Ganciclovir Susceptibilities and Analysis of UL97 Region in Cytomegalovirus (CMV) Isolates from Bone Marrow Recipients with CMV Disease after Antiviral Prophylaxis

• Published in: The Journal of infectious diseases Vol. 178; no. 2; pp. 531 - 534
• Main Authors: Erice, Alejo, Borrell, Nuria, Li, Wuyi, Miller, Wesley J., Balfour, Henry H.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.08.1998; University of Chicago Press; Oxford University Press
• Subjects: Acyclovir - administration & dosage; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - administration & dosage; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Antivirals; Biological and medical sciences; Blood; Bone marrow; Bone Marrow Transplantation - adverse effects; Codons; Concise Communications; Cytomegalovirus; Cytomegalovirus - genetics; Cytomegalovirus - isolation & purification; Cytomegalovirus Infections - drug therapy; Cytomegalovirus Infections - prevention & control; Cytomegalovirus Infections - virology; Ganciclovir - pharmacology; Ganciclovir - therapeutic use; Genetic mutation; Humans; Infections; Medical sciences; Pharmacology. Drug treatments; Phosphotransferases (Alcohol Group Acceptor) - genetics; Pneumonia; Point Mutation; Restriction Mapping; Viremia; Viruses; Human; Chemoprophylaxis; Acyclic nucleoside; Purine nucleoside; Nucleotide sequence; Herpesviridae; Recipient; Betaherpesvirinae; Human cytomegalovirus; Virus; Antibiotic; Chemotherapy; Ganciclovir; Treatment; Multiple resistance; Aciclovir; Bone marrow; Antiviral; Graft; Clinical isolate
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/517467

Ganciclovir susceptibilities and UL97 sequences were analyzed in 20 cytomegalovirus (CMV) isolates recovered from 15 bone marrow transplant recipients with active CMV infection after prophylaxis with acyclovir (group I; 12 isolates) or after acyclovir prophylaxis followed by ganciclovir therapy (group II; 8 isolates). All group I isolates were susceptible to ganciclovir. Five group II isolates were susceptible to ganciclovir, and 3 isolates (all from the same person) were resistant to ganciclovir (IC50 >12 μM). Ganciclovir resistance UL97 mutations were found in 4 group II isolates, including a ganciclovir-susceptible isolate obtained from 1 patient after 41 days of therapy with ganciclovir and 3 ganciclovir-resistant isolates obtained from another patient after 73, 116, and 132 days of treatment with ganciclovir. Ganciclovir-resistant CMV isolates may emerge rapidly in bone marrow transplant recipients who are treated with ganciclovir after receiving prophylaxis with acyclovir.