A community cluster of influenza A(H3N2) with a PA E199G substitution showed reduced in vitro susceptibility to baloxavir, suggesting potential clonal spread of resistant strains.
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PA E199G H3N2 cluster shows in vitro baloxavir resistance with apparent community spread; leaves open clinical impact and surveillance needs.
A community cluster of influenza A(H3N2) caused by viruses with an E199G substitution in PA was detected in Nara, Japan, between February and March 2023. The three patients with these mutant viruses had not received antiviral treatment before specimen collection but patients in the same hospital had. The sequences of the mutant viruses were closely related, suggesting clonal spread in Nara. They showed reduced susceptibility to baloxavir in vitro; however, the clinical significance of the PA E199G substitution remains unclear.
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Takashita et al. (2023) studied this question.
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