A 22-year-old woman presented with an ulcer on her right earlobe 2 months ago, with inflammation and enlarged ipsilateral lymph nodes in her neck. She was treated with antibiotics without success and then was referred to an infectious disease specialist. She has a cat at home with sporotrichosis, but without direct contact with the lesion, she did not remember any scratching by the cat. She also mentioned wearing a semi-jewel earring. This is a rare and unusual case of sporotrichosis in the earlobe, probably caused by wearing an earring contaminated by the cat's fungus that was present in the home environment. The delay in diagnosis and treatment led to the worsening of the injury and loss of the earlobe.
{"title":"Sporotrichosis in the earlobe caused by placing an earing","authors":"Evelyn Zacarias , Talita Alves , Claudilson Bastos , Paulo Athanazio , Sergio Arruda","doi":"10.1016/j.bjid.2024.104464","DOIUrl":"10.1016/j.bjid.2024.104464","url":null,"abstract":"<div><div>A 22-year-old woman presented with an ulcer on her right earlobe 2 months ago, with inflammation and enlarged ipsilateral lymph nodes in her neck. She was treated with antibiotics without success and then was referred to an infectious disease specialist. She has a cat at home with sporotrichosis, but without direct contact with the lesion, she did not remember any scratching by the cat. She also mentioned wearing a semi-jewel earring. This is a rare and unusual case of sporotrichosis in the earlobe, probably caused by wearing an earring contaminated by the cat's fungus that was present in the home environment. The delay in diagnosis and treatment led to the worsening of the injury and loss of the earlobe.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104464"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928839","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}
Pub Date : 2024-11-29DOI: 10.1016/j.bjid.2024.104483
Luciene Silva dos Santos , Sayros Akyro Soares Martins , Francine Ramos Scheffer , Alexandre Seiji Maekawa , Rafaela de Paula Silva , Gabriel Rabelo de Araújo , Paulo Eduardo Neves Ferreira Velho , Marina Rovani Drummond
Specific Pathogen-Free (SPF) animals are bred and maintained to exclude pathogens associated with significant morbidity or mortality, which may pose a risk to research replicability. The BALB/c strain is distributed globally and is among the most commonly used inbred strains in immunology and infectious disease research. Despite being a widely distributed bacterium that causes chronic infection, Bartonella henselae infection has not been investigated in any protocol that characterizes SPF animals. The objective of this study was to investigate the potential natural infection of laboratory animals of the BALB/c lineage by B. henselae. To achieve this, ten immunocompetent BALB/c mice were obtained directly from the bioterium and euthanized for collection of samples, including blood, skin, spleen, liver, heart, eye, kidney, intestine, esophagus, and brain. DNA was extracted using a commercial kit and tested via nested PCR for the ftsZ gene, as well as conventional PCR and qualitative real-time PCR using Sybr® Green for the citrate synthase gene (gltA), all specific reactions for B. henselae. All animals showed detection of B. henselae DNA in at least two different reactions in different tissues. The sequenced amplicons showed 100 % similarity to B. henselae. The use of mice infected by B. henselae in experiments is undesirable, as the bacteria can affect several aspects of the animal's physiology and consequently influence the results of the project, especially when subjected to immunosuppression. More studies are needed to understand and confirm the natural infection in experimental animals by Bartonella spp.. To date, no additional published reports of contamination of experimental animals by these bacteria have been identified.
