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Volume 16, Number 7—July 2010


Oseltamivir Resistance in Adult Oncology and Hematology Patients Infected with Pandemic (H1N1) 2009 Virus, Australia

Adrian R. TramontanaComments to Author , Biju George, Aeron C. Hurt, Joseph S. Doyle, Katherine Langan, Alistair B. Reid, Janet M. Harper, Karin Thursky, Leon J. Worth, Dominic E Dwyer, C. Orla Morrissey, Paul D.R. Johnson, Kirsty L. Buising, Simon James Harrison, John F. Seymour, Patricia E. Ferguson, Bin Wang, Justin T. Denholm, Allen C. Cheng, and Monica Slavin
Author affiliations: Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia (A.R. Tramontana, K. Thursky, L.J. Worth, S.J. Harrison, J.F. Seymour, M. Slavin); Western Hospital, Footscray, Victoria, Australia (A.R. Tramontana); Westmead Hospital, Sydney, New South Wales, Australia (B. George, D.E. Dwyer, B. Wang), World Health Organization Collaborating Centre for Reference and Research on Influenza, North Melbourne, Victoria, Australia (A.C. Hurt); The Alfred Hospital, Prahran, Victoria, Australia (J.S. Doyle, C.O. Morrissey); Austin Health, Heidelberg, Victoria, Australia (K. Langan, P.D.R. Johnson); St. Vincent’s Hospital, Melbourne, Victoria, Australia (A.B. Reid, K.L. Buising); Royal Melbourne Hospital, Melbourne (J.M. Harper, J.T. Denholm, M. Slavin); Centre for Infectious Diseases and Microbiology, Sydney (P.E. Ferguson); Monash University, Prahran (A.C. Cheng)

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Table 2

Characteristics of 4 patients infected with oseltamivir-resistant pandemic influenza A (H1N1) virus isolates, Australia*†

Characteristic Patient no.
1 5 12 20
Within 100 days of HSCT‡ No Yes No
Time to development of resistance, d 22 11§ 8 4
Time of last positive NAT result, d 28 16 8 4
Change to zanamivir Yes No No No
Time to zanamivir, d 36
Died Yes Yes No No
LOS, d 39 66 21 9

*HSCT, hematopoietic stem cell transplant; NAT, nucleic acid test; LOS, length of stay.
†Oseltamivir resistance was influenza virus with H275Y mutation.
‡Time from commencement of oseltamivir.
§Detected in bronchoalveolar lavage specimen with negative NAT on nasopharyngeal swab 3 d before first and 10 d after last bronchoscopy. This patient received oseltamivir for 5 d.

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