Brazilian Journal of Infectious Diseases最新文献

{"title":"Risk factors associated with syphilis among patients at a sexual health center in Brazil: A retrospective study","authors":"Cristhiane Campos Marques ,&nbsp;Fabiana Nunes de Carvalho Mariz ,&nbsp;Thaisa Campos Marques ,&nbsp;Juliana Tessari Dias Rohr ,&nbsp;Berenice Moreira ,&nbsp;Paula Beatriz Santiago ,&nbsp;Nathália Araujo Varela da Costa ,&nbsp;Juliana Marques de Oliveira ,&nbsp;Otávio Toledo Nóbrega ,&nbsp;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> &lt; 0.0001), previous sexually transmitted infections (OR = 2.36, <em>p</em> &lt; 0.0001), and use of drugs (OR = 1.29, <em>p</em> &lt; 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}

{"title":"SARS-CoV-2 sublineages recovered from southern Brazilian cases during Omicron wave in 2023, early introduction of JN.1","authors":"Mellanie Fontes-Dutra ,&nbsp;Micheli Filippi ,&nbsp;Meriane Demoliner ,&nbsp;Alexandre Sita ,&nbsp;Fernando Rosado Spilki","doi":"10.1016/j.bjid.2025.104557","DOIUrl":"10.1016/j.bjid.2025.104557","url":null,"abstract":"<div><div>Since the emergence of the novel coronavirus SARS-CoV-2, public health measures have adapted as the virus evolve and acquired greater transmissibility and escape from the previous immune response. Genomic surveillance is a reliable and decisive tool for monitoring the evolutionary dynamics of the virus and its nucleotide diversity. Rio Grande do Sul is a southern Brazilian state that borders Argentina and Uruguay, and genomic and epidemiological surveillance led to early detection of COVID-19 variants, as seen in P.1 lineage. The study aimed to investigate the genetic characterization of SARS-CoV-2 Omicron sublineages in Rio Grande do Sul, Brazil, during 2023. By obtaining viral RNA from nasopharyngeal swabs positive for SARS-CoV-2, we performed high-throughput sequencing and data were analyzed using bioinformatic approaches. Our results revealed a dynamic change in Omicron sublineages during 2023, with the occurrence of JN.1+JN.1* reads during December 2023, parallel to the first JN.1 official record in Brazil, occurred in Ceará state, which is in the northeast region of Brazil. These data revealed a distinct nucleotide diversity in S gene of JN.1 reads, highlighting the importance of genomic surveillance in Rio Grande do Sul for the early detection of the entry of future SARS-CoV-2 variants into Brazil.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 4","pages":"Article 104557"},"PeriodicalIF":3.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470764","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}

{"title":"Emergency and persistence of Escherichia coli ST131 as community-onset antimicrobial resistant urinary tract infection in Rio de Janeiro, Brazil","authors":"Eduardo Moreira de Castro ,&nbsp;Isadora Silva Barcellos ,&nbsp;Guilherme Santoro-Lopes ,&nbsp;Ana Paula de Souza da Silva ,&nbsp;Luís Guilherme de Araújo Longo ,&nbsp;Mariana Anjo Barbosa ,&nbsp;Gabriela Camarano de Oliveira ,&nbsp;Lucas Cecílio Vilar ,&nbsp;Adriana Lúcia Pires Ferreira ,&nbsp;Karla Rodrigues Miranda ,&nbsp;Beatriz Meurer Moreira","doi":"10.1016/j.bjid.2025.104555","DOIUrl":"10.1016/j.bjid.2025.104555","url":null,"abstract":"<div><div>Urinary Tract Infections (UTI) are among the most common public health problems worldwide, mostly caused by <em>Escherichia coli.</em> High-risk pandemic clones, especially ST131, are known for their association with multidrug resistance. A better understanding of epidemiologic and molecular characteristics may provide insights into the dissemination and evolution of this pathogen. The present study aims to investigate selected clonal characteristics of a large collection of UTI-causing <em>E. coli</em> isolates from Rio de Janeiro, an urban center in Brazil. We set up a collection of 992 <em>E. coli</em> isolates from patients with UTI in 2019. We determined antimicrobial susceptibility, Extended Spectrum Betalactamase (ESBL) production and clonal composition of isolates and compared results with data from 2015. Frequencies of four most isolated pandemic clones (ST131, ST69, ST73 and ST95) were determined by PCR; ST131 clades were determined by PCR and <em>fimH</em> gene sequence; ESBL-producing isolates underwent MLST. Resistance frequencies were &gt; 30 % for ampicillin and ciprofloxacin. ST131 isolates were the most frequent clone (14 %), increasing significantly from 2015, comprising 52 % of all ESBL-producing strains. Clade C formed most ST131 isolates (56 %), including 40 % of all ESBL-producing isolates, most in Clade C2; almost all <em>fim</em>H30. ST131, formed by heterogeneous lineages, was established as a major source of ESBL isolates in the community, with a major contribution to antimicrobial resistant UTI.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 4","pages":"Article 104555"},"PeriodicalIF":3.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280454","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}

{"title":"Neurological manifestations of acute SARS-CoV-2 infection in a reference hospital in Bahia, Brazil","authors":"Jesângeli de Sousa Dias ,&nbsp;Maria Augusta Moreira Rebouças ,&nbsp;Lilian Verena da Silva Carvalho ,&nbsp;Thais Sampaio Silva ,&nbsp;Jair Santana dos Santos ,&nbsp;Astrid Xiomara Tatiana Otero Melendez ,&nbsp;Carlos Brites","doi":"10.1016/j.bjid.2025.104542","DOIUrl":"10.1016/j.bjid.2025.104542","url":null,"abstract":"<div><h3>Background</h3><div>Neurologic manifestations of Coronavirus Disease-19 (COVID-19) have been associated with patients’ disease severity and outcome. This study aimed to describe the frequency and characteristics of the neurological manifestations in a group of hospitalized individuals with COVID-19 and their associations with patient outcomes.</div></div><div><h3>Methods</h3><div>Patients aged 18 years or older admitted to a local hospital between April and June 2020 with SARS-CoV-2 detected by RT-PCR were included in this retrospective observational study. The characteristics of participants were collected from electronic medical records using a structured questionnaire. A Poisson regression model was used to examine the influence of neurological manifestations on mortality.</div></div><div><h3>Results</h3><div>A total of 305 participants with COVID-19 were included, with 57.7 % of them presenting neurological symptoms. There were 62 (20.3 %) individuals with acute encephalopathy, with a mean age of 65.5 ± 15.9 years. In this group, higher Prevalence Ratios (PR) of comorbidities (1.6) and severe disease (3.6) were present, predisposing factors for acute encephalopathy. They were also more likely to be admitted to the intensive care unit (3.1) and to die (2.4). The median Neutrophil-Lymphocyte Ratio (NLR) was 7 (Interquartile Range [IQR: 4‒12]). Fifty-two (17 %) participants presented chemosensory dysfunction, with a mean age 53.3 ± 14 years and a lower PR of comorbidity (0.8) than those without. The severe diseases’ PR was slightly higher (1.1), but the PR of ICU admission (0.7), and deaths (0.4) was lower. The LNR was 3.8 (IQR: 2.2–7.8). Poisson regression analysis revealed that severe illness (PR = 3.13), cardiopathy (PR = 1.65), acute encephalopathy (PR = 1.49), diabetes (PR = 1.46), and neutrophil-lymphocyte ratio (PR = 1.04) were associated with death. Conversely, having chemosensory disorders (PR = 0.44) and a prolonged hospital stay (PR = 0.96) were associated with survival.</div></div><div><h3>Conclusion</h3><div>Patients with acute encephalopathy had more severe forms of COVID-19 and higher mortality. In contrast, chemosensory dysfunction was associated with milder disease manifestations and a better prognosis.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 4","pages":"Article 104542"},"PeriodicalIF":3.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134160","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}

