alexa Failure to Detect Oseltamivir Resistance by Rolling Ci
ISSN: 1948-5964

Journal of Antivirals & Antiretrovirals
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Research Article

Failure to Detect Oseltamivir Resistance by Rolling Circle Amplification and Sequencing Following Use in an Influenza A (H3N2) Outbreak at an Aged Care Facility

Alexander Rosewell1,2, Bin Wang3, Nitin K Saksena3, C Raina MacIntyre1, Richard Lindley4, Clayton Chiu1, Carol Shineberg1, Elizabeth Clarke1, Ken McPhie5, V Mala Ratnamohan5, Robert Booy1, Dominic E Dwyer5,*

1National Centre for Immunisation Research and Surveillance for Vaccine Preventable Diseases, The Children’s Hospital at Westmead, University of Sydney, Westmead, NSW, Australia

2National Centre for Epidemiology and Population Health, The Australian National University College of Medicine and Health Sciences, Canberra, ACT, Australia

3Centre for Virus Research, Westmead Millennium Institute, Westmead, NSW, Australia

4Discipline of Medicine, Westmead Hospital (C24), The University of Sydney, Westmead, NSW, Australia

5Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, Westmead Hospital, Westmead, NSW, Australia

Corresponding Author:
Dr. Dominic E Dwyer BSc (Med), MB BS, MD,
FRACP, FRCPA, Centre for Infectious Diseases and Microbiology Laboratory Services,
ICPMR, Westmead Hospital, Westmead, NSW,
Aust ralia,
Phone : +612 9845 6255,
Fax : +612 9633 5314,
E-mail : [email protected]

Received Date: October 15, 2009; Accepted Date: November 04, 2009; Published Date: November 05, 2009

Citation: Rosewell A, Wang B, Saksena NK, MacIntyre CR, Lindley R, et al. (2009) Failure to Detect Oseltamivir Resistance by Rolling Circle Amplification and Sequencing Following Use in an Influenza A (H3N2) Outbreak at an Aged Care Facility. J Antivir Antiretrovir 1: 056-061. doi:

Copyright: © 2009 Rosewell A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Background: The recent worldwide emergence of increasing oseltamivir resistance to influenza A H1N1 may have important implications for influenza prevention and control. Objectives: To assess oseltamivir use, the emergence of resistance and the outcome of an influenza A H3N2 outbreak. Patients/Methods: Following identification of an influenza outbreak through active surveillance, the investigators offered treatment and prophylaxis with oseltamivir to both Aged Care Facility (ACF) residents and staff. The investigators conducted genotypic sensitivity testing using sequencing and rolling circle amplfication for known oseltamivir resistance mutations. Results: An influenza A H3N2 outbreak affecting an ACF with 90 residents and 79 staff was identified 6 days after the initial case. Oseltamivir prophylaxis was commenced on day 7. The overall attack rate was 10%, with 13 of 92 residents and 4 of 79 staff infected.There was no evidence of the development of genotypic resistance, even at low levels, to oseltamivir in patients tested whilst on treatment or prophylaxis. Conclusions: There was no clinical or genotypic evidence of oseltamivir resistance, an important observation in the context of recent reported antiviral resistance in other influenza A subtypes.

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