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Journal of Clinical Microbiology, May 2009, p. 1372-1378, Vol. 47, No. 5
0095-1137/09/$08.00+0     doi:10.1128/JCM.01993-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Influenza Antiviral Resistance Testing in New York and Wisconsin, 2006 to 2008: Methodology and Surveillance Data ^,

Jennifer M. Laplante,¹ Steven A. Marshall,² Matthew Shudt,¹ Tam T. Van,² Erik S. Reisdorf,² Lisa A. Mingle,¹ Peter A. Shult,² and Kirsten St. George^1*

Wadsworth Center, New York State Department of Health, Albany, New York,¹ Wisconsin State Laboratory of Hygiene, 465 Henry Mall, Madison, Wisconsin 53706²

Received 15 October 2008/ Returned for modification 12 December 2008/ Accepted 17 March 2009

The need for effective influenza antiviral susceptibility surveillance methods has increased due to the emergence of near-universal adamantane resistance in influenza A/H3N2 viruses during the 2005-2006 season and the appearance of oseltamivir resistance in the influenza A/H1N1 virus subtype during the 2007-2008 season. The two classes of influenza antivirals, the neuraminidase inhibitors (NAIs) and the adamantanes, are well characterized, as are many mutations that can confer resistance to these drugs. Adamantane resistance is imparted mainly by a S31N mutation in the matrix gene, while NAI resistance can result from a number of mutations in the neuraminidase gene. During the 2007-2008 season, a neuraminidase mutation (H274Y) conferring resistance to the NAI oseltamivir emerged worldwide in the A/H1N1 virus subtype. Surveillance methodology and data from New York (NY) and Wisconsin (WI) for the 2006-2007 and 2007-2008 influenza seasons are presented. We used an existing pyrosequencing method (R. A. Bright et al., Lancet 366:1175-1181, 2005) and a modified version of this method for detection of adamantane resistance mutations. For NAI resistance mutation detection, we used a mutation-specific pyrosequencing technique and developed a neuraminidase gene dideoxy sequencing method. Adamantane resistance in the A/H3N2 virus samples was 100% for 2007-2008, similar to the 99.8% resistance nationwide as reported by the CDC. Adamantane resistance was found in only 1.2% of NY and WI A/H1N1 virus samples, compared to that found in 10.8% of samples tested nationwide as reported by the CDC. Influenza A/H1N1 virus H274Y mutants were found in 11.1% of NY samples for 2007-2008, a level comparable to the 10.9% nationwide level reported by the CDC; in contrast, mutants were found in 17.4% of WI samples. These results indicate the need for regional influenza antiviral surveillance.

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* Corresponding author. Mailing address: Laboratory of Viral Diseases, Wadsworth Center, Griffin Laboratory, NYS Department of Health, Empire State Plaza, P.O. Box 509, Albany, NY 12201-0509. Phone: (518) 869-4520. Fax: (518) 869-6487. E-mail: kxs16{at}health.state.ny.us

Published ahead of print on 25 March 2009.

Supplemental material for this article may be found at http://jcm.asm.org/.

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Journal of Clinical Microbiology, May 2009, p. 1372-1378, Vol. 47, No. 5
0095-1137/09/$08.00+0     doi:10.1128/JCM.01993-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.