Cluster of Oseltamivir-Resistant 2009 Pandemic Influenza A (H1N1) Virus Infections on a Hospital Ward among Immunocompromised Patients—North Carolina, 2009
| Autor: | Agam K Rao, Ian Greenwald, Daniel J. Sexton, Jonathan Duffy, Arjun Srinivasan, Varough M. Deyde, Cameron R. Wolfe, Larisa V. Gubareva, Aaron T. Fleischauer, Natalie J. M. Dailey, Luke F. Chen, Deverick J. Anderson, Alicia M. Fry, Zack Moore |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Adult
medicine.medical_specialty Oseltamivir medicine.drug_class viruses medicine.disease_cause Antiviral Agents Disease Outbreaks Interviews as Topic chemistry.chemical_compound Major Articles and Brief Reports Immunocompromised Host Influenza A Virus H1N1 Subtype Internal medicine Pandemic Drug Resistance Viral Influenza Human Influenza A virus North Carolina Immunology and Allergy Medicine Humans Pandemics Phylogeny Aged Retrospective Studies Cross Infection biology Neuraminidase inhibitor business.industry Transmission (medicine) virus diseases biochemical phenomena metabolism and nutrition Middle Aged Virology Hospitals respiratory tract diseases Infectious Diseases chemistry Case-Control Studies Chemoprophylaxis biology.protein Human mortality from H5N1 business Neuraminidase |
| Popis: | Oseltamivir resistance among 2009 pandemic influenza A (H1N1) viruses (pH1N1) is rare. We investigated a cluster of oseltamivir-resistant pH1N1 infections in a hospital ward.We reviewed patient records and infection control measures and interviewed health care personnel (HCP) and visitors. Oseltamivir-resistant pH1N1 infections were found with real-time reverse-transcription polymerase chain reaction and pyrosequencing for the H275Y neuraminidase (NA) mutation. We compared hemagglutinin (HA) sequences from clinical samples from the outbreak with those of other surveillance viruses.During the period 6-11 October 2009, 4 immunocompromised patients within a hematology-oncology ward exhibited symptoms of pH1N1 infection. The likely index patient became febrile 8 days after completing a course of oseltamivir; isolation was instituted 9 days after symptom onset. Three other case patients developed symptoms 1, 3, and 5 days after the index patient. Three case patients were located in adjacent rooms. HA and NA sequences from case patients were identical. Twelve HCP and 6 visitors reported influenza symptoms during the study period. No other pH1N1 isolates from the hospital or from throughout the state carried the H275Y mutation.Geographic proximity, temporal clustering, presence of H275Y mutation, and viral sequence homology confirmed nosocomial transmission of oseltamivir-resistant pH1N1. Diagnostic vigilance and prompt isolation may prevent nosocomial transmission of influenza. |
| Databáze: | OpenAIRE |
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