{"id":6213,"date":"2024-05-16T15:30:56","date_gmt":"2024-05-16T06:30:56","guid":{"rendered":"http:\/\/www.med.niigata-u.ac.jp\/pub\/?p=6213"},"modified":"2024-05-16T15:30:56","modified_gmt":"2024-05-16T06:30:56","slug":"2024%e5%b9%b45%e6%9c%8814%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\/05\/16\/2024%e5%b9%b45%e6%9c%8814%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\u5e745\u670814\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
\n2024\u5e745\u670814\u65e5\u6642\u70b9
\n2023\u5e7410\u6708\u304b\u30892024\u5e743\u6708\u306b\u304b\u3051\u3066\u3001\u5408\u8a08168\u4ef6\u306e\u521d\u8a3a\u6642\u691c\u4f53\u304c\u63a1\u53d6\u3055\u308c\u307e\u3057\u305f\u3002\u518d\u8a3a\u6642\u691c\u4f53\u306f50\u4ef6\u63a1\u53d6\u3055\u308c\u3001\u3046\u306134\u4ef6\u306f\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6295\u4e0e\u5f8c\u306b\u63a1\u53d6\u3055\u308c\u307e\u3057\u305f\uff08\u88681\uff09\u3002
\n\"\"<\/a>
\n2023\u5e7410\u6708\u4ee5\u964d\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6A(H1N1)pdm09\u309251\u4ef6\u3001A(H3N2)\u309263\u4ef6\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6A\u578b\uff08\u4e9c\u578b\u304c\u7279\u5b9a\u4e0d\u80fd\uff09\u30928\u4ef6\u3001B\/\u30d3\u30af\u30c8\u30ea\u30a2\u309231\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\u306f8\u6708\u9803\u304b\u3089A(H1N1)pdm09\u3068A(H3N2)\u304c\u540c\u6642\u6d41\u884c\u3057\u300111\u6708\u304b\u308912\u6708\u306b\u30d4\u30fc\u30af\u3068\u306a\u308a\u307e\u3057\u305f\u3002\u305d\u306e\u5f8cA\u578b\u304c\u6e1b\u5c11\u3059\u308b\u3068\u3068\u3082\u306b\u30011\u6708\u304b\u3089B\/\u30d3\u30af\u30c8\u30ea\u30a2\u304c\u5897\u52a0\u3057\u30012\u6708\u4ee5\u964d\u306fB\u578b\u304c\u4e3b\u6d41\u3068\u306a\u308a\u307e\u3057\u305f\u3002
\n\"\"<\/a>
\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

\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\u306e51\u682a\u3001A(H3N2)\u306e63\u682a\u3001B\u578b\u306e31\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
\n\"\"<\/a>
\n\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6295\u4e0e\u5f8c\u306b\u63a1\u53d6\u3055\u308c\u305f\u691c\u4f53\u6570\u306f34\u4ef6\u3067\u3057\u305f\uff08\u518d\u8a3a\u6642\u691c\u4f53\uff09\uff08\u88682\uff09\u3002\u3053\u306e\u3046\u306117\u4ef6\u304cA(H1N1)pdm09\u3067\u3001\u3046\u30614\u4ef6\u304c\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0PCR\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\u304b\u3089\u691c\u51fa\u3055\u308c\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\u306b\u3088\u308b\u6cbb\u7642\u5f8c\u306e PA\/I38T \u306e\u51fa\u73fe\u983b\u5ea6\u306f\u3001\u6cbb\u7642\u75c7\u4f8b\u6570\u3092\u6bcd\u6570\u3068\u3059\u308b\u3068 7.1% (1\/14) \u3067\u3057\u305f\u3002\u518d\u8a3a\u66422\u56de\u76ee\u306b\u63a1\u53d6\u3055\u308c\u305f\u691c\u4f53\u3067\u3001\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0PCR\u6cd5\u304c\u967d\u6027\u3068\u78ba\u8a8d\u3055\u308c\u305f\u691c\u4f53\u3092\u6bcd\u6570\u3068\u3057\u305f\u5834\u5408\u3001\u983b\u5ea6\u306f 50.0% \u306b\u5897\u52a0\u3057\u307e\u3057\u305f\u3002B\/Victoria\u306f2\u4ef6\u3067\u3057\u305f\u304c\u3001\u518d\u8a3a\u6642\u306e\u30ea\u30a2\u30eb\u30bf\u30a4\u30e0PCR\u306e\u7d50\u679c\u306f\u5168\u3066\u9670\u6027\u3067\u3057\u305f\u3002<\/p>\n

