{"id":6154,"date":"2024-03-27T18:50:48","date_gmt":"2024-03-27T09:50:48","guid":{"rendered":"http:\/\/www.med.niigata-u.ac.jp\/pub\/?p=6154"},"modified":"2024-04-24T11:30:37","modified_gmt":"2024-04-24T02:30:37","slug":"2024%e5%b9%b43%e6%9c%8821%e6%97%a5%e3%80%80%e6%8a%97%e3%82%a4%e3%83%b3%e3%83%95%e3%83%ab%e3%82%a8%e3%83%b3%e3%82%b6%e5%89%a4%e6%84%9f%e5%8f%97%e6%80%a7%e4%bd%8e%e4%b8%8b%e6%a0%aa%e8%aa%bf%e6%9f%bb","status":"publish","type":"post","link":"http:\/\/www.med.niigata-u.ac.jp\/pub\/2024\/03\/27\/2024%e5%b9%b43%e6%9c%8821%e6%97%a5%e3%80%80%e6%8a%97%e3%82%a4%e3%83%b3%e3%83%95%e3%83%ab%e3%82%a8%e3%83%b3%e3%82%b6%e5%89%a4%e6%84%9f%e5%8f%97%e6%80%a7%e4%bd%8e%e4%b8%8b%e6%a0%aa%e8%aa%bf%e6%9f%bb\/","title":{"rendered":"2024\u5e743\u670821\u65e5\u3000\u6297\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u5264\u611f\u53d7\u6027\u4f4e\u4e0b\u682a\u8abf\u67fb\u306e\u7d50\u679c"},"content":{"rendered":"

\u7d50\u679c\u306e\u6982\u8981<\/p>\n

2024\u5e74\uff13\u6708\uff12\uff11\u65e5\u6642\u70b9<\/p>\n

2023\u5e7410\u6708\u304b\u30892024\u5e742\u6708\u306b\u304b\u3051\u3066\u3001\u5408\u8a08146\u4ef6\u306e\u521d\u8a3a\u6642\u691c\u4f53\u304c\u63a1\u53d6\u3055\u308c\u307e\u3057\u305f\u3002\u518d\u8a3a\u6642\u691c\u4f53\u306f49\u4ef6\u63a1\u53d6\u3055\u308c\u3001\u3046\u306128\u4ef6\u306f\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6295\u4e0e\u5f8c\u306b\u63a1\u53d6\u3055\u308c\u307e\u3057\u305f\uff08\u88681\uff09\u3002<\/p>\n

\"\"<\/a><\/p>\n

2023\u5e7410\u6708\u4ee5\u964d\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6A(H1N1)pdm09\u309248\u4ef6\u3001A(H3N2)\u309258\u4ef6\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6A\u578b\uff08\u4e9c\u578b\u304c\u7279\u5b9a\u4e0d\u80fd\uff09\u30927\u4ef6\u3001B\/\u30d3\u30af\u30c8\u30ea\u30a2\u309221\u4ef6\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6B\u578b\uff08\u7cfb\u7d71\u304c\u7279\u5b9a\u4e0d\u80fd\uff09\u30921\u4ef6\u691c\u51fa\u3057\u307e\u3057\u305f\uff08\u88681\uff0c\u56f31\uff09\u3002\u4eca\u30b7\u30fc\u30ba\u30f3\u306fA(H1N1)pdm09\u3068A(H3N2)\u306e\u540c\u6642\u6d41\u884c\u3067\u3042\u308a\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u691c\u51fa\u6570\u306f11\u6708\u304c\u6700\u3082\u591a\u304f\u300112\u6708\u4ee5\u964d\u306f\u5f90\u3005\u306b\u6e1b\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n

\"\"<\/a><\/p>\n

 <\/p>\n

\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u30a6\u30a4\u30eb\u30b9\u306ePA\u86cb\u767d38\u4f4d\u304c\u30a4\u30bd\u30ed\u30a4\u30b7\u30f3\u304b\u3089\u30b9\u30ec\u30aa\u30cb\u30f3\u306b\u5909\u7570\u3057\u305f\u30a6\u30a4\u30eb\u30b9(PA\/I38T\u5909\u7570\u682a)\u306f\u3001\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u306b\u5bfe\u3057\u3066\u611f\u53d7\u6027\u4f4e\u4e0b\u3092\u793a\u3059\u3068\u8a00\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u3053\u306ePA\/I38T\u5909\u7570\u682a\u3092\u7279\u7570\u7684\u306b\u691c\u51fa\u3059\u308b\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0PCR\u6cd5\uff08\u30b5\u30a4\u30af\u30ea\u30f3\u30d6\u30d7\u30ed\u30fc\u30d6\u6cd5\uff09\u3092\u63a1\u53d6\u3055\u308c\u305f\u691c\u4f53\u5168\u3066\u306b\u5b9f\u65bd\u3057\u307e\u3057\u305f\u3002<\/p>\n

