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Prevalence of cytomegalovirus antiviral drug resistance in transplant recipients.
Kleiboeker, Steven B.
Afiliação
  • Kleiboeker SB; Eurofins Viracor Clinical Diagnostics, 18000 West 99th Street, Lenexa, KS, 66219, USA. Electronic address: stevekleiboeker@eurofins-viracor.com.
Antiviral Res ; 215: 105623, 2023 07.
Article em En | MEDLINE | ID: mdl-37150409
Cytomegalovirus (CMV) is a significant human pathogen, especially for immunocompromised patients, often treated with one or more antiviral drugs. Although the prevalence of resistance is low, the impact of drug resistant CMV infections on patient outcomes is high and genotypic testing is recommended when resistance is suspected. To assess the prevalence of CMV drug resistance mutations among samples submitted for genotypic testing, 2750 patient sample results were analyzed. Testing was performed by sequencing for ganciclovir (GCV), cidofovir (CDV), foscarnet (FOS), maribavir (MBV) and/or letermovir (LMV) resistance conferring mutations. Of the 2750 patient samples, 826 (30.04%) had resistance to one or more anti-CMV drug. Resistance mutations were most common in UL97, with 27.64% and 9.96% of samples having GCV and MBV mutations, respectively. Resistance mutations in UL54 were less common, with 6.11%, 5.98% and 1.76% of samples having GCV, CDV and FOS mutations, respectively. For LMV, resistance mutations in UL56 were present in 7.17% of samples, with mutations at codon 325 representing 80.95% of the observed LMV resistance mutations. Resistance to two drugs was identified in 215 samples and to 3 or more drugs in 35 samples. While a high prevalence of CMV resistance mutations was identified, this must be taken in the context of healthcare providers submitting samples from patients with suspected resistant CMV strains. For these patients, rapid monitoring for resistance allows treatment modifications based on objective results rather than empiric drug selection, which is particularly relevant given the presence of mutations conferring resistance to more than one drug.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Citomegalovirus / Transplantados Tipo de estudo: Prevalence_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Antiviral Res Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Citomegalovirus / Transplantados Tipo de estudo: Prevalence_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Antiviral Res Ano de publicação: 2023 Tipo de documento: Article