Anti-viral Resistance
Influenza susceptibility testing on influenza viruses was initiated in the Virology Laboratory in 2006. The program has grown and developed substantially since its inception. A proportion of all submitted influenza positive specimens are routinely tested for resistance surveillance purposes. Aggregate results of this testing are posted weekly in the New York State Weekly Influenza Surveillance Report[1]. Additionally, influenza positive patients not responding to influenza antiviral therapy can be submitted for testing following consultation with the laboratory. Please contact the laboratory for approval of testing before shipping any specimens. The patient must fulfill the following initial criteria:
- Confirmed influenza positive test results (by any method)
- Completed a 5 day course of antiviral therapy with no clinical improvement
Other helpful information:
- What type/subtype of influenza is the patient infected with?
- What antiviral drug was administered?
- start and end dates of treatment?
- Is the patient immunocompromised?
Available Influenza Antiviral Drug Susceptibility Testing Methods
| Influenza Viruses | Antiviral Drug Class Targets* | Antiviral Drug Specific Mutations Detected | |
|---|---|---|---|
| Pyrosequencing | A/H1pdm09 and A/H3 | Neuraminidase and Polymerase Inhibitors | (A/H1pdm09) I223, H275Y, (A/H3) E119, R292, N294 |
| Dideoxy | A/H1pdm09, A/H3, and B | Neuraminidase Inhibitors | All in NA Gene |
| Whole Genome Sequencing | All influenza viruses | Adamantanes and Neuraminidase Inhibitors | Not Specific |
| Neuraminidase Inhibition | All influenza viruses | Neuraminidase Inhibitors | Not Specific |
| Polymerase Inhibition | All influenza viruses | Polymerase Inhibitors |
*FDA approved influenza antivirals
For further information on influenza anti-viral testing please contact the Team Lead Jennifer Laplante[2] at 518-474-4177.
The CDC[3] provides additional information on influenza antiviral drug resistance.