{"id":6189,"date":"2024-04-23T17:36:46","date_gmt":"2024-04-23T08:36:46","guid":{"rendered":"http:\/\/www.med.niigata-u.ac.jp\/pub\/?p=6189"},"modified":"2024-04-24T11:30:07","modified_gmt":"2024-04-24T02:30:07","slug":"2024%e5%b9%b44%e6%9c%8823%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\/04\/23\/2024%e5%b9%b44%e6%9c%8823%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\u5e744\u670819\u65e5\u3000\u6297\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u5264\u611f\u53d7\u6027\u4f4e\u4e0b\u682a\u8abf\u67fb\u306e\u7d50\u679c"},"content":{"rendered":"

 <\/p>\n

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

2024\u5e744\u670819\u65e5\u6642\u70b9<\/p>\n

2023\u5e7410\u6708\u304b\u30892024\u5e742\u6708\u306b\u304b\u3051\u3066\u3001\u5408\u8a08153\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\u306133\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\u309226\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\u3001A(H3N2)\u304a\u3088\u3073B\/\u30d3\u30af\u30c8\u30ea\u30a2\u304c\u691c\u51fa\u3055\u308c\u307e\u3057\u305f\u3002A(H1N1)pdm09\u3068A(H3N2)\u304c8\u6708\u9803\u304b\u3089\u540c\u6642\u6d41\u884c\u3057\u300111\uff5e12\u6708\u306b\u30d4\u30fc\u30af\u304c\u3042\u308a\u307e\u3057\u305f\u3002A\u578b\u306f\u305d\u306e\u5f8c\u6e1b\u5c11\u3057\u30011\u6708\u304b\u3089B\/\u30d3\u30af\u30c8\u30ea\u30a2\u304c\u5897\u3048\u30012\u6708\u4ee5\u964d\u306fB\u578b\u304c\u6d41\u884c\u306e\u4e3b\u6d41\u3068\u306a\u308a\u307e\u3057\u305f\u3002<\/p>\n

\"\"<\/a><\/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

\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\u306e26\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

\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6295\u4e0e\u5f8c\u306b\u63a1\u53d6\u3055\u308c\u305f\u691c\u4f53\uff08\u518d\u8a3a\u6642\u691c\u4f53\uff09\u306f33\u4ef6\u3067\u3057\u305f\uff08\u88682\uff09\u300217\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)\u306f14\u4ef6\u3067\u3001\uff12\u4ef6\u304cPCR\u967d\u6027\u3067\u3001\u3046\u30611\u4ef6\u306bPA\/I38T\u5909\u7570\u304c\u691c\u51fa\u3055\u308c\u307e\u3057\u305f\u3002\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6295\u4e0e\u5f8c\u306ePA\/I38T\u5909\u7570\u682a\u306e\u51fa\u73fe\u983b\u5ea6\u306f7.1\uff05\u3067\u3057\u305f\uff08 1\/14\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\u306b\u3064\u3044\u3066\u3001NGS\u3067\u89e3\u6790\u3067\u304d\u305f\u306e\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\uff080.\uff10\uff05, 0\/2\uff09\u3002A(H3N2)\u306e\uff11\u4ef6\u306b\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

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

NGS\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\u306e7\u4ef6\u3001A(H3N2)\u306e5\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\"\"<\/a><\/p>\n

 <\/p>\n

Summary of Results.<\/p>\n

As of April 19, 2024<\/p>\n

From October 2023 to March 2024, a total of 153 initial visit specimens were collected. There were 49 specimens collected at follow-up visits (second visits), of which 33 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), 26 case of B\/Victoria and 1 case of lineage unidentified B\u00a0 were detected (Table 1 and Figure 1). This season, A(H1N1)pdm09, A(H3N2), and B\/Victoria were detected. A(H1N1)pdm09 and A(H3N2) were simultaneously prevalent from around August, with a peak in November and December. Type A subsequently declined, B\/Victoria increased from January, and type B became the mainstay of the epidemic from February onward.<\/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

None of the 48 of A(H1N1)pdm09, 58 of A(H3N2), and 26 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 33 specimens collected after administration of baloxavir (follow-up visit specimens) (Table 2). Among these, 17 were A(H1N1)pdm09, with 4 testing PCR positive, but the PA\/I38T substitution was not detected. There were 14 cases of A(H3N2), with two testing PCR positive; interestingly, one was PA\/I38T positive. The frequency of PA\/I38T emergence after treatment with baloxavir was 7.1% (1\/14). Additionally, two B\/Victoria cases tested negative for PCR on the 2nd visit. [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.<\/p>\n

Two influenza A(H1N1)pdm09 and two A(H3N2) positive samples, derived from post-baloxavir-treated patients, underwent NGS,\u00a0 No PA-variants was found 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 (50%, 1\/2) (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 7 A(H1N1)pdm09, 5 A(H3N2) and 1 B\/Victoria (Table 4). One post-oseltamivir-treated sample was sequenced and no any variants, inhibiting NAIs was confirmed (Table 4).<\/p>\n","protected":false},"excerpt":{"rendered":"

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…\u7d9a\u304d\u3092\u8aad\u3080<\/a><\/p>\n","protected":false},"author":1,"featured_media":6197,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1,3,11],"tags":[],"class_list":["post-6189","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-blog","category-influenzasearch"],"jetpack_featured_media_url":"http:\/\/www.med.niigata-u.ac.jp\/pub\/wppublichealth\/wp-content\/uploads\/2024\/04\/\u30b9\u30e9\u30a4\u30c91-1.jpg","jetpack_shortlink":"https:\/\/wp.me\/ph72WZ-1BP","jetpack-related-posts":[{"id":6141,"url":"http:\/\/www.med.niigata-u.ac.jp\/pub\/2024\/02\/26\/2024%e5%b9%b42%e6%9c%8816%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\/","url_meta":{"origin":6189,"position":0},"title":"2024\u5e742\u670816\u65e5\u3000\u6297\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u5264\u611f\u53d7\u6027\u4f4e\u4e0b\u682a\u8abf\u67fb\u306e\u7d50\u679c","author":"public-health","date":"2024\u5e742\u670826\u65e5","format":false,"excerpt":"2024\u5e742\u670816\u65e5\u6642\u70b9 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