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    Oseltamivir Resistance in Adult Oncology and Hematology Patients Infected with Pandemic (H1N1) 2009 Virus, Australia
    Tramontana, AR ; George, B ; Hurt, AC ; Doyle, JS ; Langan, K ; Reid, AB ; Harper, JM ; Thursky, K ; Worth, LJ ; Dwyer, DE ; Morrissey, CO ; Johnson, PDR ; Buising, KL ; Harrison, SJ ; Seymour, JF ; Ferguson, PE ; Wang, B ; Denholm, JT ; Cheng, AC ; Slavin, M (CENTERS DISEASE CONTROL, 2010-07)
    We describe laboratory-confirmed influenza A pandemic (H1N1) 2009 in 17 hospitalized recipients of a hematopoietic stem cell transplant (HSCT) (8 allogeneic) and in 15 patients with malignancy treated at 6 Australian tertiary centers during winter 2009. Ten (31.3%) patients were admitted to intensive care, and 9 of them were HSCT recipients. All recipients of allogeneic HSCT with infection <100 days posttransplantation or severe graft-versus-host disease were admitted to an intensive care unit. In-hospital mortality rate was 21.9% (7/32). The H275Y neuraminidase mutation, which confers oseltamivir resistance developed in 4 of 7 patients with PCR positive for influenza after > or = 4 days of oseltamivir therapy. Three of these 4 patients were critically ill. Oseltamivir resistance in 4 (13.3%) of 30 patients who were administered oseltamivir highlights the need for ongoing surveillance of such resistance and further research on optimal antiviral therapy in the immunocompromised.