Brazilian Journal of Infectious Diseases最新文献_第3页

Severe Staphylococcus aureus infection: associated factors and outcomes. 严重金黄色葡萄球菌感染：相关因素和结果。

IF 2.8 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-09-01 Epub Date: 2025-08-09 DOI: 10.1016/j.bjid.2025.104573

Narendra Babu Valobdás, Marcelo Ribeiro Alves, Erica Aparecida Dos Santos Ribeiro da Silva, Maria Cristina da Silva Lourenço, Beatriz Coelho de Negreiros Nascimento, Valdilea Gonçalves Veloso, Sandra Wagner Cardoso, Cristiane da Cruz Lamas

Introduction: Staphylococcus aureus causes potentially life-threatening infections, with a somber prognosis when the infection is caused by methicillin-resistant S. aureus due to limited treatment options. The present study describes serious infections by S. aureus in patients hospitalized in an infectious disease's unit in Rio de Janeiro, Brazil, between 2016 and 2021.

Material and methods: This was a retrospective study based on data from positive samples diagnosed by the microbiology laboratory and by review of medical records. Clinical-demographic variables and outcomes were compared between Patients Living with HIV (PLHIV) and non-HIV patients. Data were analyzed using Jamovi 1.6 and R 4.0.1 statistical software.

Results: A total of 67 patients with a serious S. aureus infection were identified, of whom 29 presented bacteremia and 38 other infections. Thirty-one of 67 (46.3%) were PLHIV. The median age of all patients was 46years, although PLHIV were significantly younger than non-HIV individuals (36 vs. 60 years-old, p < 0.001). The median CD4 lymphocyte count was 95 cells/mm³. Community infection occurred in 36/67 (53.7%) patients, of whom 19/36 (52.7%) had bacteremia. A total of 20 MRSA infections (29.9% of the patients) were identified, which accounted for 14/36 (38.8%) of the community infections. More than a third of PLHIV (38.7%) had MRSA, and all these were sensitive to cotrimoxazole. No difference in mortality was found between PLHIV and non-HIV patients, nor between the MRSA and MSSA groups. Bacteremia was present in 29 patients; MRSA accounted for 9 (31.0%) of these. The 30-day mortality was 4/9 (44.4%) and 2/20 (10%) in MRSA and MSSA bacteremia, respectively.

Conclusions: The most frequent comorbidity in patients with severe S. aureus infections was HIV, with a high rate of MRSA infections recorded in PLHIV. PLHIV were younger, but did not suffer higher mortality, although they did have more relapses and new staphylococcal infections.

简介：金黄色葡萄球菌引起可能危及生命的感染，当感染是由耐甲氧西林金黄色葡萄球菌引起时，由于治疗方案有限，预后黯淡。本研究描述了2016年至2021年期间在巴西里约热内卢里约热内卢传染病病房住院的患者中金黄色葡萄球菌的严重感染。材料和方法：这是一项回顾性研究，基于微生物实验室诊断的阳性样本数据和查阅医疗记录。比较HIV感染者（PLHIV）和非HIV患者的临床人口学变量和结果。采用Jamovi 1.6和r4.0.1统计软件对数据进行分析。结果：共发现67例严重金黄色葡萄球菌感染，其中29例出现菌血症，38例出现其他感染。67例中31例（46.3%）为PLHIV。所有患者的中位年龄为46岁，尽管PLHIV患者明显比非hiv患者年轻（36岁vs 60岁，p < 0.001）。中位CD4淋巴细胞计数为95个细胞/mm3。社区感染发生率为36/67(53.7%)，其中19/36（52.7%）发生菌血症。共发现MRSA感染20例（占29.9%），占社区感染14/36（38.8%）。超过三分之一（38.7%）的PLHIV患者存在MRSA，且均对复方新诺明敏感。PLHIV患者和非hiv患者的死亡率没有差异，MRSA组和MSSA组之间也没有差异。29例患者出现菌血症；其中MRSA占9例（31.0%）。MRSA和MSSA菌血症30天死亡率分别为4/9（44.4%）和2/20（10%）。结论：重症金黄色葡萄球菌感染患者最常见的合并症是HIV，其中PLHIV患者MRSA感染率较高。PLHIV患者更年轻，但死亡率不高，尽管他们有更多的复发和新的葡萄球菌感染。

{"title":"Severe Staphylococcus aureus infection: associated factors and outcomes.","authors":"Narendra Babu Valobdás, Marcelo Ribeiro Alves, Erica Aparecida Dos Santos Ribeiro da Silva, Maria Cristina da Silva Lourenço, Beatriz Coelho de Negreiros Nascimento, Valdilea Gonçalves Veloso, Sandra Wagner Cardoso, Cristiane da Cruz Lamas","doi":"10.1016/j.bjid.2025.104573","DOIUrl":"10.1016/j.bjid.2025.104573","url":null,"abstract":"<p><strong>Introduction: </strong>Staphylococcus aureus causes potentially life-threatening infections, with a somber prognosis when the infection is caused by methicillin-resistant S. aureus due to limited treatment options. The present study describes serious infections by S. aureus in patients hospitalized in an infectious disease's unit in Rio de Janeiro, Brazil, between 2016 and 2021.</p><p><strong>Material and methods: </strong>This was a retrospective study based on data from positive samples diagnosed by the microbiology laboratory and by review of medical records. Clinical-demographic variables and outcomes were compared between Patients Living with HIV (PLHIV) and non-HIV patients. Data were analyzed using Jamovi 1.6 and R 4.0.1 statistical software.</p><p><strong>Results: </strong>A total of 67 patients with a serious S. aureus infection were identified, of whom 29 presented bacteremia and 38 other infections. Thirty-one of 67 (46.3%) were PLHIV. The median age of all patients was 46years, although PLHIV were significantly younger than non-HIV individuals (36 vs. 60 years-old, p < 0.001). The median CD4 lymphocyte count was 95 cells/mm<sup>3</sup>. Community infection occurred in 36/67 (53.7%) patients, of whom 19/36 (52.7%) had bacteremia. A total of 20 MRSA infections (29.9% of the patients) were identified, which accounted for 14/36 (38.8%) of the community infections. More than a third of PLHIV (38.7%) had MRSA, and all these were sensitive to cotrimoxazole. No difference in mortality was found between PLHIV and non-HIV patients, nor between the MRSA and MSSA groups. Bacteremia was present in 29 patients; MRSA accounted for 9 (31.0%) of these. The 30-day mortality was 4/9 (44.4%) and 2/20 (10%) in MRSA and MSSA bacteremia, respectively.</p><p><strong>Conclusions: </strong>The most frequent comorbidity in patients with severe S. aureus infections was HIV, with a high rate of MRSA infections recorded in PLHIV. PLHIV were younger, but did not suffer higher mortality, although they did have more relapses and new staphylococcal infections.</p>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"104573"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low levels of vaccine coverage and immunity against hepatitis B virus in children with hematological malignancies in Brazil 巴西血液恶性肿瘤儿童乙型肝炎病毒疫苗覆盖率低，免疫水平低

