Flight William George, Bright-Thomas Rowland, Mutton Kenneth, Webb Kevin, Jones Andrew
Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
BMJ Case Rep. 2011 Apr 26;2011:bcr0220113874. doi: 10.1136/bcr.02.2011.3874.
The authors report the case of a 25-year-old patient with cystic fibrosis (CF) who developed pandemic influenza A/H1N1 during a visit to the USA in August 2010. The patient has severe CF lung disease and takes maintenance oral corticosteroids. The influenza virus was positive for the H275Y oseltamivir-resistance mutation despite the patient never having received oseltamivir. The patient has remained sputum-positive for over 4 months despite inhaled zanamivir therapy. This is the first reported case of transmission of oseltamivir-resistant H1N1 influenza to a patient with CF. The frequency of prolonged sputum carriage of pandemic influenza and transmission of oseltamivir-resistant strains are unknown on a population level. However, if our observations are replicated in other CF patients, they are potentially of considerable importance to clinical and infection-control practices in this patient group.
作者报告了一例25岁的囊性纤维化（CF）患者的病例，该患者于2010年8月在美国访问期间感染了甲型H1N1大流行性流感。该患者患有严重的CF肺部疾病，正在接受口服糖皮质激素维持治疗。尽管该患者从未接受过奥司他韦治疗，但流感病毒的H275Y奥司他韦耐药突变检测呈阳性。尽管接受了吸入扎那米韦治疗，该患者痰液阳性仍持续了4个多月。这是首例报告的耐奥司他韦H1N1流感病毒传播给CF患者的病例。在人群层面，大流行性流感长期痰液携带的频率以及耐奥司他韦毒株的传播情况尚不清楚。然而，如果我们的观察结果在其他CF患者中得到证实，它们可能对该患者群体的临床和感染控制实践具有相当重要的意义。
