Distribution of Respiratory Infection Viruses in 2019-2020 Season and Determination of Oseltamivir Resistance of Influenza Viruses

Öz

Objective: This study aimed to determine the seasonal distribution of the factor data of viral agents determined by the multiplex PCR method in routine practice in patients admitted to the hospital with upper respiratory tract infection symptoms and to detect oseltamivir resistance in viruses that are positive for Influenza A (H1N1). Methods: Nasopharyngeal swab and bronchoalveolar lavage samples of 354 patients between the ages of 0-94 who were admitted to the Sakarya University Sakarya Training and Research Hospital with symptoms of upper respiratory tract infection between 12 September 2019 and 19 February 2020 were studied with the multiplex PCR method. Oseltamivir resistance was investigated in 11 samples selected from Influenza A (H1N1) positive samples by Sanger sequence analysis method. Results: One or more respiratory viruses were identified in 233 (66%) of 354 respiratory samples evaluated. Of these, 64 (27.5%) are Influenza A/H1N1, 4 (1.7%) are Influenza A/H3N2, 24 (10.3%) are Influenza B, 64 (27.5) are Respiratory. Syncytial Virus A/B (RSV A/B), 58 (24.9%) Rhinovirus/Enterovirus, 18 (7.7%) Adenovirus, 12 (5.2%) Human Metapneumo Virus (hMPV) ), 10 (4.3%) Bocavirus, 4 (1.7%) Parainfluenza 1, 7 (3%) Parainfluenza 3, 3 (1.3%) Parainfluenza 4, 5 (2.1%) were found to be Coronavirus HKU1 and 13 (5.6%) were found to be Coronavirus NL63. More than one factor was detected simultaneously in 45 of 233 positive samples (19.3%). Oseltamivir resistance was not found in any of the 11 influenza A/H1N1 positive samples. Conclusion: No oseltamivir resistance was observed in any of the Influenza A/H1N1 positive samples evaluated in this study. Periodic analysis of influenza A/H1N1 strains for oseltamivir resistance is necessary to guide empirical treatment.

Anahtar Kelimeler

• Influenza
• sequence analysis.
• oseltamivir
• drug resistance

Kaynakça

1. Grohskopf LA, Alyanak E, Broder KR et al.Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2019–20 influenza season. MMWR Recomm Rep. 2019;69(8):1-24. doi: 10.15585/mmwr.rr6908a1.
2. Özışık L, Çalık Başaran N, Ünal S. Her Yönüyle Influenza 2016 Türkiye. İç Hastalıkları Dergisi. 2016;23:1-11.
3. Yıldırım A. Hacettepe Üniversitesi İhsan Doğramacı Çocuk Hastanesi’nde 2016-2017 ve 2017-2018 Mevsimsel Influenza Sezonunda Influenza Enfeksiyonuyla İlişkili Olabilecek Semptomlarla Hastaneye Yatmış ve Nazofarengeal Sürüntü Örneğinde Influenza Virüsü Tespit Edilmiş Çocuk Hastaların Klinik ve Epidemiyolojik Özelliklerinin ve Hastalığın Aileye Sosyal Yükünün Değerlendirilmesi. (Tez). Ankara: Hacettepe Üniversitesi, Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, 2019.
4. Aktürk H, Sütçü M, Badur S, et al. Influenza ve diğer solunum yolu virüslerinin klinik ve epidemiyolojik özelliklerinin değerlendirilmesi. Turk Pediatri Ars. 2015;50(4):217-225. doi.10.5152/TurkPediatriArs.2015.2827
5. Çiftçi E, Karbuz A, Kendirli T. Influenza ve oseltamivir kullanımı. Turk Pediatri Ars. 2016;51(2):63-71. doi.10.5152/TurkPediatriArs.2016.2359
6. Öksüz B. Influenza A 2009 (H1N1) Virüsünde H275Y Mutasyonunun Real-Time RT PCR Yöntemi ile Araştırılması. (Tez). İstanbul: Yeditepe Üniversitesi, Sağlık Bilimleri Enstitüsü, Moleküler Tıp Ana Bilim Dalı, 2017.
7. Liu M, Huang LZX, Smits AA, et al. Human-type sialic acid receptors contribute to avian influenza A virus binding and entry by hetero-multivalent interactions. Nat Commun. 2022;13(1):4054. doi: 10.1038/s41467-022-31840-0.
8. Waters D, Theodoratou E, Campbell H, Rudan I, Chopra M. Optimizing community case management strategies to achieve equitable reduction of childhood pneumonia mortality: An application of Equitable Impact Sensitive Tool (EQUIST) in five low–and middle–income countries. J Glob Health. 2012;2(2):020402. doi: 10.7189/jogh.02.020402

