Recovery of a Multidrug‐Resistant Strain of Pandemic Influenza A 2009 (H1N1) Virus Carrying a Dual H275Y/I223R Mutation from a Child after Prolonged Treatment with Oseltamivir

Abstract
To the Editor—Resistance to oseltamivir in strains of the pandemic influenza A 2009 (H1N1) virus, although rare, has been reported worldwide [1]. The oseltamivir resistance is caused by a single mutation, H275Y, in the neuraminidase, which does not affect susceptibility to zanamivir. Here we report an influenza A 2009 (H1N1) virus strain with 2 neuraminidase mutations (H275Y and I223R) with laboratory evidence for multidrug resistance.

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