{"title":"Investigation of natural infection of BALB C mice by Bartonella henselae","authors":"Luciene Silva dos Santos , Sayros Akyro Soares Martins , Francine Ramos Scheffer , Alexandre Seiji Maekawa , Rafaela de Paula Silva , Gabriel Rabelo de Araújo , Paulo Eduardo Neves Ferreira Velho , Marina Rovani Drummond","doi":"10.1016/j.bjid.2024.104483","DOIUrl":"10.1016/j.bjid.2024.104483","url":null,"abstract":"<div><div>Specific Pathogen-Free (SPF) animals are bred and maintained to exclude pathogens associated with significant morbidity or mortality, which may pose a risk to research replicability. The BALB/c strain is distributed globally and is among the most commonly used inbred strains in immunology and infectious disease research. Despite being a widely distributed bacterium that causes chronic infection, <em>Bartonella henselae</em> infection has not been investigated in any protocol that characterizes SPF animals. The objective of this study was to investigate the potential natural infection of laboratory animals of the BALB/c lineage by <em>B. henselae</em>. To achieve this, ten immunocompetent BALB/c mice were obtained directly from the bioterium and euthanized for collection of samples, including blood, skin, spleen, liver, heart, eye, kidney, intestine, esophagus, and brain. DNA was extracted using a commercial kit and tested via nested PCR for the <em>ftsZ</em> gene, as well as conventional PCR and qualitative real-time PCR using Sybr® Green for the citrate synthase gene (<em>gltA</em>), all specific reactions for <em>B. henselae</em>. All animals showed detection of <em>B. henselae</em> DNA in at least two different reactions in different tissues. The sequenced amplicons showed 100 % similarity to <em>B. henselae</em>. The use of mice infected by <em>B. henselae</em> in experiments is undesirable, as the bacteria can affect several aspects of the animal's physiology and consequently influence the results of the project, especially when subjected to immunosuppression. More studies are needed to understand and confirm the natural infection in experimental animals by <em>Bartonella</em> spp.. To date, no additional published reports of contamination of experimental animals by these bacteria have been identified.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104483"},"PeriodicalIF":3.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744348","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}
Pub Date : 2024-11-29DOI: 10.1016/j.bjid.2024.104484
Christine Stauber , Leile Camila Jacob-Nascimento , Caroline Grosch , Moisés da Silva Sousa , Moyra M. Portilho , Rosângela O. Anjos , Margo A. Brinton , Uriel Kitron , Mitermayer G. Reis , Guilherme S. Ribeiro
Introduction
Dengue cases in the Americas in 2024 have reached record highs, especially in Brazil. However, surveillance remains suboptimal and new methods are needed to monitor Dengue Virus (DENV) spread. To assess whether wastewater-based epidemiology would be a useful tool, we investigated the presence of DENV RNA in dengue patients’ urine and oral fluid from an endemic area to inform how shedding in these fluids occurs and provide insight for wastewater surveillance.
Methods
We examined how often DENV RNA is detected in urine and oral fluid from dengue patients confirmed by serum RT-qPCR, NS1 ELISA or IgM seroconversion in Salvador, Brazil.
Results
Of 88 confirmed cases, 9.1 % were positive for DENV RNA in urine (7/88) or oral fluid (1/88). Of 53 serum RT-qPCR-positive patients, 6 (11.3 %) showed detectable DENV RNA in acute- or convalescent-phase urine. Patients with RT-qPCR-positive urine had a lower frequency of DENV IgG in acute-phase serum (a proxy for secondary infection) (57 % vs. 74 %) and a lower median serum RT-qPCR cycle threshold than those with negative urine (21.8 vs. 23.9).
Conclusion
The low presence of DENV RNA in urine suggests that additional research is needed to evaluate whether using wastewater-based epidemiology to monitor DENV transmission is possible.