 <\/p>\n

\u4eca\u56de\u7279\u7b46\u3059\u3079\u304d\u7d50\u679c\u3068\u3057\u3066\u3001\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0PCR\u304a\u3088\u3073\u6b21\u4e16\u4ee3\u30b7\u30fc\u30b1\u30f3\u30b7\u30f3\u30b0\u306b\u3088\u308a\u3001\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6cbb\u7642\u5f8c\u306bPA\/I38T\u5909\u7570\u3092\u6709\u3059\u308b\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6A(H3N2)\u30a6\u30a4\u30eb\u30b9\u30921\u682a\u691c\u51fa\u3057\u307e\u3057\u305f\u3002<\/p>\n

 <\/p>\n

\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0PCR\u6cd5\u306b\u3088\u308a\u3001PA\/I38T\u5909\u7570\u3092\u691c\u51fa\u3057\u305f\u3068\u3053\u308d\u3001\u6297\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u85ac\u6295\u4e0e\u524d\u306eA(H1N1)pdm09\u306e48\u682a\u3001A(H3N2)\u306e58\u682a\u3001B\u578b\u306e1\u682a\u306e\u3044\u305a\u308c\u306b\u304a\u3044\u3066\u3082PA\/I38T\u5909\u7570\u306f\u691c\u51fa\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\uff08\u88682\uff09\u3002<\/p>\n

\"\"<\/a><\/p>\n

 <\/p>\n

\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6295\u4e0e\u5f8c\u306b\u63a1\u53d6\u3055\u308c\u305f\u691c\u4f53\uff08\u518d\u8a3a\u6642\u691c\u4f53\uff09\u306f28\u4ef6\u3067\u3057\u305f\uff08\u88682\uff09\u300215\u4ef6\u304cA(H1N1)pdm09\u3067\u3001\u3046\u30614\u4ef6\u304cPCR\u967d\u6027\u3067\u3057\u305f\u304c\u3001PA\/I38T\u5909\u7570\u306f\u691c\u51fa\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\u3002A(H3N2)\u306f11\u4ef6\u3067\u3001\uff12\u4ef6\u304cPCR\u967d\u6027\u3067\u3001\u3046\u30611\u4ef6\u306bPA\/I38T\u5909\u7570\u304c\u691c\u51fa\u3055\u308c\u3001\u3053\u306e\u51fa\u73fe\u983b\u5ea6\u306f9.0\uff05\u3067\u3057\u305f\uff08 1\/11\uff09\u3002B\/Victoria\u306f2\u4ef6\u3067\u3057\u305f\u304c\u3001\u518d\u8a3a\u306ePCR\u7d50\u679c\u3067\u306f\u5168\u3066\u9670\u6027\u3067\u3057\u305f\u3002<\/p>\n

 <\/p>\n

[PA\u907a\u4f1d\u5b50\u89e3\u6790\uff3d<\/p>\n

\u6b21\u4e16\u4ee3\u30b7\u30fc\u30af\u30a8\u30f3\u30b7\u30f3\u30b0\uff08NGS\uff09\u3092\u5b9f\u65bd\u3057\u305f\u521d\u8a3a\u6642\u691c\u4f5346\u4ef6\u306f\u3001A(H1N1)pdm09\u304c21\u4ef6\u3001A(H3N2)\u304c24\u4ef6\u3001B\u578b\u304c1\u4ef6\u3067\u3001\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u306b\u5bfe\u3059\u308b\u611f\u53d7\u6027\u4f4e\u4e0b\u3092\u793a\u3059\u3068\u5831\u544a\u3055\u308c\u305fPA\u5909\u7570\u306f\u3059\u3079\u3066\u306e\u691c\u4f53\u306b\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n

\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6295\u4e0e\u5f8c\u306b\u63a1\u53d6\u3055\u308c\u305f\u691c\u4f53\uff08\u518d\u8a3a\u6642\u691c\u4f53\uff09\u306f\u3001A(H1N1)pdm09\u304c2\u4ef6\u3001A(H3N2)\u304c2\u4ef6\u3067\u3057\u305f\u3002A(H1N1)pdm09\u306b\u306f\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u306b\u5bfe\u3059\u308b\u611f\u53d7\u6027\u4f4e\u4e0b\u3092\u793a\u3059\u3068\u5831\u544a\u3055\u308c\u305f\u5909\u7570\u306f\u691c\u51fa\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\u304c\uff080.\uff10\uff05, 0\/2\uff09\u3001A(H3N2)\u306e\uff11\u4ef6\u3067\u306fPA\/I38T\u5909\u7570\u304c\u691c\u51fa\u3055\u308c\u307e\u3057\u305f\uff0820.\uff10\uff05, 1\/5\uff09\uff08\u88683\uff09\u3002<\/p>\n

