宁夏2011-2012年甲型H1N1流感病毒NAI耐药性研究

Neuraminidase inhibitor resistance among influenza A(H1N1) viruses isolated from the mainland of Ningxia

目的调查宁夏流行甲型H1N1流感病毒对神经氨酸酶抑制剂类药物的耐药情况,为抗病毒治疗提供一定参考。方法选取2011-2012年宁夏流感监测分离到的40株甲型H1N1流感病毒,通过NA基因测序分析其重要氨基酸位点变异情况,同时选取9株毒株使用化学发光法进行奥司他韦和扎那米韦两种药物的敏感性测定,分析其耐药情况。结果基因耐药结果表明,40株甲型H1N1流感病毒NA基因发生变异的氨基酸位点分别为M19I、T60N/T、V106I、V241I、N248D、N369K、N386S和D451G,未发现第275、294、152和119位氨基酸发生变异;生物耐药结果表明,奥司他韦和扎那米韦两种药物对选择的9株毒株为正常抑制。结论神经氨酸酶抑制剂类药物对宁夏流行甲型H1N1病毒均敏感,可以继续用以临床治疗,但随着抗病毒治疗病人的增加和病毒的自身变异,应加强耐药性监测以提供及时准确的耐药信息。

Objective To investigate the resistance to neuraminidase inhibitor（ NAI） of influenza pandemic A（ H1N1） 2009 viruses in Ningxia province,and to provide valuable information for antiviral therapeutics. Methods Totally 40 A（ H1N1） pdm09 strains were selected from Ningxia influenza surveillance network during 2011- 2012,and all strains were performed neuraminidase（ NA） genetic sequencing for analyzing the amino acid mutations related to NAI resistance,and 9 strains were performed chemiluminesce- based testing for detecting the sensibility of oseltamivir and zanamivir. Results The mutation sites of NA gene included M19 I,T60N /T,V106 I,V241I,N248 D,N369K,N386 S and D451 G among Ningxia A（ H1N1） pdm09 strains,and no mutation sites related to resistance was found. Oseltamivir and zanamivir were sensitive to selected 9 strains. Conclusion Although oseltamivir and zanamivir are sensitive to influenza pandemic A（ H1N1）,2009 viruses in Ningxia province,we need to strengthen surveillance because of growing antiviral therapy patients and virus mutation.