IF 2.8 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-08-28 DOI: 10.1016/j.bjid.2025.104575

Vitória Machado Krüger , Alexandre Lemos da Silva , Luciano Zubaran Goldani

Hepatitis B remains a global health concern due its high prevalence and association with chronic liver disease. Although vaccination is safe and effective in immunocompetent individuals, patients with hematological malignancies often exhibit immune dysfunction and reduced vaccine responses, increasing their susceptibility to vaccine-preventable infections. This study aimed to assess the hepatitis B vaccination status and immunoprotection in pediatric oncology patients treated at a tertiary public hospital in southern Brazil. A retrospective, single-center study was conducted with patients aged 0 to 15 years undergoing treatment for hematological malignancies between 2020 and 2022. Clinical and demographic data were obtained from electronic medical records, including vaccination history and hepatitis B serology profile. Vaccination status was verified through the National Immunization Program Information System. A total of 101 patients were evaluated, comprising 58 (57.4 %) males and 43 (42.6 %) females. The predominant diagnosis was acute lymphoblastic leukemia, reported in 67 cases (66.3 %). All patients underwent chemotherapy protocols, and 28 (27.7 %) died during the study period. Serological data for hepatitis B were available for 66 patients (65.3 %), with the highest proportions of missing data for anti-HBs (25.7 %) and total anti-HBc (13.9 %). None tested positive for HBsAg, 2 (2.3 %) were positive for total anti-HBc and 33 (44.0 %) for anti-HBs. Regarding vaccination status, 62 (61.4 %) had completed the hepatitis B vaccine series, 12 (11.9 %) had incomplete schedules, and 27 (26.7 %) had no records available. Only 10 patients (13.5 %) received additional vaccination after oncological diagnosis. Among those with a complete vaccination schedule, 27 (55.1 %) did not develop protective antibodies. These findings demonstrate low level of immunoprotection and suboptimal vaccine coverage against hepatitis B in this population. Optimizing vaccination protocols and monitoring strategies are essential to ensure adequate immunization against hepatitis B and other preventable diseases in immunosuppressed pediatric patients receiving care in Brazil.

由于乙型肝炎的高患病率和与慢性肝病的相关性，它仍然是一个全球性的健康问题。虽然疫苗接种在免疫能力强的个体中是安全有效的，但血液恶性肿瘤患者往往表现出免疫功能障碍和疫苗反应降低，增加了他们对疫苗可预防感染的易感性。本研究旨在评估巴西南部一家三级公立医院儿科肿瘤患者的乙肝疫苗接种状况和免疫保护。一项回顾性、单中心研究对2020年至2022年间接受血液恶性肿瘤治疗的0至15岁患者进行了研究。临床和人口统计数据来自电子病历，包括疫苗接种史和乙型肝炎血清学概况。通过国家免疫规划信息系统核实疫苗接种情况。共评估101例患者，其中男性58例（57.4%），女性43例（42.6%）。主要诊断为急性淋巴细胞白血病，报告67例（66.3%）。所有患者都接受了化疗方案，28例（27.7%）在研究期间死亡。66名患者（65.3%）可获得乙型肝炎血清学数据，其中抗- hbs（25.7%）和总抗- hbc（13.9%）数据缺失比例最高。无HBsAg阳性，2例（2.3%）总抗- hbc阳性，33例（44.0%）抗- hbs阳性。关于疫苗接种情况，62人（61.4%）完成了乙型肝炎疫苗系列接种，12人（11.9%）时间表不完整，27人（26.7%）没有可用记录。只有10例患者（13.5%）在肿瘤诊断后接受了额外的疫苗接种。在接种完整疫苗计划的患者中，27例（55.1%）未产生保护性抗体。这些发现表明，该人群对乙型肝炎的免疫保护水平较低，疫苗覆盖率不理想。优化疫苗接种方案和监测战略对于确保在巴西接受治疗的免疫抑制儿科患者获得针对乙型肝炎和其他可预防疾病的充分免疫至关重要。

{"title":"Low levels of vaccine coverage and immunity against hepatitis B virus in children with hematological malignancies in Brazil","authors":"Vitória Machado Krüger , Alexandre Lemos da Silva , Luciano Zubaran Goldani","doi":"10.1016/j.bjid.2025.104575","DOIUrl":"10.1016/j.bjid.2025.104575","url":null,"abstract":"<div><div>Hepatitis B remains a global health concern due its high prevalence and association with chronic liver disease. Although vaccination is safe and effective in immunocompetent individuals, patients with hematological malignancies often exhibit immune dysfunction and reduced vaccine responses, increasing their susceptibility to vaccine-preventable infections. This study aimed to assess the hepatitis B vaccination status and immunoprotection in pediatric oncology patients treated at a tertiary public hospital in southern Brazil. A retrospective, single-center study was conducted with patients aged 0 to 15 years undergoing treatment for hematological malignancies between 2020 and 2022. Clinical and demographic data were obtained from electronic medical records, including vaccination history and hepatitis B serology profile. Vaccination status was verified through the National Immunization Program Information System. A total of 101 patients were evaluated, comprising 58 (57.4 %) males and 43 (42.6 %) females. The predominant diagnosis was acute lymphoblastic leukemia, reported in 67 cases (66.3 %). All patients underwent chemotherapy protocols, and 28 (27.7 %) died during the study period. Serological data for hepatitis B were available for 66 patients (65.3 %), with the highest proportions of missing data for anti-HBs (25.7 %) and total anti-HBc (13.9 %). None tested positive for HBsAg, 2 (2.3 %) were positive for total anti-HBc and 33 (44.0 %) for anti-HBs. Regarding vaccination status, 62 (61.4 %) had completed the hepatitis B vaccine series, 12 (11.9 %) had incomplete schedules, and 27 (26.7 %) had no records available. Only 10 patients (13.5 %) received additional vaccination after oncological diagnosis. Among those with a complete vaccination schedule, 27 (55.1 %) did not develop protective antibodies. These findings demonstrate low level of immunoprotection and suboptimal vaccine coverage against hepatitis B in this population. Optimizing vaccination protocols and monitoring strategies are essential to ensure adequate immunization against hepatitis B and other preventable diseases in immunosuppressed pediatric patients receiving care in Brazil.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"Article 104575"},"PeriodicalIF":2.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Single-base polymorphism of the ACE2 and TNF-alpha genes in patients with the cardiac and indeterminate forms of Chagas disease 心脏和不确定形式恰加斯病患者中ACE2和tnf - α基因的单碱基多态性

IF 2.8 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-08-14 DOI: 10.1016/j.bjid.2025.104574

Bruna da Cruz Carvalho , Cilmery Suemi Kurokawa , Rodrigo Mattos dos Santos , Daniela Filadelfo Sanches , Simone Baldini Lucheis , Erika Alessandra Pellison Nunes da Costa

Introduction

Chagas Disease (CD) is caused by the protozoan Trypanosoma cruzi and is endemic to 21 Latin American countries. It is estimated that 6 to 7 million people in Latin America are infected. Clinical manifestations occur in two phases, acute and chronic. The chronic phase may present as indeterminate, cardiac, digestive, or mixed. Few studies have investigated why some infected individuals remain asymptomatic, while others develop more severe clinical forms of the disease. The present study aimed to evaluate the frequency of Single Nucleotide Polymorphisms (SNPs) in the ACE2 and TNF-alpha genes in chronic and indeterminate forms of CD and assess their association with clinical data and comorbidities.