\"\"<\/a><\/p>\n

 <\/p>\n

[NA\u907a\u4f1d\u5b50\u89e3\u6790\uff3d<\/p>\n

\u5909\u7570\u306b\u3064\u3044\u3066\u3001NGS\u3092\u5b9f\u65bd\u3057\u305f\u521d\u8a3a\u6642\u691c\u4f5346\u691c\u4f53\u306f\u3001\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u3092\u542b\u3080NA\u963b\u5bb3\u5264\u306b\u5bfe\u3059\u308b\u611f\u53d7\u6027\u4f4e\u4e0b\u3092\u793a\u3059\u3068\u5831\u544a\u3055\u308c\u305fNA\u5909\u7570\u306f\u3059\u3079\u3066\u306e\u691c\u4f53\u306b\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u6295\u4e0e\u5f8c\u306b\u63a1\u53d6\u3055\u308c\u305f\u691c\u4f53A(H1N1)pdm09\u306e1\u4ef6\u3001A(H3N2)\u306e2\u4ef6\u3001B\u578b\u306e1\u4ef6\u306b\u306f\u3001NA\u963b\u5bb3\u5264\u306b\u5bfe\u3059\u308b\u611f\u53d7\u6027\u3092\u4f4e\u4e0b\u3055\u305b\u308b\u5909\u7570\u306fNA\u907a\u4f1d\u5b50\u306b\u691c\u51fa\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\uff08\u88684\uff09\u3002<\/p>\n

\"\"<\/a><\/p>\n

 <\/p>\n

 <\/p>\n

Summary of Results.
\nAs of March 21, 2024<\/p>\n

From October 2023 to February 2024, a total of 146 initial visit specimens were collected. There were 49 specimens collected at follow-up visits (second visits), of which 28 were collected after administration of baloxavir (Table 1).<\/p>\n

Since October 2023, 48 cases of influenza A(H1N1)pdm09, 58 cases of A(H3N2), 7 cases of influenza A (subtype unidentified), 21 case of B\/Victoria and 1 case of B lineage unidentified were detected (Table 1 and Figure 1). This season saw a simultaneous circulation of A(H1N1)pdm09, A(H3N2) and B\/Victoria with the highest number of influenza detections in November, gradually decreasing from December onwards.<\/p>\n

A virus with a substitution at position 38 of the PA protein, from isoleucine to threonine (PA\/I38T mutation), is reported to confer reduced sensitivity to baloxavir. We implemented a real-time PCR method (cycling probe method) specifically designed to detect this PA\/I38T mutation on all samples.<\/p>\n

Of note, we found one influenza A(H3N2) virus with PA\/I38T substitution after the treatment of baloxavir by real-time PCR and next generation sequencing.<\/p>\n

None of the 48 of A(H1N1)pdm09, 58 of A(H3N2), and 21 of influenza B\/Victoria collected before administration of antiviral influenza drugs showed the presence of the PA\/I38T mutation by real-time PCR (Table 2).<\/p>\n

There were 28 specimens collected after administration of baloxavir (follow-up visit specimens) (Table 2). Of these, 15 were A(H1N1)pdm09, with 4 testing positive via PCR, and the PA\/I38T substitution was not detected. Among the 11 cases of A(H3N2), one tested positive for PA\/I38T. This mutation appeared at a frequency of 9.0% (1\/11). There were two B\/Victoria cases, which were PCR negative at the 2nd<\/sup> visit.<\/p>\n

[PA Gene Analysis]<\/p>\n

Forty-six initial visit specimens were subjected to next-generation sequencing (NGS), with 21 cases of A(H1N1)pdm09, 24 case of A(H3N2), and 1 case of type B. None of first visit specimen had any PA substitution, with reduced susceptibility to baloxavir. Two influenza A(H1N1)pdm09 and two A(H3N2) post-baloxavir-treated viruses underwent NGS. No PA-variants was founded among A(H1N1)pdm09 strains (0.0%, 0\/2). One influenza A(H3N2)-infected, post-baloxavir-treated case, with PA\/I38T substitution was confirmed in the PA protein by NGS (20%, 1\/5) (Table 3).<\/p>\n

[NA Gene Analysis]<\/p>\n

Same 46 strains analyzed for NA substitutions, affecting sensitivity to neuraminidase inhibitors (NAIs). NGS results showed no substitution in the NA gene affecting sensitivity to NAIs in the 46 prior to treatment cases of A(H1N1)pdm09, A(H3N2) and B\/Victoria (Table 4). One influenza A(H1N1)pdm09 and 2 A(H3N2) post-oseltamivir-treated sample were sequenced and no any variants, inhibiting NAIs was confirmed (Table 4).<\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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