Virology laboratory, University Hospital of Bordeaux, France.
Euro Surveill. 2011 Jan 27;16(4):19776.
From May 2009 to January 2010, the Virology Laboratory at the University Hospital of Bordeaux received more than 4,000 nasopharyngeal samples from the Aquitaine region (south-west France) for the diagnosis of pandemic influenza A(H1N1)2009. Eighty-three infected patients deteriorated and were admitted to intensive care units. Our study focused on 24 of these patients. Positivity for influenza A(H1N1)2009 was monitored by realtime PCR and duration of viral shedding was determined. The first available sample of each patient was analysed for bacterial, fungal and viral co-infection. We observed six bacterial (or bacterial/fungal) co-infections and one viral co-infection with respiratory syncytial virus. The samples were analysed for the presence of the neuraminidase H275Y (N1 numbering) mutation, which confers resistance to oseltamivir, by realtime PCR of the neuraminidase gene. No H275Y mutation was observed in any of the viral strains screened in this study. In parallel, a fragment of the haemagglutinin gene encoding amino acid residues 173 to 362 was sequenced to detect mutations that had been reported to increase the severity of the disease. Two patients were infected by strains bearing the D222G (H3 numbering) mutation. The viral shedding of A(H1N1)2009 in this study ranged from four to 28 days with a median of 11 days.
从 2009 年 5 月至 2010 年 1 月，波尔多大学附属医院的病毒学实验室收到了来自法国西南部阿基坦地区的 4000 多个鼻咽样本，用于诊断 2009 年甲型流感大流行（H1N1）。83 名感染患者病情恶化并被收入重症监护病房。我们的研究集中在这 24 名患者身上。通过实时 PCR 监测甲型流感 A(H1N1)2009 的阳性率，并确定病毒脱落的持续时间。分析了每位患者的第一个可用样本，以确定细菌、真菌和病毒的合并感染情况。我们观察到了六例细菌（或细菌/真菌）合并感染和一例呼吸道合胞病毒合并感染。通过实时 PCR 对神经氨酸酶基因进行分析，检测了这些样本中是否存在导致奥司他韦耐药的神经氨酸酶 H275Y（N1 编号）突变。在本研究中筛选的病毒株中均未观察到 H275Y 突变。同时，对编码 173 至 362 个氨基酸残基的血凝素基因进行了测序，以检测已报道可增加疾病严重程度的突变。两名患者感染了携带 D222G（H3 编号）突变的病毒株。本研究中 A(H1N1)2009 的病毒脱落时间从 4 天到 28 天不等，中位数为 11 天。