[PA\u907a\u4f1d\u5b50\u89e3\u6790\uff3d
\n\u6b21\u4e16\u4ee3\u30b7\u30fc\u30af\u30a8\u30f3\u30b7\u30f3\u30b0\uff08NGS\uff09\u3092\u7528\u3044\u3066\u89e3\u6790\u3067\u304d\u305f\u521d\u8a3a\u6642\u691c\u4f5352\u4ef6\u306f\u3001A(H1N1)pdm09\u304c23\u4ef6\u3001A(H3N2)\u304c28\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
\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\u3067\u3001A(H1N1)pdm09\u306e3\u4ef6\u3068A(H3N2)\u306e3\u4ef6\u3092\u3001NGS\u306b\u3088\u308a\u89e3\u6790\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u307e\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\uff080.0\uff05, 0\/3\uff09\u3002A(H3N2)\u306e\uff11\u4ef6\u306bPA\/I38T\u5909\u7570\u304c\u691c\u51fa\u3055\u308c\u307e\u3057\u305f\u3002\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6cbb\u7642\u75c7\u4f8b\u6570\u3092\u6bcd\u6570\u3068\u3059\u308b\u3068\u3001\u3053\u306e\u51fa\u73fe\u983b\u5ea6\u306f12.5\uff05\u3067\u3057\u305f\u304c\uff081\/8\uff09\u3001NGS\u306b\u3088\u308b\u89e3\u6790\u3092\u884c\u3046\u3053\u3068\u304c\u3067\u304d\u305f\u518d\u8a3a\u6642\u691c\u4f53\u6570\u3092\u6bcd\u6570\u3068\u3059\u308b\u3068\u3001\u51fa\u73fe\u983b\u5ea6\u306f33.3\uff05\u306b\u5897\u52a0\u3057\u307e\u3057\u305f\uff081\/3\uff09\u3002\uff08\u88683\uff09\u3002
\n\"\"<\/a>
\n[NA\u907a\u4f1d\u5b50\u89e3\u6790\uff3d
\nNGS\u306b\u3088\u308a\u89e3\u6790\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u305f\u691c\u4f53\u306b\u3064\u3044\u3066\u3001\u540c\u69d8\u306b\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u3092\u542b\u3080\u30ce\u30a4\u30e9\u30df\u30cb\u30c0\u30fc\u30bc\u963b\u5bb3\u5264\uff08NA\u963b\u5bb3\u5264\uff09\u306b\u5bfe\u3059\u308b\u611f\u53d7\u6027\u4f4e\u4e0b\u3092\u793a\u3059\u3068\u5831\u544a\u3055\u308c\u305fNA\u907a\u4f1d\u5b50\u306e\u5909\u7570\u306b\u3064\u3044\u3066\u3082\u78ba\u8a8d\u3092\u884c\u3044\u307e\u3057\u305f\u3002\u521d\u8a3a\u6642\u306b\u63a1\u53d6\u3055\u308c\u305f52\u691c\u4f53\u3068\u3001\u6cbb\u7642\u524d\u5f8c\u306e\u30da\u30a2\u691c\u4f53\u63a1\u53d6\u4f8b\u3067\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u6295\u4e0e\u524d\u306b\u63a1\u53d6\u3055\u308c\u305fA(H1N1)pdm09\u306e7\u4ef6\u3001A(H3N2)\u306e6\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\u3002\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u6295\u4e0e\u5f8c\u691c\u4f533\u4ef6\u306b\u3082\u691c\u51fa\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\uff08\u88684\uff09\u3002
\n\"\"<\/a><\/p>\n

Summary of Results.
\nAs of May 14, 2024
\nFrom October 2023 to March 2024, a total of 168 initial visit specimens were collected. There were 50 specimens collected at follow-up visits (second visits), of which 34 were collected after administration of baloxavir (Table 1).
\nSince October 2023, 51 cases of Influenza A(H1N1)pdm09, 63 cases of A(H3N2), 8 cases of Influenza A (subtype unidentified), 31 cases of B\/Victoria, and 1 case of lineage unidentified B were detected (Table 1 and Figure 1). During this season, 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.
\nA 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.
\nNone of the 51 of A(H1N1)pdm09, 63 of A(H3N2), and 31 of influenza B\/Victoria samples collected before administration of antiviral influenza drugs showed the presence of the PA\/I38T mutation by real-time PCR (Table 2).
\nThere were 34 specimens collected after administration of baloxavir (follow-up visit specimens) (Table 2). Of these, 17 were A(H1N1)pdm09, of which 4 were PCR positive, but the PA\/I38T substitution was not detected. There were 14 cases of A(H3N2), two were PCR positive, one of them was PA\/I38T positive. The frequency of PA\/I38T appearance after treatment with baloxavir was 7.1% based on the number of treated cases (1\/14). The frequency increases to 50.0% when based on cycling probe real-time PCR positives in the second samples (1\/2). There were two B\/Victoria cases, which were PCR negative at the 2nd visit.
\n[PA Gene Analysis]
\nFifty-two initial visit specimens were able to be analyzed using next-generation sequencing (NGS), with 23 cases of A(H1N1)pdm09, 28 case of A(H3N2), and 1 case of type B. None of first visit specimen had any PA substitution, with reduced susceptibility to baloxavir.
\nAmong post-baloxavir-treated cases, 3 influenza A(H1N1)pdm09 and 3 A(H3N2) samples were successfully analyzed by NGS. No PA variants were found among A(H1N1)pdm09 strains (0.0%, 0\/3). One influenza A(H3N2)-infected, post-baloxavir-treated case with PA\/I38T substitution was confirmed in the PA protein by NGS. The frequency of PA variant appearance analyzed by NGS after treatment with baloxavir was 12.5 % based on the number of treated cases (1\/8). The frequency increases to 33.3 % when based on the samples that could be analyzed by NGS in the second samples (1\/3) (Table 3).
\n[NA Gene Analysis]
\nThe same 52 strains successfully sequenced by NGS were 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 52 prior to treatment cases, which included 7 A(H1N1)pdm09, 6 A(H3N2) and 1 B\/Victoria (Table 4). Three post-oseltamivir-treated samples were sequenced and no any NA variants inhibiting NAIs was confirmed (Table 4). <\/p>\n","protected":false},"excerpt":{"rendered":"

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