Methods

The study included 51 male patients with the indeterminate chronic forms of CD and 22 male patients with cardiac chronic forms of CD. All patients were treated at the HC-FMB/UNESP outpatient clinic. Deoxyribonucleic Acid (DNA) was extracted from blood samples and genotyped using Sanger sequencing and Restriction Fragment Length Polymorphism (RFLP) to analyze the ACE2 rs2074192 and TNF-alpha rs1800629 polymorphisms.

Results

Analysis of the ACE2 rs2074192 SNP revealed no significant differences in the frequencies of the Guanine (G) and Adenine (A) alleles. Similarly, analysis of the TNF-alpha rs1800629 SNP revealed no significant differences in the frequencies of the GG, GA, and AA genotypes.

Conclusion

No significant associations were found between the studied polymorphisms and the clinical forms of CD. However, further studies with larger sample sizes are needed to confirm these findings.

恰加斯病（CD）是由克氏锥虫引起的原生动物，在21个拉丁美洲国家流行。据估计，拉丁美洲有600万至700万人受到感染。临床表现分为急性和慢性两期。慢性期可表现为不确定期、心源性、消化性或混合性。很少有研究调查了为什么一些感染者没有症状，而另一些人却出现了更严重的临床症状。本研究旨在评估慢性和不确定形式CD中ACE2和tnf - α基因单核苷酸多态性（snp）的频率，并评估其与临床数据和合并症的关系。方法本研究纳入51例男性慢性不确定型CD患者和22例男性心源性慢性CD患者，所有患者均在HC-FMB/UNESP门诊接受治疗。从血液样本中提取脱氧核糖核酸（DNA），采用Sanger测序和限制性片段长度多态性（RFLP）进行基因分型，分析ACE2 rs2074192和tnf - α rs1800629多态性。结果ACE2 rs2074192 SNP分析显示鸟嘌呤(G)和腺嘌呤(A)等位基因频率无显著差异。同样，对TNF-alpha rs1800629 SNP的分析显示，GG、GA和AA基因型的频率没有显著差异。结论所研究的多态性与CD的临床形式之间没有明显的关联。然而，需要进一步的更大样本量的研究来证实这些发现。

{"title":"Single-base polymorphism of the ACE2 and TNF-alpha genes in patients with the cardiac and indeterminate forms of Chagas disease","authors":"Bruna da Cruz Carvalho , Cilmery Suemi Kurokawa , Rodrigo Mattos dos Santos , Daniela Filadelfo Sanches , Simone Baldini Lucheis , Erika Alessandra Pellison Nunes da Costa","doi":"10.1016/j.bjid.2025.104574","DOIUrl":"10.1016/j.bjid.2025.104574","url":null,"abstract":"<div><h3>Introduction</h3><div>Chagas Disease (CD) is caused by the protozoan <em>Trypanosoma cruzi</em> and is endemic to 21 Latin American countries. It is estimated that 6 to 7 million people in Latin America are infected. Clinical manifestations occur in two phases, acute and chronic. The chronic phase may present as indeterminate, cardiac, digestive, or mixed. Few studies have investigated why some infected individuals remain asymptomatic, while others develop more severe clinical forms of the disease. The present study aimed to evaluate the frequency of Single Nucleotide Polymorphisms (SNPs) in the ACE2 and TNF-alpha genes in chronic and indeterminate forms of CD and assess their association with clinical data and comorbidities.</div></div><div><h3>Methods</h3><div>The study included 51 male patients with the indeterminate chronic forms of CD and 22 male patients with cardiac chronic forms of CD. All patients were treated at the HC-FMB/UNESP outpatient clinic. Deoxyribonucleic Acid (DNA) was extracted from blood samples and genotyped using Sanger sequencing and Restriction Fragment Length Polymorphism (RFLP) to analyze the ACE2 rs2074192 and TNF-alpha rs1800629 polymorphisms.</div></div><div><h3>Results</h3><div>Analysis of the ACE2 rs2074192 SNP revealed no significant differences in the frequencies of the Guanine (G) and Adenine (A) alleles. Similarly, analysis of the TNF-alpha rs1800629 SNP revealed no significant differences in the frequencies of the GG, GA, and AA genotypes.</div></div><div><h3>Conclusion</h3><div>No significant associations were found between the studied polymorphisms and the clinical forms of CD. However, further studies with larger sample sizes are needed to confirm these findings.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"Article 104574"},"PeriodicalIF":2.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

SARS-CoV-2 investigation in cerebrospinal fluid from meningitis patients during the first pandemic wave 第一波大流行期间脑膜炎患者脑脊液中SARS-CoV-2的调查

IF 2.8 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-08-05 DOI: 10.1016/j.bjid.2025.104571

Maria Cecilia Cergole-Novella , Thayná Rosa Bispo , Elaine Monteiro Matsuda , Daniela Rodrigues Colpas , Ivana Barros de Campos

SARS-CoV-2 predominantly affects the respiratory system; however, during the first pandemic wave, there was a concern about its neuroinvasive potential due to its ability to replicate in neural cells and the neurological signs widely reported as impaired taste or smell. This study aimed to evaluate the presence of SARS-CoV-2 in cerebrospinal fluid (CSF) from suspected cases of meningitis. During the first year of the pandemic, from January 2020 to February 2021, CSF samples were first submitted to multiplex qPCR to detect the three main bacteria causing meningitis (Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae), as the routine of the laboratory, but also, they were submitted to RT-qPCR to SARS-CoV-2 detection. Some samples (20 %) were positive for one bacterium; however, none were positive for the virus, suggesting that the incidence of SARS-CoV-2 in meninges is extremely low. This study with other data in the literature contributes to the epidemiologic surveillance of SARS-CoV-2.