{"title":"Presence of dengue virus RNA in urine and oral fluid of laboratory-confirmed dengue patients: Implications for wastewater surveillance","authors":"Christine Stauber , Leile Camila Jacob-Nascimento , Caroline Grosch , Moisés da Silva Sousa , Moyra M. Portilho , Rosângela O. Anjos , Margo A. Brinton , Uriel Kitron , Mitermayer G. Reis , Guilherme S. Ribeiro","doi":"10.1016/j.bjid.2024.104484","DOIUrl":"10.1016/j.bjid.2024.104484","url":null,"abstract":"<div><h3>Introduction</h3><div>Dengue cases in the Americas in 2024 have reached record highs, especially in Brazil. However, surveillance remains suboptimal and new methods are needed to monitor Dengue Virus (DENV) spread. To assess whether wastewater-based epidemiology would be a useful tool, we investigated the presence of DENV RNA in dengue patients’ urine and oral fluid from an endemic area to inform how shedding in these fluids occurs and provide insight for wastewater surveillance.</div></div><div><h3>Methods</h3><div>We examined how often DENV RNA is detected in urine and oral fluid from dengue patients confirmed by serum RT-qPCR, NS1 ELISA or IgM seroconversion in Salvador, Brazil.</div></div><div><h3>Results</h3><div>Of 88 confirmed cases, 9.1 % were positive for DENV RNA in urine (7/88) or oral fluid (1/88). Of 53 serum RT-qPCR-positive patients, 6 (11.3 %) showed detectable DENV RNA in acute- or convalescent-phase urine. Patients with RT-qPCR-positive urine had a lower frequency of DENV IgG in acute-phase serum (a proxy for secondary infection) (57 % vs. 74 %) and a lower median serum RT-qPCR cycle threshold than those with negative urine (21.8 vs. 23.9).</div></div><div><h3>Conclusion</h3><div>The low presence of DENV RNA in urine suggests that additional research is needed to evaluate whether using wastewater-based epidemiology to monitor DENV transmission is possible.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104484"},"PeriodicalIF":3.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744290","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}
Pub Date : 2024-11-28DOI: 10.1016/j.bjid.2024.104468
Marcos Daniel Mendes Padilha , Francisco Tiago de Vasconcelos Melo , Rogério Valois Laurentino , Andrea Nazaré Monteiro Rangel da Silva , Rosimar Neris Martins Feitosa
Viral hepatitis is a public health problem, about 1 million people die due to complications of this viral disease, the etiological agents responsible for inducing cirrhosis and cellular hepatocarcinoma are HBV and HCV, both hepatotropic viruses that cause asymptomatic infection in most cases. The regulation of the microbiota performs many physiological functions, which can induce normal intestinal function and produce essential nutrients for the human body. Metabolites derived from gut microbiota or direct regulation of host immunity and metabolism have been reported to profoundly affect tumorigenesis in liver disease. If the microbiota is unbalanced, both exogenous and symbiotic microorganisms can affect a pathological process. It is well understood that the microbiota plays a role in viral diseases and infections, specifically the hepatic portal pathway has been linked to the gut-liver axis. In HBV and HCV infections, the altered bacterial representatives undergo a state of dysbiosis, with subsequent establishment of the pathobiome with overexpression of taxons such as Bacteroides, Clostridium, Lactobacillus, Enterobacter, and Enterococcus. This dysregulated microbiome induces a microenvironment conducive to the development of hepatic complications in patients with acute and chronic HBV and HCV infection, with subsequent dysregulation of cytokines IFN-α/β, TNF-α, IL-1β, TGF-β, IL-6 and IL-10, which alter the dysfunction and damage of the hepatic portal system. In view of the above, this review aimed to correlate the pathophysiological mechanisms in HBV and HCV infection, the dysregulation of the microbiome in patients infected with HBV and HCV, the most altered cytokines in the microbiome, and the most altered bacterial representatives in the pathobiome of infection.
