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PubMed · 42695189

Detection of nirsevimab-resistant RSV-B variants in children carrying the F:N201T substitution through genomic surveillance, Spain, 2025/26 season.

María Iglesias-Caballero·Jose A Infantes·Albert Campoy·Sara Camarero-Serrano·Silvia Moreno·Olga Cano·Germán Vallejo-Palma·Carmen González-Velasco·Cristina Gaona·Pedro Camacho-Martinez·Laura Merino-Diaz·Sonia Vázquez-Morón·Francisco Pozo·Jose A Lepe·Vicente Mas·Inmaculada Casas
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Abstract

During Spain's 2025/26 RSV season, three children were infected with RSV-B viruses carrying the F protein N201T substitution. Two who received nirsevimab that season were hospitalised (one required intensive care); the third was treated previously. Recombinant expression studies confirmed reduced nirsevimab recognition. Genomic data indicated sporadic emergence across distinct RSV-B backgrounds rather than expansion of a single lineage. Findings highlight the importance of combining genomic surveillance with antigenic characterisation to detect and interpret variants with reduced susceptibility to antibody-based prevention.

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HumansSpainRespiratory Syncytial Virus, HumanRespiratory Syncytial Virus InfectionsInfantDrug Resistance, ViralAntiviral AgentsMaleFemaleChild, PreschoolSeasonsViral Fusion Proteinsgenomic surveillancenirsevimabrespiratory syncytial virusviral evolutionJournal Article

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María Iglesias-Caballero, Jose A Infantes, Albert Campoy, Sara Camarero-Serrano, Silvia Moreno, Olga Cano, Germán Vallejo-Palma, Carmen González-Velasco, Cristina Gaona, Pedro Camacho-Martinez, Laura Merino-Diaz, Sonia Vázquez-Morón, Francisco Pozo, Jose A Lepe, Vicente Mas, Inmaculada Casas. 2026. Detection of nirsevimab-resistant RSV-B variants in children carrying the F:N201T substitution through genomic surveillance, Spain, 2025/26 season.. https://doi.org/10.2807/1560-7917.es.2026.31.35.2600690

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