SARS-CoV-2主要影响呼吸系统；然而，在第一波大流行期间，由于其在神经细胞中复制的能力以及广泛报道的味觉或嗅觉受损等神经症状，人们对其神经侵入性潜力感到担忧。本研究旨在评估疑似脑膜炎病例脑脊液中SARS-CoV-2的存在。在大流行的第一年，即2020年1月至2021年2月，脑脊液样本首先作为实验室常规提交多重qPCR检测导致脑膜炎的三种主要细菌（脑膜炎奈瑟菌、肺炎链球菌和流感嗜血杆菌），同时也提交了RT-qPCR检测SARS-CoV-2。部分样本（20%）对一种细菌呈阳性；然而，没有一个病毒呈阳性，这表明SARS-CoV-2在脑膜中的发病率极低。本研究与文献中的其他数据有助于SARS-CoV-2的流行病学监测。

{"title":"SARS-CoV-2 investigation in cerebrospinal fluid from meningitis patients during the first pandemic wave","authors":"Maria Cecilia Cergole-Novella , Thayná Rosa Bispo , Elaine Monteiro Matsuda , Daniela Rodrigues Colpas , Ivana Barros de Campos","doi":"10.1016/j.bjid.2025.104571","DOIUrl":"10.1016/j.bjid.2025.104571","url":null,"abstract":"<div><div>SARS-CoV-2 predominantly affects the respiratory system; however, during the first pandemic wave, there was a concern about its neuroinvasive potential due to its ability to replicate in neural cells and the neurological signs widely reported as impaired taste or smell. This study aimed to evaluate the presence of SARS-CoV-2 in cerebrospinal fluid (CSF) from suspected cases of meningitis. During the first year of the pandemic, from January 2020 to February 2021, CSF samples were first submitted to multiplex qPCR to detect the three main bacteria causing meningitis (<em>Neisseria meningitidis, Streptococcus pneumoniae</em>, and <em>Haemophilus influenzae</em>), as the routine of the laboratory, but also, they were submitted to RT-qPCR to SARS-CoV-2 detection. Some samples (20 %) were positive for one bacterium; however, none were positive for the virus, suggesting that the incidence of SARS-CoV-2 in meninges is extremely low. This study with other data in the literature contributes to the epidemiologic surveillance of SARS-CoV-2.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"Article 104571"},"PeriodicalIF":2.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bacterial profile and antimicrobial resistance in diabetic foot ulcer infections: a 10-year retrospective cohort study 糖尿病足溃疡感染的细菌特征和抗菌素耐药性：一项10年回顾性队列研究

IF 2.8 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-07-31 DOI: 10.1016/j.bjid.2025.104570

Roberto Zambelli , Ana Flavia Santos , Larissa Resende Moreira , Hugo Miguel Ribeiro , Rodrigo Simões , João Murilo Magalhães , Priscila Constantino , Maria Clara Salomão , Cesar de Cesar Netto , Amanda Oliveira Leopoldino

Introduction

Diabetic Foot Infections (DFI) are severe complications of diabetes, often resulting in poor clinical outcomes, including amputations. The objective of this study is to identify the main pathogens causing infections in the diabetic foot ulcers, as well as the antibiotic resistance profile.

Methods

This study included all patients treated for diabetic foot infections at a private tertiary hospital between 2013 and 2022. Demographic data, including age, sex, Body Mass Index (BMI), and the level of amputation were extracted from electronic medical records and collected for all patients. Microbiological and resistance patterns were evaluated following standardized protocols. Cases with incomplete demographic or microbiological data were excluded.

Results

This retrospective cohort study analyzed data from 459 diabetic patients, among them, 337 patients with positive cultures were included, resulting in 507 culture results from surgical samples. Gram-negative bacteria accounted for 55.2 % of isolates, with Enterobacterales (41 %) and non-fermenters (14.2 %) being most prevalent. Proteus sp. (10.3 %) and Escherichia coli (8.3 %) were the most common Gram-negative organisms, with significant resistance to ESBL (15.4 %) and quinolones (29.3 %). Among Gram-positive cocci (43.6 %), Staphylococcus aureus (16.8 %) showed 21.1 % methicillin resistance, while Enterococcus sp. exhibited vancomycin resistance (7 %). Multidrug resistance was identified in 16 % of Pseudomonas sp. and 63.6 % of Acinetobacter sp., raising concerns about limited therapeutic options.

Conclusion

The predominance of Gram-negative bacteria and high levels of antimicrobial resistance highlight the need for regular monitoring of local microbiological profiles. Targeted antimicrobial strategies can significantly reduce the morbidity associated with DFI and improve clinical outcomes in diabetic patients.

糖尿病足部感染（DFI）是糖尿病的严重并发症，通常导致不良的临床结果，包括截肢。本研究的目的是确定引起糖尿病足溃疡感染的主要病原体，以及抗生素耐药性。方法本研究纳入2013年至2022年在一家私立三级医院接受糖尿病足感染治疗的所有患者。从电子病历中提取并收集所有患者的人口统计数据，包括年龄、性别、身体质量指数（BMI）和截肢程度。按照标准化方案评估微生物学和耐药模式。排除人口统计学或微生物学资料不完整的病例。结果本回顾性队列研究分析了459例糖尿病患者的资料，其中337例培养阳性，手术标本培养结果507例。革兰氏阴性菌占55.2%，其中肠杆菌（41%）和非发酵菌（14.2%）最为普遍。最常见的革兰氏阴性菌为变形杆菌（10.3%）和大肠埃希菌（8.3%），对ESBL（15.4%）和喹诺酮类药物（29.3%）具有显著耐药性。革兰氏阳性球菌（43.6%）中，金黄色葡萄球菌（16.8%）耐甲氧西林21.1%，肠球菌（7%）耐万古霉素。在16%的假单胞菌和63.6%的不动杆菌中发现了多药耐药，这引起了对有限治疗选择的关注。结论革兰氏阴性菌占主导地位，耐药程度高，应定期对当地微生物进行监测。靶向抗菌策略可以显著降低糖尿病患者DFI相关的发病率，改善糖尿病患者的临床预后。

{"title":"Bacterial profile and antimicrobial resistance in diabetic foot ulcer infections: a 10-year retrospective cohort study","authors":"Roberto Zambelli , Ana Flavia Santos , Larissa Resende Moreira , Hugo Miguel Ribeiro , Rodrigo Simões , João Murilo Magalhães , Priscila Constantino , Maria Clara Salomão , Cesar de Cesar Netto , Amanda Oliveira Leopoldino","doi":"10.1016/j.bjid.2025.104570","DOIUrl":"10.1016/j.bjid.2025.104570","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetic Foot Infections (DFI) are severe complications of diabetes, often resulting in poor clinical outcomes, including amputations. The objective of this study is to identify the main pathogens causing infections in the diabetic foot ulcers, as well as the antibiotic resistance profile.</div></div><div><h3>Methods</h3><div>This study included all patients treated for diabetic foot infections at a private tertiary hospital between 2013 and 2022. Demographic data, including age, sex, Body Mass Index (BMI), and the level of amputation were extracted from electronic medical records and collected for all patients. Microbiological and resistance patterns were evaluated following standardized protocols. Cases with incomplete demographic or microbiological data were excluded.</div></div><div><h3>Results</h3><div>This retrospective cohort study analyzed data from 459 diabetic patients, among them, 337 patients with positive cultures were included, resulting in 507 culture results from surgical samples. Gram-negative bacteria accounted for 55.2 % of isolates, with <em>Enterobacterales</em> (41 %) and non-fermenters (14.2 %) being most prevalent. <em>Proteus</em> sp. (10.3 %) and <em>Escherichia coli</em> (8.3 %) were the most common Gram-negative organisms, with significant resistance to ESBL (15.4 %) and quinolones (29.3 %). Among Gram-positive cocci (43.6 %), <em>Staphylococcus aureus</em> (16.8 %) showed 21.1 % methicillin resistance, while <em>Enterococcus</em> sp. exhibited vancomycin resistance (7 %). Multidrug resistance was identified in 16 % of <em>Pseudomonas</em> sp. and 63.6 % of <em>Acinetobacter</em> sp., raising concerns about limited therapeutic options.</div></div><div><h3>Conclusion</h3><div>The predominance of Gram-negative bacteria and high levels of antimicrobial resistance highlight the need for regular monitoring of local microbiological profiles. Targeted antimicrobial strategies can significantly reduce the morbidity associated with DFI and improve clinical outcomes in diabetic patients.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"Article 104570"},"PeriodicalIF":2.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Indications and prescriptions of penicillins in a population of Colombia: A cross-sectional study 哥伦比亚人群中青霉素的适应症和处方：一项横断面研究