{"title":"Dysregulation in the microbiota by HBV and HCV infection induces an altered cytokine profile in the pathobiome of infection","authors":"Marcos Daniel Mendes Padilha , Francisco Tiago de Vasconcelos Melo , Rogério Valois Laurentino , Andrea Nazaré Monteiro Rangel da Silva , Rosimar Neris Martins Feitosa","doi":"10.1016/j.bjid.2024.104468","DOIUrl":"10.1016/j.bjid.2024.104468","url":null,"abstract":"<div><div>Viral hepatitis is a public health problem, about 1 million people die due to complications of this viral disease, the etiological agents responsible for inducing cirrhosis and cellular hepatocarcinoma are HBV and HCV, both hepatotropic viruses that cause asymptomatic infection in most cases. The regulation of the microbiota performs many physiological functions, which can induce normal intestinal function and produce essential nutrients for the human body. Metabolites derived from gut microbiota or direct regulation of host immunity and metabolism have been reported to profoundly affect tumorigenesis in liver disease. If the microbiota is unbalanced, both exogenous and symbiotic microorganisms can affect a pathological process. It is well understood that the microbiota plays a role in viral diseases and infections, specifically the hepatic portal pathway has been linked to the gut-liver axis. In HBV and HCV infections, the altered bacterial representatives undergo a state of dysbiosis, with subsequent establishment of the pathobiome with overexpression of taxons such as <em>Bacteroides, Clostridium, Lactobacillus, Enterobacter,</em> and <em>Enterococcus</em>. This dysregulated microbiome induces a microenvironment conducive to the development of hepatic complications in patients with acute and chronic HBV and HCV infection, with subsequent dysregulation of cytokines IFN-α/β, TNF-α, IL-1β, TGF-β, IL-6 and IL-10, which alter the dysfunction and damage of the hepatic portal system. In view of the above, this review aimed to correlate the pathophysiological mechanisms in HBV and HCV infection, the dysregulation of the microbiome in patients infected with HBV and HCV, the most altered cytokines in the microbiome, and the most altered bacterial representatives in the pathobiome of infection.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104468"},"PeriodicalIF":3.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744349","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}
Pub Date : 2024-11-27DOI: 10.1016/j.bjid.2024.104482
Daniela V. Pachito , Mauricio Longato , Guilherme Cordeiro , Paulo H.R.F. Almeida , Ricardo Macarini Ferreira , Ana Paula N. Burian
Introduction
Community-Acquired Pneumonia (CAP) caused by pneumococcus and Invasive Pneumococcal Disease (IPD) pose a substantial economic burden on health systems. The objective of the present study is to explore hospitalization costs of pneumococcal disease in the public health system in Brazil, the Unified Health System.
Methods
Retrospective analysis of administrative data on hospitalized cases of pneumococcal disease from January 2019 to July 2023. Hospitalization cases recorded with ICD-10 codes of CAP due to S. pneumoniae and IPD were retrieved from DATASUS, the inpatient information system of the Unified Health System in Brazil. Costs were converted to US dollars by Using Purchasing Power Parity (USD-PPP). Absolute number of hospitalizations, costs of hospitalizations and healthcare resource utilization were presented descriptively. The annual cost estimate was calculated. Differences in costs by type of clinical presentation and age group were assessed. Factors associated with higher costs were explored by multiple linear regression models.
Results
A total of 22,498 hospitalization episodes were analyzed. Total cost of hospitalizations was USD-PPP 13,958,959 (BRL 34,659,578) with an annual mean estimate of USD-PPP 3,045,591 (BRL 7,562,090). Cost per hospitalization episode was significantly higher for meningitis, followed by septicemia, CAP and arthritis, with median values ranging from USD-PPP 190.93 to 615.14 (BRL 476.20 to 1529.02). (Kruskal-Wallis χ2 = 6473, df = 3, p-value < 0.0001). Costs were significantly higher among individuals aged 60-years and older. (Kruskal-Wallis test; χ2 = 773.53; df = 2, p-value < 0.0001). There were differences in age at hospitalization, length of stay, and ICU utilization among types of clinical presentations.
Conclusions
Our findings reveal the economic burden associated with pneumococcal disease in the Unified Health System in Brazil. Hospitalization costs were higher for cases of meningitis and among individuals aged 60-years and above.
