pacific region were collected through sentinel surveillance, hospital, and general practitioner networks. Clinical and epidemiological information was collected on patients infected with oseltamivir-resistant viruses.

RESULTS

Twenty-nine (15%) of 191 A(H1N1)pdm09 viruses collected between May and September 2011 from Hunter New England (HNE), Australia, contained the H275Y neuraminidase substitution responsible for oseltamivir resistance. Only 1 patient had received oseltamivir before specimen collection. The resistant strains were genetically very closely related, suggesting the spread of a single variant. Ninety percent of cases lived within 50 kilometers. Three genetically similar oseltamivir-resistant variants were detected outside of HNE, including 1 strain from Perth, approximately 4000 kilometers away. Computational analysis predicted that neuraminidase substitutions V241I, N369K, and N386S in these viruses may offset the destabilizing effect of the H275Y substitution.

CONCLUSIONS

This cluster represents the first widespread community transmission of H275Y oseltamivir-resistant A(H1N1)pdm09 influenza. These cases and data on potential permissive mutations suggest that currently circulating A(H1N1)pdm09 viruses retain viral fitness in the presence of the H275Y mutation and that widespread emergence of oseltamivir-resistant strains may now be more likely.

Authors+Show Affiliations

WHO Collaborating Centre for Reference and Research on Influenza, North Melbourne, Victoria, Australia. aeron.hurt@influenzacentre.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22561367

Citation

Hurt, A C., et al. "Characteristics of a Widespread Community Cluster of H275Y Oseltamivir-resistant A(H1N1)pdm09 Influenza in Australia." The Journal of Infectious Diseases, vol. 206, no. 2, 2012, pp. 148-57.
Hurt AC, Hardie K, Wilson NJ, et al. Characteristics of a widespread community cluster of H275Y oseltamivir-resistant A(H1N1)pdm09 influenza in Australia. J Infect Dis. 2012;206(2):148-57.
Hurt, A. C., Hardie, K., Wilson, N. J., Deng, Y. M., Osbourn, M., Leang, S. K., ... Barr, I. G. (2012). Characteristics of a widespread community cluster of H275Y oseltamivir-resistant A(H1N1)pdm09 influenza in Australia. The Journal of Infectious Diseases, 206(2), pp. 148-57. doi:10.1093/infdis/jis337.
Hurt AC, et al. Characteristics of a Widespread Community Cluster of H275Y Oseltamivir-resistant A(H1N1)pdm09 Influenza in Australia. J Infect Dis. 2012 Jul 15;206(2):148-57. PubMed PMID: 22561367.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of a widespread community cluster of H275Y oseltamivir-resistant A(H1N1)pdm09 influenza in Australia. AU - Hurt,A C, AU - Hardie,K, AU - Wilson,N J, AU - Deng,Y M, AU - Osbourn,M, AU - Leang,S K, AU - Lee,R T C, AU - Iannello,P, AU - Gehrig,N, AU - Shaw,R, AU - Wark,P, AU - Caldwell,N, AU - Givney,R C, AU - Xue,L, AU - Maurer-Stroh,S, AU - Dwyer,D E, AU - Wang,B, AU - Smith,D W, AU - Levy,A, AU - Booy,R, AU - Dixit,R, AU - Merritt,T, AU - Kelso,A, AU - Dalton,C, AU - Durrheim,D, AU - Barr,I G, Y1 - 2012/05/04/ PY - 2012/5/8/entrez PY - 2012/5/9/pubmed PY - 2012/8/29/medline SP - 148 EP - 57 JF - The Journal of infectious diseases JO - J. Infect. Dis. VL - 206 IS - 2 N2 - BACKGROUND: Oseltamivir resistance in A(H1N1)pdm09 influenza is rare, particularly in untreated community cases. Sustained community transmission has not previously been reported. METHODS: Influenza specimens from the Asia-Pacific region were collected through sentinel surveillance, hospital, and general practitioner networks. Clinical and epidemiological information was collected on patients infected with oseltamivir-resistant viruses. RESULTS: Twenty-nine (15%) of 191 A(H1N1)pdm09 viruses collected between May and September 2011 from Hunter New England (HNE), Australia, contained the H275Y neuraminidase substitution responsible for oseltamivir resistance. Only 1 patient had received oseltamivir before specimen collection. The resistant strains were genetically very closely related, suggesting the spread of a single variant. Ninety percent of cases lived within 50 kilometers. Three genetically similar oseltamivir-resistant variants were detected outside of HNE, including 1 strain from Perth, approximately 4000 kilometers away. Computational analysis predicted that neuraminidase substitutions V241I, N369K, and N386S in these viruses may offset the destabilizing effect of the H275Y substitution. CONCLUSIONS: This cluster represents the first widespread community transmission of H275Y oseltamivir-resistant A(H1N1)pdm09 influenza. These cases and data on potential permissive mutations suggest that currently circulating A(H1N1)pdm09 viruses retain viral fitness in the presence of the H275Y mutation and that widespread emergence of oseltamivir-resistant strains may now be more likely. SN - 1537-6613 UR - https://www.unboundmedicine.com/medline/citation/22561367/Characteristics_of_a_widespread_community_cluster_of_H275Y_oseltamivir_resistant_A_H1N1_pdm09_influenza_in_Australia_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jis337 DB - PRIME DP - Unbound Medicine ER -