湖州市甲3型流感病毒烷胺类药物耐药性分析

Adamantane resistance among influenza H3 subtype virus isolates from the mainland of Huzhou

目的:分析湖州市2009年-2012年流感流行期甲3型流感病毒流行株对金刚烷胺的耐药情况,为流感的临床治疗用药提供参考。方法:选取湖州市流感监测网络和流感暴发疫情中所分离的48株甲3型流感病毒株,提取病毒核酸,采用RT-PCR扩增病毒M2基因片段,纯化后进行核苷酸序列测定,用生物信息软件分析与耐药有关的氨基酸位点。结果:48株甲3型流感病毒分离株中,43株M2蛋白跨膜区耐药位点的氨基酸被置换,对金刚烷胺耐药率为89.58%。2009年-2012年4个流行期耐药率分别为85.71%、78.57%、94.12%和100%。变异主要发生在M2蛋白跨膜区第31位氨基酸,42株发生了S31N置换,占87.5%,其次是在第27位,有3株发生了V27A置换,占6.25%。结论:人群甲3型流感对金刚烷胺类药物耐药率较高,应加强耐药性监测,提醒卫生部门应对流感大流行谨慎使用此类药物。

Objective：To analyze the resistance of influenza H3 subtype isolates to amantadine in Huzhou during 2009-2012 and to provide a reference for the clinical use of amantadine.Methods：Forty-eight strains of influenza H3 subtype viral strains were randomly selected from influenza surveillance network and outbreaks in Huzhou,viral RNA was extracted,and M2 gene segments were amplified by reverse transcription polymerase chain reaction（RT-PCR）.PCR products were purified and sequenced and the positions of amino acids providing resistance to amantadine were analyzed using biometric software.Results： Of the 48 strains of influenza H3 subtype virus,forty-three strains had amino acid changes at the transmembrane domain of the M2 protein;the resistance rate to amantadine was 89.58%.During the influenza season from 2009 to 2012,the resistance rates of influenza H3 subtype virus to adamantane were 85.71%,78.57%,94.12% and 100%.Of the 43 amantadine resistant strains,forty-two（87.5%） strains had amino acid changes at site S31N and three strains（6.25%）had changes at V27A.Conclusion： The rate of resistance to amantadine is high among the epidemic strains of influenza H3 suptype virus in population of Huzhou,so the hygiene department should strengthen drug-resistance monitoring for clinical rational use in influenza epidemic.