{"title":"Hospitalization due to pneumococcal disease in the Unified Health System in Brazil: A retrospective analysis of administrative data","authors":"Daniela V. Pachito , Mauricio Longato , Guilherme Cordeiro , Paulo H.R.F. Almeida , Ricardo Macarini Ferreira , Ana Paula N. Burian","doi":"10.1016/j.bjid.2024.104482","DOIUrl":"10.1016/j.bjid.2024.104482","url":null,"abstract":"<div><h3>Introduction</h3><div>Community-Acquired Pneumonia (CAP) caused by pneumococcus and Invasive Pneumococcal Disease (IPD) pose a substantial economic burden on health systems. The objective of the present study is to explore hospitalization costs of pneumococcal disease in the public health system in Brazil, the Unified Health System.</div></div><div><h3>Methods</h3><div>Retrospective analysis of administrative data on hospitalized cases of pneumococcal disease from January 2019 to July 2023. Hospitalization cases recorded with ICD-10 codes of CAP due to <em>S. pneumoniae</em> and IPD were retrieved from DATASUS, the inpatient information system of the Unified Health System in Brazil. Costs were converted to US dollars by Using Purchasing Power Parity (USD-PPP). Absolute number of hospitalizations, costs of hospitalizations and healthcare resource utilization were presented descriptively. The annual cost estimate was calculated. Differences in costs by type of clinical presentation and age group were assessed. Factors associated with higher costs were explored by multiple linear regression models.</div></div><div><h3>Results</h3><div>A total of 22,498 hospitalization episodes were analyzed. Total cost of hospitalizations was USD-PPP 13,958,959 (BRL 34,659,578) with an annual mean estimate of USD-PPP 3,045,591 (BRL 7,562,090). Cost per hospitalization episode was significantly higher for meningitis, followed by septicemia, CAP and arthritis, with median values ranging from USD-PPP 190.93 to 615.14 (BRL 476.20 to 1529.02). (Kruskal-Wallis <em>χ</em><sup>2</sup> = 6473, <em>df</em> = 3, <em>p</em>-value < 0.0001). Costs were significantly higher among individuals aged 60-years and older. (Kruskal-Wallis test; <em>χ</em><sup>2</sup> = 773.53; <em>df</em> = 2, <em>p</em>-value < 0.0001). There were differences in age at hospitalization, length of stay, and ICU utilization among types of clinical presentations.</div></div><div><h3>Conclusions</h3><div>Our findings reveal the economic burden associated with pneumococcal disease in the Unified Health System in Brazil. Hospitalization costs were higher for cases of meningitis and among individuals aged 60-years and above.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104482"},"PeriodicalIF":3.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142719861","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}
Pub Date : 2024-11-26DOI: 10.1016/j.bjid.2024.104466
João Paulo da Silva-Sampaio , Raniela Borges Sinimbu , Julia Trece Marques , Abilio Francisco de Oliveira Neto , Livia Melo Villar
A retrospective and cross-sectional study was carried out on blood donors from Piauí State located at Northeastern Brazil to evaluate the prevalence of Hepatitis E Virus (HEV) infection. Serum samples were tested for anti-HEV IgG and IgM using electrochemiluminescence and HEV RNA was tested using real time PCR. A total of 890 individuals were included with median age of 33.4 years and most of them were male and lived at Mid-Northern region of the State. Prevalences of anti-HEV IgG and IgM were 1.35 % and 0.11 %, respectively. None HEV-RNA was detected. This study demonstrated low prevalence of HEV infection in blood donors in this region.
{"title":"Seroprevalence of hepatitis E virus infection in blood donors from Piauí State, Northeast Brazil","authors":"João Paulo da Silva-Sampaio , Raniela Borges Sinimbu , Julia Trece Marques , Abilio Francisco de Oliveira Neto , Livia Melo Villar","doi":"10.1016/j.bjid.2024.104466","DOIUrl":"10.1016/j.bjid.2024.104466","url":null,"abstract":"<div><div>A retrospective and cross-sectional study was carried out on blood donors from Piauí State located at Northeastern Brazil to evaluate the prevalence of Hepatitis E Virus (HEV) infection. Serum samples were tested for anti-HEV IgG and IgM using electrochemiluminescence and HEV RNA was tested using real time PCR. A total of 890 individuals were included with median age of 33.4 years and most of them were male and lived at Mid-Northern region of the State. Prevalences of anti-HEV IgG and IgM were 1.35 % and 0.11 %, respectively. None HEV-RNA was detected. This study demonstrated low prevalence of HEV infection in blood donors in this region.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104466"},"PeriodicalIF":3.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699046","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}
Pub Date : 2024-11-26DOI: 10.1016/j.bjid.2024.104481
Balbina Chilombo Albano, Leticia Ramos Dantas, Gabriel Burato Ortis, Paula Hansen Suss, Felipe Francisco Tuon
Background
Treating NDM-producing bacteria poses a significant challenge, especially for those bacteria inherently resistant to polymyxin, such as Serratia marcescens, necessitating combined therapies.
