Prolonged shedding of amantadine- and oseltamivir-resistant influenza A(H3N2) virus with dual mutations in an immunocompromised infant

Antivir Ther. 2010;15(7):1059-63. doi: 10.3851/IMP1657.

Abstract

In this study, we report a case of multidrug-resistant influenza A(H3N2) virus isolated from an immunosuppressed patient with prolonged viral shedding. We also describe the genetic characterization of the haemagglutinin, neuraminidase and M2 influenza genes. The virus contained the substitutions E119V in neuraminidase and V27A in M2, which produce resistance to oseltamivir and adamantanes, respectively. This is the first report of this dual mutation pattern in multidrug-resistant influenza A(H3N2) virus.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amantadine / therapeutic use*
  • Amino Acid Sequence
  • Antiviral Agents / therapeutic use
  • Drug Resistance, Multiple, Viral*
  • Hemagglutinin Glycoproteins, Influenza Virus / genetics
  • Humans
  • Immunocompromised Host*
  • Infant
  • Influenza A Virus, H3N2 Subtype / drug effects*
  • Influenza A Virus, H3N2 Subtype / genetics
  • Influenza A Virus, H3N2 Subtype / isolation & purification
  • Influenza, Human / drug therapy
  • Influenza, Human / virology
  • Male
  • Molecular Sequence Data
  • Mutation
  • Neuraminidase / genetics
  • Oseltamivir / therapeutic use*
  • Viral Matrix Proteins / genetics

Substances

  • Antiviral Agents
  • Hemagglutinin Glycoproteins, Influenza Virus
  • M2 protein, Influenza A virus
  • Viral Matrix Proteins
  • Oseltamivir
  • Amantadine
  • Neuraminidase