上海市2018—2019年度A/H1N1(pdm09)亚型流感病毒的耐药性及<i>NA</i>基因特性研究

赵雪; 滕峥; 房方皓; 蒋慧; 牟嘉斌; 吴佳谨; 姜晨彦; 袁政安; 林庆能; 张曦

doi:10.19428/j.cnki.sjpm.2020.19857

上海市2018—2019年度A/H1N1(pdm09)亚型流感病毒的耐药性及NA基因特性研究

Drug resistence and NA gene characteristics of influenza virus A/H1N1(pdm09) studied in Shanghai during 2018-2019

摘要

摘要:
目的通过监测2018—2019年度上海市优势流行株A/H1N1(pdm09)亚型流感病毒对神经氨酸酶抑制剂(NAIs)的耐药情况，为上海市流感临床用药提供参考。
方法随机选取60株A/H1N1(pdm09)亚型流行株，采用神经氨酸酶抑制实验及神经氨酸酶(NA)基因测序的方法，开展流行株对奥司他韦及扎那米韦敏感性和耐药性的监测和分析。
结果60株流行株均对奥司他韦和扎那米韦敏感，未发现敏感性降低或者显著降低的情况；基因序列分析也未发现NA在催化活性关键位点及辅助位点出现氨基酸变异，佐证了神经氨酸酶抑制实验的表型检测结果。
结论上海市2018—2019年度流行的A/H1N1(pdm09)亚型流感病毒对神经氨酸酶抑制剂依然敏感，为临床用药提供了科学参考。随着药物的广泛使用，应持续加强流感病毒耐药性监测，以有效指导临床用药。

Abstract:
ObjectiveA/H1N1(pdm09) viruses were the dominant strains in Shanghai during 2018-2019 influenza surveillance year.This study is to provide a scientific reference for clinical drug use by investigating the susceptibility of A/H1N1(pdm09) viruses to neuraminidase inhibitors(NAIs).
MethodsSixty strains of A/H1N1(pdm09) viruses were randomly selected for testing the susceptibility and drug resistance to Oseltamivir and Zanamivir by means of neutaminidase inhibition and neuraminidase (NA) gene sequencing.
ResultsThe 60 epidemic strains all proved to be susceptible to Oseltamivir and Zanamivir and the susceptibility was not observed to be decreased or remarkably decreased.In genetic sequencing, NA was not observed to present amino acid mutation at the key sites and auxiliary sites in catalytic activity, which confirmed the results of the phototypic detection of neuraminidase inhibition.
ConclusionThe subtype influenza viruses A/H1N1(pdm09) circulating in Shanghai during 2018-2019 surveillance year are still sensitive to NAIs, which provides a scientific reference for clinical use of drugs.However, we monitored only a number of strains and think that the work monitoring antiviral susceptibility should be continued with the wide use of the drugs.

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