IF 3 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-07-16 DOI: 10.1016/j.bjid.2025.104572

Luis Fernando Valladales-Restrepo , Brayan Stiven Aristizábal-Carmona , Luisa María Londoño-Toro , Mariavictoria del Valle Jaramillo-Lima , Mariana Osorno-Ríos , Jorge Enrique Machado-Alba

Inappropriate use of antibiotics plays a key role in increasing bacterial resistance. The aim was to determine the prescription patterns and approved and unapproved indications for the use of penicillins in a group of patients from Colombia. This was a cross-sectional study on the use of penicillins in outpatients. The subjects were identified from a population-based drug dispensing database. Approved and unapproved indications were determined from records of the Food and Drug Administration (FDA) of the United States and the National Institute of Food and Drug Surveillance (INVIMA) of Colombia. Descriptive and multivariate analyses were performed. A total of 137,070 patients were identified; the average age was 35.8 ± 23.5 years, and 56.2 % were women. Amoxicillin (73.4 %), dicloxacillin (11.7 %) and sultamicillin (6.0 %) were the most prescribed penicillins, mainly for upper respiratory tract infections (43.0 %). In 68.9 % cases, penicillins were used for approved indications, especially to treat Helicobacter pylori (17.3 %). In 31.1 % of cases, penicillin prescriptions were used for unapproved indications (acute rhinopharyngitis: 8.1 %). Patients with skin and soft tissue infections (aOR = 2.82; 95 % CI 2.57‒3.09), with lower respiratory tract infections (aOR = 2.02; 95 % CI 1.89‒2.16), and those treated with dicloxacillin (aOR = 2.84; 95 % CI 2.07‒3.89) were more likely to be prescribed penicillins for unapproved indications. Amoxicillin was the most widely used penicillin in outpatients. Penicillins were frequently used for unapproved indications not recommended by drug regulatory agencies.

不适当使用抗生素在增加细菌耐药性方面起着关键作用。目的是确定哥伦比亚一组患者使用青霉素的处方模式以及已批准和未批准的适应症。这是一项关于门诊病人使用青霉素的横断面研究。受试者是从基于人群的药品调剂数据库中确定的。根据美国食品和药物管理局（FDA）和哥伦比亚国家食品和药物监测研究所（INVIMA）的记录确定了已批准和未批准的适应症。进行了描述性和多变量分析。共有137,070名患者被确定；平均年龄35.8±23.5岁，女性占56.2%。阿莫西林（73.4%）、双氯西林（11.7%）和舒他西林（6.0%）是处方最多的青霉素类药物，主要用于上呼吸道感染（43.0%）。在68.9%的病例中，青霉素用于批准的适应症，特别是治疗幽门螺杆菌（17.3%）。在31.1%的病例中，青霉素处方被用于未经批准的适应症（急性鼻咽炎：8.1%）。皮肤软组织感染患者(aOR = 2.82；95% CI 2.57-3.09)，下呼吸道感染(aOR = 2.02；95% CI 1.89-2.16)，双氯西林组(aOR = 2.84；95% CI 2.07-3.89)更有可能在未经批准的适应症中使用青霉素。阿莫西林是门诊使用最广泛的青霉素。青霉素经常被用于药物监管机构不推荐的未经批准的适应症。

{"title":"Indications and prescriptions of penicillins in a population of Colombia: A cross-sectional study","authors":"Luis Fernando Valladales-Restrepo , Brayan Stiven Aristizábal-Carmona , Luisa María Londoño-Toro , Mariavictoria del Valle Jaramillo-Lima , Mariana Osorno-Ríos , Jorge Enrique Machado-Alba","doi":"10.1016/j.bjid.2025.104572","DOIUrl":"10.1016/j.bjid.2025.104572","url":null,"abstract":"<div><div>Inappropriate use of antibiotics plays a key role in increasing bacterial resistance. The aim was to determine the prescription patterns and approved and unapproved indications for the use of penicillins in a group of patients from Colombia. This was a cross-sectional study on the use of penicillins in outpatients. The subjects were identified from a population-based drug dispensing database. Approved and unapproved indications were determined from records of the Food and Drug Administration (FDA) of the United States and the National Institute of Food and Drug Surveillance (INVIMA) of Colombia. Descriptive and multivariate analyses were performed. A total of 137,070 patients were identified; the average age was 35.8 ± 23.5 years, and 56.2 % were women. Amoxicillin (73.4 %), dicloxacillin (11.7 %) and sultamicillin (6.0 %) were the most prescribed penicillins, mainly for upper respiratory tract infections (43.0 %). In 68.9 % cases, penicillins were used for approved indications, especially to treat <em>Helicobacter pylori</em> (17.3 %). In 31.1 % of cases, penicillin prescriptions were used for unapproved indications (acute rhinopharyngitis: 8.1 %). Patients with skin and soft tissue infections (aOR = 2.82; 95 % CI 2.57‒3.09), with lower respiratory tract infections (aOR = 2.02; 95 % CI 1.89‒2.16), and those treated with dicloxacillin (aOR = 2.84; 95 % CI 2.07‒3.89) were more likely to be prescribed penicillins for unapproved indications. Amoxicillin was the most widely used penicillin in outpatients. Penicillins were frequently used for unapproved indications not recommended by drug regulatory agencies.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"Article 104572"},"PeriodicalIF":3.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in Brazil 50岁或以上的带状疱疹门诊患者的卫生资源使用和流行病学概况：巴西修改的德尔菲共识小组

IF 3 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-07-04 DOI: 10.1016/j.bjid.2025.104560

Ângela Maria Bagattini , Michelle Quarti Machado da Rosa , Jorge A. Gomez , Jamile Ballivian , Agustín Casarini , Ariel Bardach , Cristiana Maria Toscano

