美国Mpox患者的特科维里马特耐药性,2022-2023年
Emerging infectious diseases
|October 19, 2023
概括
在2022年爆发期间,麻疹病毒 (MPXV) 中出现了对Tecovirimat的耐药性. 大多数耐药菌株是在接受多种治疗的免疫受损患者中发现的,尽管整体耐药性仍然很低.
科学领域:
- 病毒学 病毒学
- 抗病毒药物耐药性 抗病毒药物耐药性
- 基因组学就是基因组学.
背景情况:
- 在2022年跨国病毒 (MPXV) 爆发时,人们广泛使用了tecovirimat (TPOXX).
- 德科维里马特向MPXV F13L基因;F13中的突变可以赋予耐药性.
- 了解特科维里马特耐药性对于管理MPXV感染至关重要.
研究的目的:
- 调查2022年爆发期间的抗tecovirimat的MPXV的出现和特征.
- 在临床隔离物中识别与tecovirimat耐药性相关的突变.
- 评估与患者治疗和免疫状况相关的特科维里马特耐药性的流行率.
主要方法:
- 基因组测序MPXV分离物以确定F13L基因中的突变.
- 使用病毒细胞病变效应试验进行表型耐药性测试.
- 对抗性,患者特征和治疗史之间的相关性分析.
主要成果:
- 基因组测序确定了11种已知的和13种与tecovirimat耐药性相关的新突变.
- 在124个测试分离物中,在96个分离物中检测到一种耐药的表型 (来自68名患者中的46名).
- 大多数耐药分离物来自于接受多次tecovirimat治疗的严重免疫受损患者;未经治疗的患者的分离物仍然敏感.
结论:
- 在MPXV中抗Tecovirimat与特定的F13L基因突变有关.
- 免疫功能低下个体的长期治疗与耐药MPXV菌株的出现有关.
- 与接受治疗的患者总数相比,对特科维瑞马抗性MPXV的总频率仍然很低 (<1%).
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