<綜説>新潟県の高齢者施設と一般病院・医院におけるアマンタジン耐性インフルエンザウイルスの分子疫学

概要

論文の詳細を見る
Amantadine (Am) is effective in treatment and prevention of human influenza A virus infections, although treated individuals may excrete resistant viruses. However, their impacts have been incompletely defined. To detect Amantadine resistant influeza A virus strains, we have developed a PCR-restriction fragment length polymorphism (PCR-RFLP) analyses for nasopharyngeal swabs. We could detect 5 resistant viruses (3.3%) in 152 isolates from children prior to the treatment in the 1999/2000 season, indicating that circulation of drug-resistant viruses was not so high in the community even with excess use of Am. Furthermore, we investigated the clinical consequences of Am resistance viruses associated with therapy in children, and our results suggest that one third of treated children excrete resistant viruses, and that they show a reduction of a fever on day 3,but a recrudescence of fever on day 5. In nursing homes, we found that resistant influenza virus strains were circulating at a high frequency in Japan. Am resistant strains after treatment in two seasons from 1999 to 2001 were found higher in H 3 N 2 than H 1 N 1. Predominant genotype of resistant strain was Ser-31-Asn in H 3 N 2 and Val-27-Ala in H 1 N 1,showing different diversity of amino acid substitution in H 3 N 2 and H 1 N 1. Thus, we request that a nationwide monitoring system be established to survey the appearance of resistant influenza A virus in Japan.
新潟大学の論文
2002-06-10