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First case in Italy of acquired resistance to oseltamivir in an immunocompromised patient with influenza A/H1N1v infection.

Author(s): Campanini G, Piralla A, Rovida F, Puzelli S, Facchini M, Locatelli F, Minoli L, Percivalle E, Donatelli I, Baldanti F, Surveillance Group for New Influenza A/H1N1v Investigation in Italy

Affiliation(s): Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.

Publication date & source: 2010-07, J Clin Virol., 48(3):220-2. Epub 2010 May 5.

Publication type: Case Reports; Research Support, Non-U.S. Gov't

A pandemic influenza A/H1N1v strain with the neuraminidase H274Y mutation was detected in nasal secretions of a 2-year-old leukemic patient with influenza-like illness after 18 days of treatment with oseltamivir. At baseline, no drug-resistant virus was found, while 4 days after treatment initiation a mixture of wild-type and mutated virus was detected. After treatment interruption, the wild type influenza virus re-emerged and became prevalent in nasal secretions after a few days, suggesting the lower fitness of the mutated virus strain. The patient slowly improved concurrently with a decrease in virus load, which resulted negative 42 days after diagnosis. No other drug-resistant influenza A/H1N1v virus strains have been detected in Italy (up to the end of November 2009) since the first case of the novel A/H1N1v virus was identified in the country (May 2009). Copyright (c) 2010 Elsevier B.V. All rights reserved.

Page last updated: 2010-10-05

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