Herpes Zoster (HZ) and its complications, such as Postherpetic Neuralgia (PHN), are associated with significant burden in elderly. In Brazil, data on economic and epidemiologic HZ burden is still limited. We conducted a Delphi panel to assess healthcare resource use in HZ outpatients aged 50-years and older. Diagnosis and treatment resources, proportion of referral and hospitalization were estimated considering HZ, PHN, ophthalmic and neurologic zoster typical cases. A diverse group of 20 medical specialists was selected, and responded anonymously to an online questionnaire. Consensus was met if ≥ 75 % agreement was reached in the 1st round, and if not met, a 2nd round was held. Summary statistics are reported stratified by age-groups and healthcare system (public and private). Responses were obtained from 19 and 17 panel members in the 1st and 2nd rounds, respectively. The proportion HZ outpatients with PHN increased significantly with age (4 % in 50‒59; 14 % in ≥ 80 years). Ophtalmic and neurological complications ranged from 5 %‒13 % across age groups. Absenteeism was high, ranging from 30 %‒68 % of patients depending on the clinical presentation. HZ patients required 2‒3 medical visits, and referral to another medical specialty varied from 10 %‒22 % across age ranges, doubling for NPH patients. Proportion of hospitalization varied from 1–8 %. HZ diagnosis was mainly clinical (93 %). Acyclovir (95 %) and valaciclovir (80 %) were the therapy of choice in the public and private systems, respectively. Pain management included dipyrone and codeine (63 %), pregabalin (58 %), and gabapentin (Neurontin) (48 %). Our results report significant healthcare resource utilization by elderly HZ patients in Brazil.

带状疱疹（HZ）及其并发症，如带状疱疹后神经痛（PHN），与老年人的重大负担相关。在巴西，关于HZ的经济和流行病学负担的数据仍然有限。我们采用德尔菲法评估50岁及以上HZ门诊患者的医疗资源使用情况。考虑HZ、PHN、眼科和神经系统带状疱疹典型病例，评估诊断和治疗资源、转诊和住院比例。20名医学专家组成的多元化小组被选中，并匿名回答了一份在线问卷。如果在第一轮中达成≥75%的共识，则达成共识，如果未达成共识，则举行第二轮。摘要统计数据按年龄组和医疗保健系统（公立和私立）分层报告。评审小组在第一轮及第二轮分别收到19位及17位成员的回应。伴有PHN的HZ门诊患者比例随年龄的增长而显著增加(50-59岁为4%；≥80年的14%)。眼科和神经系统并发症在各年龄组中占5% - 13%。缺勤率很高，根据临床表现，缺勤率从30% - 68%不等。HZ患者需要2-3次就诊，转诊到其他医学专科的比例在不同年龄范围内从10% - 22%不等，NPH患者的比例翻了一番。住院比例从1 - 8%不等。HZ主要是临床诊断（93%）。阿昔洛韦（95%）和伐昔洛韦（80%）分别是公立和私立系统的首选治疗方法。疼痛治疗包括双吡隆和可待因（63%），普瑞巴林（58%）和加巴喷丁（Neurontin）（48%）。我们的研究结果报告了巴西老年HZ患者显著的医疗资源利用率。

{"title":"Health resource use and epidemiologic profile of herpes zoster outpatients aged 50 years or older: a modified Delphi consensus panel in Brazil","authors":"Ângela Maria Bagattini , Michelle Quarti Machado da Rosa , Jorge A. Gomez , Jamile Ballivian , Agustín Casarini , Ariel Bardach , Cristiana Maria Toscano","doi":"10.1016/j.bjid.2025.104560","DOIUrl":"10.1016/j.bjid.2025.104560","url":null,"abstract":"<div><div>Herpes Zoster (HZ) and its complications, such as Postherpetic Neuralgia (PHN), are associated with significant burden in elderly. In Brazil, data on economic and epidemiologic HZ burden is still limited. We conducted a Delphi panel to assess healthcare resource use in HZ outpatients aged 50-years and older. Diagnosis and treatment resources, proportion of referral and hospitalization were estimated considering HZ, PHN, ophthalmic and neurologic zoster typical cases. A diverse group of 20 medical specialists was selected, and responded anonymously to an online questionnaire. Consensus was met if ≥ 75 % agreement was reached in the 1st round, and if not met, a 2nd round was held. Summary statistics are reported stratified by age-groups and healthcare system (public and private). Responses were obtained from 19 and 17 panel members in the 1st and 2nd rounds, respectively. The proportion HZ outpatients with PHN increased significantly with age (4 % in 50‒59; 14 % in ≥ 80 years). Ophtalmic and neurological complications ranged from 5 %‒13 % across age groups. Absenteeism was high, ranging from 30 %‒68 % of patients depending on the clinical presentation. HZ patients required 2‒3 medical visits, and referral to another medical specialty varied from 10 %‒22 % across age ranges, doubling for NPH patients. Proportion of hospitalization varied from 1–8 %. HZ diagnosis was mainly clinical (93 %). Acyclovir (95 %) and valaciclovir (80 %) were the therapy of choice in the public and private systems, respectively. Pain management included dipyrone and codeine (63 %), pregabalin (58 %), and gabapentin (Neurontin) (48 %). Our results report significant healthcare resource utilization by elderly HZ patients in Brazil.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"Article 104560"},"PeriodicalIF":3.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validation of immunochromatographic test in broth-enriched rectal swab specimens 免疫层析试验在富含肉汤的直肠拭子标本中的验证

IF 3 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-06-30 DOI: 10.1016/j.bjid.2025.104559

Camila Loredana P.A.M. Bezerra , Barbara de Almeida Lessa Castro , Camila Rizek , Sania Alves dos Santos , Juliana Januário Gaudereto , Ana Paula Cury , Natashia Reese , Fernanda C. Lessa , Susan Bollinger , Matias Chiarastelli Salomão , ICT validation Study Group

Rapid detection of Carbapenemase-Producing Enterobacterales (CPE) is essential for informing infection prevention and control actions to curb the spread of antimicrobial resistance. Immunochromatographic Tests (ICTs) offer a quick and cost-effective alternative to molecular methods but are typically designed for bacterial isolates rather than direct clinical specimens. We developed a protocol using the O.K.N.V.I. RESIST-5 ICT (Coris Bioconcept, Gembloux, Belgium) to detect KPC, NDM, OXA-48, VIM, and IMP carbapenemases from broth-enriched mock rectal swabs. A total of 35 well-characterized carbapenemase-producing isolates were inoculated into a 10 % stool matrix to create mock swabs. Swabs were incubated in Brain-Heart Infusion (BHI) broth, with and without a 10 μg meropenem disk, at 37 °C for 4 and 6 h. After incubation, broths were centrifuged, and pellets were tested using the ICT. Sensitivity, specificity, and accuracy were calculated for each method (with/without meropenem disk and incubation period). Optimal performance was achieved with swabs incubated in BHI broth without meropenem for 6 h, showing 100 % sensitivity, specificity, and accuracy for all the five enzymes tested. Incubation with meropenem or shorter incubation times resulted in lower sensitivities, with per-enzyme sensitivities ranging from 0 % to 100 %. The developed protocol enables rapid and accurate detection of five common carbapenemases directly from broth-enriched rectal swabs within 6 h. This method offers a practical alternative to culture-based and molecular techniques, potentially enhancing infection control measures through timely identification of CPE.

