Reduced Susceptibility to Neuraminidase Inhibitors in Influenza B Isolate, Canada.
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ABSTRACT:
SUBMITTER: Abed Y
PROVIDER: S-EPMC6433030 | biostudies-literature | 2019 Apr
REPOSITORIES: biostudies-literature
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Reduced Susceptibility to Neuraminidase Inhibitors in Influenza B Isolate, Canada.
Abed Yacine Y Fage Clément C Lagüe Patrick P Carbonneau Julie J Papenburg Jesse J Vinh Donald C DC Boivin Guy G
Emerging infectious diseases 20190401 4
We identified an influenza B isolate harboring a Gly407Ser neuraminidase substitution in an immunocompromised patient in Canada before antiviral therapy. This mutation mediated reduced susceptibility to oseltamivir, zanamivir, and peramivir, most likely by preventing interaction with the catalytic Arg374 residue. The potential emergence of such variants emphasizes the need for new antivirals. ...[more]
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Project description:ObjectivesIn British Columbia (BC), Canada, neuraminidase inhibitors (NIs) were publicly funded during the 2009 A(H1N1)pdm09 pandemic for treatment of high-risk patients and/or anyone with moderate-to-severe illness. We assessed antiviral effectiveness (AVE) against hospitalization in that context.MethodsA population-based cohort study was conducted using linked administrative data. The cohort included all individuals living in BC during the study period (1 September to 31 December 2009) with a diagnostic code consistent with influenza or pandemic H1N1. The main study period pertained to the second-wave A(H1N1)pdm09 circulation (1 October to 31 December 2009), with sensitivity analyses around the more specific pandemic peak (18 October to 7 November). Exposure was defined by same-day NI prescription. The main outcome was all-cause hospitalization within 14 days of the outpatient influenza diagnosis. Cox proportional hazards models assessed AVE with 1 : 1 propensity-score matching and covariate adjustment.ResultsAfter matching, there were 304/58,061 NI-exposed and 345/58,061 unexposed patients hospitalized during the main study period. The very young [<6 months (35.0; 95% CI 16.7-73.4)], the old [65-79 years (13.7; 95% CI 10.1-18.6)] and the very old [?80 years (38.7; 95% CI 26.6-56.5)] had the highest hospitalization rate per 1000 patients overall. Fully adjusted AVE against all-cause hospitalization during the main study period was 16% (95% CI 2%-28%), similar to the pandemic peak (15%; 95% CI -4%-30%).ConclusionsThe use of NIs was associated with modest protection against hospitalization during the 2009 pandemic, but appeared underutilized in affected age groups with the highest hospitalization risk.
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