Discussion: For H3N2 viruses, we did not detect the mutations conferring resistance to neuraminidase inhibitors such as E119V, D151E, I222V, R224K, E276D, N249S, R292K, and R371K in the NA gene segment of our H3N2 isolates.
An influenza A(H5N8) virus isolated during an outbreak at a poultry farm in Russia in 2017 has an N294S substitution in the neuraminidase and shows reduced susceptibility to oseltamivir.
Abstract: Fewer than 1% of analyzed viruses had amino acid substitutions associated with reduced susceptibility to baloxavir (PA-E199G, PA-E199E/G) or reduced or highly reduced inhibition by neuraminidase inhibitors (NA-R150/152K, NA-I221/222M, NA-I221/222I/M, NA-I221/222V, NA-I115/117V, NA-G145/147R, NA- PMID: 32631440
2020
Virology journal
Result: Other NA drug-resistance substitutions (V116A, I117V, Q136K, D151A, Y155H, R156K, D198V, I222V, R224K, Q226H, E227D, E277Q, R293K, N294S, E425G, and I436N) were not detected.
Severe cases of seasonal influenza in Russia in 2017-2018.
Result: Analysis of the NA of all studied A(H3N2) viruses for the presence of mutations conferring drug resistance revealed I222V amino acid substitution in the NA of A/Astrakhan/32/2017 strain.
Influenza A/H3N2 virus infection in immunocompromised ferrets and emergence of antiviral resistance.
Discussion: The substitution was present together with the known E119V and I222V resistance substitutions.
Dynamic Variation and Reversion in the Signature Amino Acids of H7N9 Virus During Human Infection.
PMID: 29688498
2018
The Journal of infectious diseases
Result: We conducted nucleotide polymorphism analysis of the sites related to NAI resistance in the NA segment, including R118K, E119V, D151E, R152K, I222V, R224K, H274Y, E276D, R292K, N294S, and R371K (N2 numbering).
Molecular genetic characteristics of influenza A virus clinically isolated during 2011-2016 influenza seasons in Korea.
PMID: 29489060
2018
Influenza and other respiratory viruses
Table: I222V
Discussion: Previous studies have shown that the single I222V/M substitution in the NA protein is associated with marginal levels of resistance to oseltamivir, while synergistically increased drug resistance was associated with E119V and H274Y substitutions.15, 16, 19, 22, 23, 24, 25, 26 The S31N substitution in the M2 protein was frequently detected in the more recent viral sequences and reference sequences.27 In addition, V51I and I39M substitutions were identified in the 2011-2012 and 2014-2015 fatal case sequences.
Discussion: The I222V substitution in the NA protein was found i
Neuraminidase inhibitor susceptibility and neuraminidase enzyme kinetics of human influenza A and B viruses circulating in Thailand in 2010-2015.
Discussion: However, the I222V NA substitution has a compensatory effect on the influenza A(H3N2) virus carrying E119V, and the presence of these two substitutions resulted in partially improved viral fitness in cell culture and resistance to oseltamivir.
Discussion: In our study, the A/PR8-I222V virus was susceptible to NAIs in a phenotypic NA inhibition assay and possessed slightly increased NA enzymatic activity.
Discussion: It was previously reported that an influenza A(H3N2) virus with a single I222V NA amino acid substitution was susceptible to oseltamivir and possessed slightly higher
Evolution of the neuraminidase gene of seasonal influenza A and B viruses in Thailand between 2010 and 2015.
Method: We analyzed for the presence of NA substitutions associated with either NAI-resistant genotype in differen
Result: The A(H3N2) viruses circulating in Thailand had amino acid substitutions at positions D151N/G (1.7%) and I222T/V (1.2%), which are in the active site of the NA protein and may affect enzyme activity.
Result: The strains with a I222T/V mutation were grouped into clade 3C.2; these two strains maintained the NA gene signature amino acid substitutions L81P, D93G, S367N, K369T, N402D, and I464L.
Influenza A(H7N9) virus acquires resistance-related neuraminidase I222T substitution when infected mallards are exposed to low levels of oseltamivir in water.
PMID: 26077257
2015
Antimicrobial agents and chemotherapy
Discussion: Several substitutions also seem to restore reduced fitness: I222T/V/R combined with H274Y in N1 virus and I222V combined with E119V in N2 virus.
IV mutation literature information.
PMID: 
2021
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