产碳青霉烯酶肠杆菌（CPE）的快速检测对于告知感染预防和控制行动以遏制抗微生物药物耐药性的传播至关重要。免疫层析测试（ict）提供了一种快速且具有成本效益的分子方法替代方法，但通常是为细菌分离物而不是直接临床标本设计的。我们开发了一种使用O.K.N.V.I. resistance -5 ICT （Coris Bioconcept, Gembloux, Belgium）检测富含肉汤的模拟直肠棉签中KPC、NDM、OXA-48、VIM和IMP碳青霉烯酶的方案。将35株具有良好特征的产碳青霉烯酶分离株接种到10%的粪便基质中制备模拟棉签。拭子在脑-心灌注（BHI）肉汤中（含和不含10 μg美罗培南盘），37℃孵育4和6 h。孵育后，肉汤离心，用ICT检测微球。计算每种方法（含/不含美罗培南圆盘和潜伏期）的灵敏度、特异性和准确性。棉签在不含美罗培南的BHI肉汤中孵育6 h，获得最佳性能，对所有五种酶的敏感性、特异性和准确性均为100%。用美罗培南孵育或更短的孵育时间导致较低的敏感性，对酶的敏感性从0%到100%不等。开发的方案能够在6小时内直接从富含肉汤的直肠拭子中快速准确地检测五种常见的碳青霉烯酶。该方法提供了一种基于培养和分子技术的实用替代方法，通过及时识别CPE，有可能加强感染控制措施。

{"title":"Validation of immunochromatographic test in broth-enriched rectal swab specimens","authors":"Camila Loredana P.A.M. Bezerra , Barbara de Almeida Lessa Castro , Camila Rizek , Sania Alves dos Santos , Juliana Januário Gaudereto , Ana Paula Cury , Natashia Reese , Fernanda C. Lessa , Susan Bollinger , Matias Chiarastelli Salomão , ICT validation Study Group","doi":"10.1016/j.bjid.2025.104559","DOIUrl":"10.1016/j.bjid.2025.104559","url":null,"abstract":"<div><div>Rapid detection of Carbapenemase-Producing <em>Enterobacterales</em> (CPE) is essential for informing infection prevention and control actions to curb the spread of antimicrobial resistance. Immunochromatographic Tests (ICTs) offer a quick and cost-effective alternative to molecular methods but are typically designed for bacterial isolates rather than direct clinical specimens. We developed a protocol using the O.K.N.V.I. RESIST-5 ICT (Coris Bioconcept, Gembloux, Belgium) to detect KPC, NDM, OXA-48, VIM, and IMP carbapenemases from broth-enriched mock rectal swabs. A total of 35 well-characterized carbapenemase-producing isolates were inoculated into a 10 % stool matrix to create mock swabs. Swabs were incubated in Brain-Heart Infusion (BHI) broth, with and without a 10 μg meropenem disk, at 37 °C for 4 and 6 h. After incubation, broths were centrifuged, and pellets were tested using the ICT. Sensitivity, specificity, and accuracy were calculated for each method (with/without meropenem disk and incubation period). Optimal performance was achieved with swabs incubated in BHI broth without meropenem for 6 h, showing 100 % sensitivity, specificity, and accuracy for all the five enzymes tested. Incubation with meropenem or shorter incubation times resulted in lower sensitivities, with per-enzyme sensitivities ranging from 0 % to 100 %. The developed protocol enables rapid and accurate detection of five common carbapenemases directly from broth-enriched rectal swabs within 6 h. This method offers a practical alternative to culture-based and molecular techniques, potentially enhancing infection control measures through timely identification of CPE.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"Article 104559"},"PeriodicalIF":3.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Single nucleotide polymorphisms associated with benzimidazole resistance of the β-tubulin isotype 1 gene in Ascaris lumbricoides isolated in South Africa 南非蛔虫β-微管蛋白同型1基因与苯并咪唑抗性相关的单核苷酸多态性

IF 3 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-06-28 DOI: 10.1016/j.bjid.2025.104556

Teniel Ramkhelawan , Pragalathan Naidoo , Zilungile L. Mkhize-Kwitshana

Background

Ascariasis is a parasitic infection caused by Ascaris lumbricoides and infects over 1.2 billion people worldwide. Benzimidazole (BZ) drugs remain the standard treatment in large-scale deworming programs globally. The prevalence of Single Nucleotide Polymorphisms (SNPs) in the β-tubulin gene of A. lumbricoides (F200Y, E198A and F167Y) is increasing due to the widespread use of BZ drugs.

Aim

To investigate the prevalence of the above-mentioned SNPs in a South African adult population.

Methods

This was a sub-study of the main cross-sectional study with participants (n = 414) who had been recruited from five public health clinics in the peri‑urban areas South of Durban, KwaZulu-Natal, South Africa. For the current study, a purposive selection of 20 stool samples that were positive for A. lumbricoides eggs was made. A. lumbricoides worm extracts (n = 4) were used as a positive control. Sanger sequencing and RFLP-PCR were used to identify the presence of mutations.

Results

No mutations were detected, and all genotypes observed at codons F167Y, E198A and F200Y were the homozygous wild-type genotype.

Conclusion

Although no mutations were found in this small study, the potential occurrence of mutations in a larger sample subset cannot be ruled out.

蛔虫病是一种由类蛔虫引起的寄生虫感染，全世界有超过12亿人感染。苯并咪唑（BZ）药物仍然是全球大规模驱虫计划的标准治疗方法。由于BZ类药物的广泛应用，蚓类β-微管蛋白基因（F200Y、E198A和F167Y）单核苷酸多态性（snp）的发生率越来越高。目的调查上述snp在南非成年人群中的流行情况。方法：这是主要横断面研究的一项亚研究，参与者（n = 414）从南非夸祖鲁-纳塔尔省德班南部城郊地区的五个公共卫生诊所招募。在目前的研究中，有目的地选择了20个粪便样本，这些粪便样本对蚓状拟虫卵呈阳性。阳性对照为4只拟南麻虫提取物。使用Sanger测序和RFLP-PCR来鉴定突变的存在。结果未发现突变，密码子F167Y、E198A和F200Y基因型均为纯合野生型。结论虽然在这个小的研究中没有发现突变，但不能排除在更大的样本子集中发生突变的可能性。

