Suggested citation for this article: Calatayud L, Lackenby A, Reynolds A, McMenamin J, Phin NF, Zambon MC, et al. Oseltamivir-resistant pandemic (H1N1) 2009 virus infection in England and Scotland, 2009–2010. Emerg Infect Dis. 2011 Oct; [Epub ahead of print]
Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus Infection in England and Scotland, 2009–2010
Laurence Calatayud, Angie Lackenby, Arlene Reynolds, Jim McMenamin, Nick F. Phin, Maria C. Zambon, and Richard Pebody
Author affiliations: Health Protection Agency, Centre for Infections, London, UK (L. Calatayud, A. Lackenby, N.F. Phin, M.C. Zambon, R. Pebody); and Health Protection Scotland, Glasgow, Scotland, UK (A. Reynolds, J. McMenamin)
Oseltamivir has been widely used for pandemic (H1N1) 2009 virus infection, and by April 30, 2010, a total of 285 resistant cases were reported worldwide, including 45 in the United Kingdom. To determine risk factors for emergence of oseltamivir resistance and severe infection, a case–control study was conducted in the United Kingdom. Study participants were hospitalized in England or Scotland during January 4, 2009–April 30, 2010. Controls had confirmed oseltamivir-sensitive pandemic (H1N1) 2009 virus infections, and case-patients had confirmed oseltamivir-resistant infections. Of 28 case-patients with available information, 21 (75%) were immunocompromised; 31 of 33 case-patients (94%) received antiviral drugs before a sample was obtained. After adjusting for confounders, case-patients remained significantly more likely than controls to be immunocompromised and at higher risk for showing development of respiratory complications. Selective drug pressure likely explains the development of oseltamivir resistance, especially among immunocompromised patients. Monitoring of antiviral resistance is strongly recommended in this group.
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