{"title":"Does delocalised PCR for Streptococcus B in the labour ward allow adequate administration of antibiotics to prevent early neonatal infection?","authors":"Clémentine Guetat ,&nbsp;Laetitia Roussel ,&nbsp;Marie De Antonio ,&nbsp;Marie Accoceberry ,&nbsp;Céline Houlle ,&nbsp;Fanny Petillon ,&nbsp;Marion Rouzaire ,&nbsp;Denis Gallot","doi":"10.1016/j.bjid.2025.104553","DOIUrl":"10.1016/j.bjid.2025.104553","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Streptococcus</em> B is a commensal infectious agent of the intestinal and genitourinary tract. It is often implicated in early neonatal infections. Some 10 %–30 % of women are colonised by this bacterium. Screening for carriage in women before delivery prior to antibiotic prophylaxis is thus essential. In recent years, real-time PCR tests have been developed. Our main objective was to determine whether screening for <em>Streptococcus</em> B carriage by PCR on admission (gold standard GeneXpert) permits complete antibiotic prophylaxis.</div></div><div><h3>Materials and methods</h3><div>This was an observational, retrospective study. Data set from all patients with a delocalised PCR for <em>Streptococcus</em> B (GeneXpert Instrument System) on arrival at the maternity hospital were collected between January 2022 and February 2023. We recorded 3467 test results, of which 344 were positive for <em>Streptococcus</em> B carriage. A total of 236 positive patients were included in the analysis. Antibioprophylaxis was considered complete when the patient had received at least one dose more than 4-hours before birth.</div></div><div><h3>Results</h3><div>Of the 236 patients, antibiotic therapy was incomplete in 53 cases (22.4 %) because vaginal delivery or caesarean section occurred less than 4-hours after the first dose. Antibioprophylaxis was not initiated in 33 cases. The main reason was for rapid labour in 28 cases (11.9 %). The 5 remaining cases did not receive antibiotics because probable omission by the team (2.1 %).</div></div><div><h3>Conclusion</h3><div>Delocalised PCR allows complete antibiotic prophylaxis against <em>Streptococcus</em> B in 63.6 % of cases, offering scope for improvement. While it will not be possible to improve antibioprophylaxis in case of rapid labour (within 3 hours after arrival), we should be able to prevent omissions (2.1 %) and, above all, reduce the birth rate before the second dose (22.4 %) by administering the first dose more quickly.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 4","pages":"Article 104553"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124551","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}

{"title":"Acceptability and usability of oral fluid HCV self-testing among health-facility users from Brazil: a cross-sectional study of 685 participants","authors":"Hugo Perazzo ,&nbsp;Cristiane Villela-Nogueira ,&nbsp;Maria K. Gomes ,&nbsp;Andre Daher ,&nbsp;Cristiane Siqueira-do-Valle ,&nbsp;Ketiuce Zukeram ,&nbsp;Ana Cristina G. Ferreira ,&nbsp;Karen Cristine Tonini ,&nbsp;Elton Carlos de Almeida ,&nbsp;Sandra W. Cardoso ,&nbsp;Beatriz Grinsztejn ,&nbsp;Valdilea G. Veloso","doi":"10.1016/j.bjid.2025.104544","DOIUrl":"10.1016/j.bjid.2025.104544","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>HCV Self-Testing (HCVST) can be used to uptake HCV testing. We aimed to evaluate the acceptability/usability and re-reading/re-testing agreement of oral fluid HCVST among health-facility users in the Primary Care Systemin Brazil.</div></div><div><h3>Materials and methods</h3><div>Consecutive people aged 18‒79 years using the Primary Care System (PCS) from 04-July-2022 to 30-September-2022 were invited for this cross-sectional study. The professional use OraQuick® HCV Rapid Antibody Test was used as a HCVST prototype. Oral fluid HCVST was performed relying on a step-by-step video and written/pictorial instructions. Usability was assessed by observed errors and documented need of assistance by a Healthcare Worker (HCW). After HCVST, a second HCV test was performed by the HCW using the same test-kit. <em>Re</em>-reading and re-testing concordances were evaluated (Cohen’s kappa, κ). Post-testing participant’s perspectives were assessed.