The ability to screen pathogens for drug resistance is very important in the clinic.
Larisa V. Gubareva, Varough M. Deyde, and colleagues of the Centers for Disease Control and Prevention showed in the H1N1 influenza virus of the 2009 pandemic that pyrosequencing enabled detection of mutations such as markers of drug resistance, by generating a target sequence for RT-PCR amplicons. "This assay is high throughput, sensitive, and accurate," says Gubareva. "We used it to detect changes in the influenza virus in clinical specimens without additional propagation of virus in cell cultures, greatly reducing testing time. During the pandemic, a few public health laboratories in the US used the assay to screen thousands of clinical specimens for resistance markers." Gubareva et al. also used it to determine when certain drugs should be avoided due to resistance mutations.
(V. M. Deyde, T. G. Sheu, A. A. Trujillo, M. Okomo-Adhiambo, R. Garten, A. I. Klimov, and L. V. Gubareva. 2010. Detection of molecular markers of drug resistance in 2009 pandemic influenza A (H1N1) viruses by pyrosequencing. Antimicrob. Agents Chemother. 54:1102-1110.)
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