9. Lukšić I, Kearns PK, Scott F, et al. Viral etiology of hospitalized acute lower respiratory infections in children under 5 years of age–a systematic review and meta-analysis. Croat Med J. 2013;54(2):122-34. doi: 10.3325/cmj.2013.54.122
10. Weigl J, Puppe W, Gröndahl B, Schmitt H-J. Epidemiological investigation of nine respiratory pathogens in hospitalized children in Germany using multiplex reverse-transcriptase polymerase chain reaction. Eur J Clin Microbiol Infect Dis. 2000;19(5):336-43. doi: 10.1007/s100960050490.
11. Özdamar M, Türkoğlu S. Detection of respiratory pathogens in lower respiratory tract infections by multiplex real time PCR in Kocaeli/Istanbul region in 2015-2017. Medeniyet Med J. 2018;33(3):188-94. doi.10.5222/MMJ.2018.71235
12. Bicer S, Giray T, Çöl D, et al. Virological and clinical characterizations of respiratory infections in hospitalized children. Ital J Pediatr. 2013;39:1-10. doi: 10.1186/1824-7288-39-22
13. Akçalı S, Yılmaz N, Güler Ö, Şanildağ T, Anıl M. Alt solunum yolu enfeksiyonu olan çocuklarda solunum yolu viral etkenlerinin sıklığı. Turk Pediatri Ars. 2013;48:215-20. doi.10.4274/tpa.493
14. Sancaklı Ö, Yenigün A, Kırdar S. Alt Solunum Yolu Enfeksiyonunda Nazofaringeal Örneklerde Polimeraz Zincir Reaksiyonu Sonuçları. J Pediatr Inf. 2012;6:174-177. doi:10.5152/ced.2012.51
15. Oshansky CM, Thomas PG. The human side of influenza. J Leukoc Biol. 2012;92(1):83-96. doi: 10.1189/jlb.1011506 16. Neumann G, Noda T, Kawaoka Y. Emergence and pandemic potential of swine-origin H1N1 influenza virus. Nature. 2009;459(7249):931-9. doi: 10.1038/nature08157.
16. Gülen F, Yıldız B, Çiçek C, Demir E, Tanaç R. Ten year retrospective evaluation of the seasonal distribution of agent viruses in childhood respiratory tract infections. Turk Pediatri Ars. 2014;49(1):42. doi: 10.5152/tpa.2014.1121
17. Sheu TG, Deyde VM, Okomo-Adhiambo M, et al. Surveillance for neuraminidase inhibitor resistance among human influenza A and B viruses circulating worldwide from 2004 to 2008. Antimicrob Agents Chemother. 2008;52(9):3284-92. doi: 10.1128/AAC.00555-08.
18. Chidlow GR, Harnett GB, Williams SH, et al. The detection of oseltamivir-resistant pandemic influenza A/H1N1 2009 viruses using a real-time RT-PCR assay. J Virol Methods. 2010;169(1):47-51. doi: 10.1016/j.jviromet.2010.06.014.
19. Okomo-Adhiambo M, Fry AM, Su S, et al. Oseltamivir-resistant influenza A (H1N1) pdm09 viruses, United States, 2013–14. Emerg İnfect Dis. 2015;21(1):136. doi: 10.3201/eid2101.141006
20. Guldemir D, Kalaycioglu AT, Altas AB, Korukluoglu G, Durmaz R. Monitoring genetic diversity of influenza A (H1N1) pdm09 virus circulating during the post-pandemic period in Turkey. Jpn J Infect Dis. 2013;66(4):299-305. doi: 10.7883/yoken.66.299.