</div></div><div><h3>Results</h3><div>685 participants (74.5% female; median age = 52 [IQR 39‒61] years, 52.5% with schooling ≤ 10 years) were included. Major observed errors [%(95%CI)] were incorrect sample collection [32.8% (29.4‒36.5)] and wrong placing the test device in the tube [15.0% (12.6‒17.9)]. A total of 35.6% (95% CI 32.1‒39.3) of participants needed assistance in at least one step of HCVST. <em>Re</em>-reading and re-testing agreements were 95.2% (κ = 0.56) and 99.7% (κ = 0.67; <em>n</em> = 626 excluding invalid tests), respectively. After HCVST, 93% felt safe, 99% would be willing to test again, and 99% would recommend HCVST. Most participants rated the HCVST experience as easy (73%) or very easy (24%).</div></div><div><h3>Conclusion</h3><div>Oral-fluid HCVST was feasible and well-accepted among users of the PCS in Brazil. HCVST can be an alternative to scale-up HCV testing.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 4","pages":"Article 104544"},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117070","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}

{"title":"Coexistence of PMQR and ESBL genes among clinical Escherichia coli isolates from community-acquired UTI in Mexicali, on the US-Mexico border","authors":"Dolores A. Marquez-Salazar ,&nbsp;Ricardo Delgadillo-Valles ,&nbsp;Gerson N. Hernandez-Acevedo ,&nbsp;Edwin Barrios-Villa ,&nbsp;Raquel Muñiz-Salazar ,&nbsp;Gilberto Lopez-Valencia ,&nbsp;Paulina Haro ,&nbsp;Enrique Trasviña-Muñoz ,&nbsp;Rafael Martinez-Miranda ,&nbsp;Jonathan Arauz-Cabrera","doi":"10.1016/j.bjid.2025.104554","DOIUrl":"10.1016/j.bjid.2025.104554","url":null,"abstract":"<div><div><em>Escherichia coli</em> is an opportunistic pathogen and a leading cause of Community-Acquired Urinary Tract Infections (CA-UTIs). <em>E. coli</em> can harbor multiple genetic resistant determinants, such as Extended Spectrum Beta-lactamases (ESBL) and Plasmid-Mediated Quinolone Resistance (PMQR) genes, complicating the empirical treatment of UTIs with β-lactams and quinolones. The aim of his study was to characterize ESBL and PMQR genes among <em>E. coli</em> isolates from CA-UTI in Mexicali, Mexico Isolates were collected from January to December 2023. Identification was performed by MALDI-TOF, and ESBL-producing determination and antimicrobial susceptibility by Vitek 2. Detection of ESBL and PMQR, and phylotyping were performed by PCR. Genetic diversity was determined by Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR). Eighty-nine <em>E. coli</em> isolates were collected from CA-UTIs. All exhibited resistance to ciprofloxacin, ceftriaxone, and cefotaxime, while being susceptible to carbapenems and ceftazidime/avibactam. All isolates tested positive for an ESBL gene, with <em>bla_CTX−_M</em> (98.9 %) being the most prevalent. Five isolates tested negative for PMQR genes; the remaining showed <em>aac(6′)-lb-cr</em> present in 85.3 %. Coexistence between ESBL and PMQR genes was noted in 95.5 %. Most prevalent plylogenetic group was group B2 (74.2 %). This study provides valuable regional data, highlighting a public health problem due to the high prevalence of ESBL and PMQR genes in <em>E. coli</em> responsible for CA-UTI, which are linked to multidrug resistance. Genetic diversity was found, suggesting multiple sources of resistant strains in the community. These findings underline the need for surveillance and control to limit the spread of resistant <em>E. coli</em>, locally and globally.</div></div><div><h3>Data summary</h3><div>The authors confirm all supporting data, code, and protocols have been provided within the article or through supplementary data files.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 4","pages":"Article 104554"},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117069","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}

