Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Occurrence and characterization of oseltamivir-resistant influenza virus in children between 2007-2008 and 2008-2009 seasons

  • Kim, Seoung Geun (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Hwang, Yoon Ha (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Shin, Yung Hae (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Kim, Sung Won (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Jung, Woo Sik (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Kim, Sung Mi (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Oh, Jae Min (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Lee, Na Young (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Kim, Mun Ju (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Cho, Kyung Soon (Institute of Health & Environment) ;
  • Park, Yeon Gyeong (Institute of Health & Environment) ;
  • Min, Sang Kee (Institute of Health & Environment) ;
  • Lee, Chang Kyu (Department of Laboratory Medicine, Korea University Anam Hospital) ;
  • Kim, Jun Sub (Division of Influenza Virus, Korea Centers for Disease Control and Prevention) ;
  • Kang, Chun (Division of Influenza Virus, Korea Centers for Disease Control and Prevention) ;
  • Lee, Joo Yeon (Division of Influenza Virus, Korea Centers for Disease Control and Prevention) ;
  • Huh, Man Kyu (Department of Molecular Biology, Dongeui University) ;
  • Kim, Chang Hoon (Office of Public Healthcare Service, Pusan National University Hospital)
  • Received : 2012.08.23
  • Accepted : 2012.10.24
  • Published : 2013.04.15
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Abstract

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 $IC_{50}$ 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.

Keywords

References

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