{"title":"Single nucleotide polymorphisms associated with benzimidazole resistance of the β-tubulin isotype 1 gene in Ascaris lumbricoides isolated in South Africa","authors":"Teniel Ramkhelawan , Pragalathan Naidoo , Zilungile L. Mkhize-Kwitshana","doi":"10.1016/j.bjid.2025.104556","DOIUrl":"10.1016/j.bjid.2025.104556","url":null,"abstract":"<div><h3>Background</h3><div>Ascariasis is a parasitic infection caused by <em>Ascaris lumbricoides</em> and infects over 1.2 billion people worldwide. Benzimidazole (BZ) drugs remain the standard treatment in large-scale deworming programs globally. The prevalence of Single Nucleotide Polymorphisms (SNPs) in the <em>β-tubulin</em> gene of <em>A. lumbricoides</em> (F200Y, E198A and F167Y) is increasing due to the widespread use of BZ drugs.</div></div><div><h3>Aim</h3><div>To investigate the prevalence of the above-mentioned SNPs in a South African adult population.</div></div><div><h3>Methods</h3><div>This was a sub-study of the main cross-sectional study with participants (<em>n</em> = 414) who had been recruited from five public health clinics in the peri‑urban areas South of Durban, KwaZulu-Natal, South Africa. For the current study, a purposive selection of 20 stool samples that were positive for <em>A. lumbricoides</em> eggs was made. <em>A. lumbricoides</em> worm extracts (<em>n</em> = 4) were used as a positive control. Sanger sequencing and RFLP-PCR were used to identify the presence of mutations.</div></div><div><h3>Results</h3><div>No mutations were detected, and all genotypes observed at codons F167Y, E198A and F200Y were the homozygous wild-type genotype.</div></div><div><h3>Conclusion</h3><div>Although no mutations were found in this small study, the potential occurrence of mutations in a larger sample subset cannot be ruled out.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"Article 104556"},"PeriodicalIF":3.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk factors associated with syphilis among patients at a sexual health center in Brazil: A retrospective study 巴西性健康中心患者中与梅毒相关的危险因素：一项回顾性研究

IF 3 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases

Pub Date : 2025-06-28 DOI: 10.1016/j.bjid.2025.104558

Cristhiane Campos Marques , Fabiana Nunes de Carvalho Mariz , Thaisa Campos Marques , Juliana Tessari Dias Rohr , Berenice Moreira , Paula Beatriz Santiago , Nathália Araujo Varela da Costa , Juliana Marques de Oliveira , Otávio Toledo Nóbrega , Carla Nunes de Araújo

Syphilis has reemerged worldwide, and knowledge about at-risk populations can assist in disease prevention and control. This study aimed to estimate the prevalence of syphilis among attendees at a Brazilian sexual health center and explore the association between sociodemographic and sexual behavioral factors with syphilis infection. A cross-sectional study was conducted at a Counselling and Testing Center (CTC) in Goiás, Brazil. We collected data from January to December 2018 to conduct a population-based study. Of 3526 patient records included in the analysis, 344 (9.8 %) belonged to participants who had syphilis, mainly at the age of 20 to 39 years old (63.1 %, p = 0.0683) and not married (62.1 %, p = 0.0042). Individuals who reported having homosexual relationships (Odds Ratio [OR = 2.93], p < 0.0001), previous sexually transmitted infections (OR = 2.36, p < 0.0001), and use of drugs (OR = 1.29, p < 0.0001) were more frequently diagnosed with the disease. Among patients with syphilis, MSM had a higher HIV co-infection rate (OR = 2.37, p = 0.0195) and also higher co-infection rates with other previous STIs (OR = 2.84, p = 0.00883). A high prevalence of syphilis among patients who attended the CTC in Goiás was revealed. Effective control of syphilis among populations at higher risk needs to be addressed to achieve disease control in Brazil.

梅毒在世界范围内重新出现，对高危人群的了解有助于疾病的预防和控制。本研究旨在估计巴西性健康中心参与者中梅毒的患病率，并探讨社会人口统计学和性行为因素与梅毒感染之间的关系。在巴西Goiás的咨询和测试中心（CTC）进行了一项横断面研究。我们收集了2018年1月至12月的数据，进行了一项基于人群的研究。在纳入分析的3526例患者记录中，344例（9.8%）属于梅毒患者，主要是20至39岁（63.1%,p = 0.0683）和未婚（62.1%,p = 0.0042）。报告有同性恋关系的个体(优势比[OR = 2.93], p <；0.0001)，既往性传播感染(OR = 2.36, p <；0.0001)和药物使用(OR = 1.29, p <；0.0001)更常被诊断为该疾病。梅毒患者中，男男性行为者HIV合并感染率较高（OR = 2.37, p = 0.0195），与其他性传播感染合并感染率较高（OR = 2.84, p = 0.00883）。在Goiás参加CTC的患者中发现了梅毒的高患病率。为在巴西实现疾病控制，需要在高风险人群中有效控制梅毒。

{"title":"Risk factors associated with syphilis among patients at a sexual health center in Brazil: A retrospective study","authors":"Cristhiane Campos Marques , Fabiana Nunes de Carvalho Mariz , Thaisa Campos Marques , Juliana Tessari Dias Rohr , Berenice Moreira , Paula Beatriz Santiago , Nathália Araujo Varela da Costa , Juliana Marques de Oliveira , Otávio Toledo Nóbrega , Carla Nunes de Araújo","doi":"10.1016/j.bjid.2025.104558","DOIUrl":"10.1016/j.bjid.2025.104558","url":null,"abstract":"<div><div>Syphilis has reemerged worldwide, and knowledge about at-risk populations can assist in disease prevention and control. This study aimed to estimate the prevalence of syphilis among attendees at a Brazilian sexual health center and explore the association between sociodemographic and sexual behavioral factors with syphilis infection. A cross-sectional study was conducted at a Counselling and Testing Center (CTC) in Goiás, Brazil. We collected data from January to December 2018 to conduct a population-based study. Of 3526 patient records included in the analysis, 344 (9.8 %) belonged to participants who had syphilis, mainly at the age of 20 to 39 years old (63.1 %, <em>p</em> = 0.0683) and not married (62.1 %, <em>p</em> = 0.0042). Individuals who reported having homosexual relationships (Odds Ratio [OR = 2.93], <em>p</em> < 0.0001), previous sexually transmitted infections (OR = 2.36, <em>p</em> < 0.0001), and use of drugs (OR = 1.29, <em>p</em> < 0.0001) were more frequently diagnosed with the disease. Among patients with syphilis, MSM had a higher HIV co-infection rate (OR = 2.37, <em>p</em> = 0.0195) and also higher co-infection rates with other previous STIs (OR = 2.84, <em>p</em> = 0.00883). A high prevalence of syphilis among patients who attended the CTC in Goiás was revealed. Effective control of syphilis among populations at higher risk needs to be addressed to achieve disease control in Brazil.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 5","pages":"Article 104558"},"PeriodicalIF":3.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0