{"title":"Ventilator-associated events criteria in the assessment of Ventilator-Associated Pneumonia (IMPACTO MR-PAV): A prospective cohort","authors":"Giovanna Marssola Nascimento ,&nbsp;Daniela Laranja Gomes Rodrigues ,&nbsp;Filipe Teixeira Piastrelli ,&nbsp;Maysa Yukari Cheno ,&nbsp;Katia Cristina Camondá Braz ,&nbsp;Lucas Bassolli de Oliveira Alves ,&nbsp;Bruno Martins Tomazini ,&nbsp;Viviane Cordeiro Veiga ,&nbsp;Beatriz Arns ,&nbsp;Bruno Adler Maccagnan Pinheiro Besen ,&nbsp;Antonio Paulo Nassar Junior ,&nbsp;Alvaro Avezum ,&nbsp;Renata Karoline Lima da Silva ,&nbsp;Conceição de Maria Pedrozo e Silva de Azevedo ,&nbsp;Maria Luiza Santana de Oliveira Silva ,&nbsp;Graziela Regina Kist ,&nbsp;Fernanda Borges Salgado ,&nbsp;Maria Tereza Farias de Moura ,&nbsp;Emerson Boschi ,&nbsp;Pedro Martins Pereira Kurtz ,&nbsp;Haliton Alves de Oliveira Junior","doi":"10.1016/j.bjid.2025.104543","DOIUrl":"10.1016/j.bjid.2025.104543","url":null,"abstract":"<div><h3>Background</h3><div>Ventilator-Associated Pneumonia (VAP) is a critical healthcare-associated infection, but no universal surveillance standard exists. In 2013, the CDC revised its criteria, incorporating Ventilator-Associated Events (VAEs) with VAPs as a subset. In Brazil, however, the Health Regulatory Agency (ANVISA) chose to retain the traditional VAP criteria. This study aimed to evaluate the incidence of VAP using both the traditional and revised criteria.</div></div><div><h3>Method</h3><div>We conducted a prospective multicentric cohort of critically ill adult patients who required mechanical ventilation in 12 Brazilian Intensive Care Units (ICU) over six months. We evaluated the level of agreement between the two criteria considering frequency and kappa coefficient. This study was registered at ClinicalTrials.gov, NCT05589727.</div></div><div><h3>Results</h3><div>The study included 987 patients and revealed that 85.7 % of VAP reported by the centers according to ANVISA criteria were not confirmed by the adjudicators. Among the adjudicators, a 16.7 % disagreement (kappa = 0.32) suggested subjectivity in applying VAP criteria. Between the two sets of criteria, an 11% disagreement (kappa = 0.12) was observed. However, manual adjudication of automatically generated VAEs showed only a 4 % disagreement, indicating greater objectivity in the VAE criteria. Despite the high agreement in VAE adjudication, this did not necessarily translate to a more reliable exclusion of non-events, which is essential for accurate surveillance.</div></div><div><h3>Conclusion</h3><div>The findings highlight the challenges in identifying and classifying VAP, emphasizing the need for improved surveillance methods. The results could inform enhancements in VAP monitoring in Brazil and potentially impact other countries using similar criteria.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 4","pages":"Article 104543"},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107560","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}

{"title":"Enteral versus intravenous antibiotics for critically ill patients: A pilot study","authors":"Dayana dos Santos Oliveira ,&nbsp;Julia Vitória da Rocha ,&nbsp;Juliano Gasparetto ,&nbsp;Carolina Hikari Yamada ,&nbsp;Joao Paulo Telles ,&nbsp;Felipe Francisco Tuon","doi":"10.1016/j.bjid.2025.104538","DOIUrl":"10.1016/j.bjid.2025.104538","url":null,"abstract":"<div><h3>Background</h3><div>While there are valid concerns regarding the use of Enteral Antibiotics (EN) in the Intensive Care Unit (ICU), the evidence opposing this practice has not been thoroughly evaluated in prior research.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate the transition from sequential Intravenous (IV) antibiotics to EN antibiotics in critically ill patients with infections.</div></div><div><h3>Methods</h3><div>This was a prospective, multicenter, randomized, unblinded clinical trial involving patients with infections who received antibiotic therapy. The study compared sequential IV antibiotic treatment to EN therapy in patients who continued standard IV therapy in the intensive care unit. Primary outcome measures included mortality and clinical improvement assessed on days 3, 5, and 10. Secondary outcomes encompassed hospital and ICU length of stay, costs, and evaluation of microbiological failure.