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KMID : 1130320130560040165
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Korean Journal of Pediatrics
2013 Volume.56 No. 4 p.165 ~ p.175
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Occurrence and characterization of oseltamivirresistant influenza virus in children between 2007-2008 and 2008-2009 seasons
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Kim Seoung-Geun
Hwang Yoon-Ha
Shin Yung-Hae
Kim Sung-Won
Jung Woo-Sik
Kim Sung-Mi
Oh Jae-Min
Lee Na-Young
Kim Mun-Ju
Cho Kyung-Soon
Park Yeon-Gyeong
Min Sang-Kee
Lee Chang-Kyu
Kim Jun-Sub
Kang Chun
Lee Joo-Yeon
Huh Man-Kyu
Kim Chang-Hoon
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Abstract
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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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KEYWORD
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Influenza, Oseltamivir, Resistance, Child
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