</div></div><div><h3>Results</h3><div>A total of67 patients were included in the EN group and 60 patients in the IV group. Most patients were classified as infected (66.1 %), with 33.1 % diagnosed with sepsis. In-hospital mortality rates were comparable between the two groups, with 31 % in the EN group and 30 % in the IV group. Clinical outcomes assessed on days 3, 5, and 10 showed no significant differences between the groups. Among the 67 patients in the EN group, 7 (10.5 %) required a return to intravenous antibiotic therapy. Notably, drug costs in the IV group increased by 207 %.</div></div><div><h3>Conclusion</h3><div>This is the first controlled and randomized study to evaluate the oral/enteral route of antibiotic administration in the ICU. The findings indicate no significant differences in clinical outcomes or survival rates between the two groups, while demonstrating reduced costs and comparable safety with EN antibiotics.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 4","pages":"Article 104538"},"PeriodicalIF":3.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948619","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}

{"title":"RIMOXCLAMIN: New therapeutic regimen for Hansen’s Disease cure based on effective sensitivity recovery","authors":"Marco Andrey Cipriani Frade ,&nbsp;Gustavo Sartori Albertino ,&nbsp;Filipe Rocha Lima ,&nbsp;Natália Aparecida de Paula ,&nbsp;Fabiana Aparecida Correa Cinto ,&nbsp;Fernanda Cruz Perecin ,&nbsp;Andrezza Westin ,&nbsp;Wilson Marques Junior ,&nbsp;Helena Barbosa Lugão","doi":"10.1016/j.bjid.2025.104539","DOIUrl":"10.1016/j.bjid.2025.104539","url":null,"abstract":"<div><h3>Background</h3><div>World Health Organization (WHO) has recommended Multidrug Therapy (MDT/WHO) for Hansen’s Disease (HD) since 1982; nevertheless, relapse, antimicrobial resistance, and adverse reactions indicate the need for new therapeutic regimens. We evaluated the efficacy and safety of the new anti-HD regimen RIMOXCLAMIN (Rifampicin, Moxifloxacin, Clarithromycin, and Minocycline) compared with standard Multidrug Therapy provided by WHO (MDT/WHO).</div></div><div><h3>Methodology/principal findings</h3><div>66 multibacillary HD new cases (46: RIMOXCLAMIN / 20: MDT/WHO) were evaluated between 2015 and 2023. Patients were followed up at least bimonthly by hansenologists for neurological and cutaneous findings and side effects of treatments. Hands/feet tactile sensitivity tests by Semmes Weinstein Monofilaments (SWM) and Physical Disability Grade (PDG) were carried out on the diagnosis, 3rd, 6th, and 12th months. 84.8 % and 80 % of the patients were classified as Borderline-Borderline (BB) in RIMOXCLAMIN and MDT/WHO groups, respectively, with no significant difference between them (<em>p</em> = 0.12). Nerve thickening was reduced by palpation in both groups: in RIMOXCLAMIN, reduction occurred early (65 % to 28 % at 6-months, <em>p</em> = 0.03; 9 % at 12-months, <em>p</em> = 0.03), while in MDT/WHO, it was later (95 % to 40 % at 12-months, <em>p</em> = 0.002). The greatest difference was at 6 months (<em>p</em> &lt; 0.0001). A significant reduction was observed in pain scales on the 3rd month of treatment only with RIMOXCLAMIN; in the end, both groups showed significant reductions in pain scales, being greater in RIMOXCLAMIN group. 0.5 % reduction in the number of abnormal SWM points on the hands compared to baseline, while in the MDT/WHO group, there was an increase of abnormal points of 5.4 %. On the feet, RIMOXCLAMIN showed a reduction of 17.9 %, while in the MDT/WHO, it was 10.3 %. During follow-up, the RIMOXCLAMIN showed a significant decrease in the sum of altered SWM points compared to MDT/WHO (<em>p</em> &lt; 0.05). Only RIMOXCLAMIN improved PDG monitoring. Both groups reported mild adverse effects.</div></div><div><h3>Conclusions/significance</h3><div>The results indicate that RIMOXCLAMIN was superior to MDT/WHO in terms of quick recovery of neurological damage, evidenced by the improvement of symptoms and sensitivity in hands and feet as early as the third month, with a progressive improvement, maintained after the end of treatment, including a reduce of patients with PDG.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 4","pages":"Article 104539"},"PeriodicalIF":3.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941658","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}