Objective
To assess in vitro the synergistic effect of different antimicrobial combinations against NDM-producing S. marcescens.
Methods
Four clinical isolates were tested with various antibiotic combinations: polymyxin, amikacin, meropenem, and aztreonam. Concentrations used were those maximized by pharmacokinetic and pharmacodynamic assessments. Synergy evaluation involved a static macrodilution test followed by a time-kill curve assay.
Results
All four isolates demonstrated resistance according to CLSI and EUCAST standards for the tested antibiotics (polymyxin, amikacin, meropenem, and aztreonam). In the macrodilution synergy test, the combination of aztreonam and amikacin was active in 2 out of 4 isolates within 24 h, and polymyxin with meropenem in only one isolate, despite of intrinsic resistance to polymyxin. However, time-kill curve analysis revealed no synergism or additive effect for combinations with the tested antimicrobials.
Conclusion
Combinations of polymyxin, meropenem, aztreonam, and amikacin at doses optimized by pharmacokinetic/pharmacodynamic were insufficient to demonstrate any synergism in NDM-producing S. marcescens isolates in time-kill curves.
{"title":"Combined therapeutic option for NDM-producing Serratia Marcescens – an in vitro study from clinical samples","authors":"Balbina Chilombo Albano, Leticia Ramos Dantas, Gabriel Burato Ortis, Paula Hansen Suss, Felipe Francisco Tuon","doi":"10.1016/j.bjid.2024.104481","DOIUrl":"10.1016/j.bjid.2024.104481","url":null,"abstract":"<div><h3>Background</h3><div>Treating NDM-producing bacteria poses a significant challenge, especially for those bacteria inherently resistant to polymyxin, such as <em>Serratia marcescens</em>, necessitating combined therapies.</div></div><div><h3>Objective</h3><div>To assess in vitro the synergistic effect of different antimicrobial combinations against NDM-producing <em>S. marcescens</em>.</div></div><div><h3>Methods</h3><div>Four clinical isolates were tested with various antibiotic combinations: polymyxin, amikacin, meropenem, and aztreonam. Concentrations used were those maximized by pharmacokinetic and pharmacodynamic assessments. Synergy evaluation involved a static macrodilution test followed by a time-kill curve assay.</div></div><div><h3>Results</h3><div>All four isolates demonstrated resistance according to CLSI and EUCAST standards for the tested antibiotics (polymyxin, amikacin, meropenem, and aztreonam). In the macrodilution synergy test, the combination of aztreonam and amikacin was active in 2 out of 4 isolates within 24 h, and polymyxin with meropenem in only one isolate, despite of intrinsic resistance to polymyxin. However, time-kill curve analysis revealed no synergism or additive effect for combinations with the tested antimicrobials.</div></div><div><h3>Conclusion</h3><div>Combinations of polymyxin, meropenem, aztreonam, and amikacin at doses optimized by pharmacokinetic/pharmacodynamic were insufficient to demonstrate any synergism in NDM-producing <em>S. marcescens</em> isolates in time-kill curves.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104481"},"PeriodicalIF":3.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699045","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}
Pub Date : 2024-11-01DOI: 10.1016/j.bjid.2024.104426
Eduarda Raunheitti Giesteira, Maria Eduarda Gonandy Araujo, Gabriella Lima Pereira da Silva, Juliana Dias de Souto Pereira, Emily Perdomo da Silva Santos, Lara Ramos do Prado, Maria Eduarda Cruz do Bonfim de Sena, Andre Ricardo Araújo da Silva
A sífilis congênita (SC) ocorre em virtude da disseminação hematogênica da bactéria Treponema pallidum, da gestante infectada não tratada ou inadequadamente tratada para o seu concepto por via transplacentária em qualquer fase gestacional ou por meio do contato com o canal de parto, se presença de lesões genitais maternas. O presente estudo tem como objetivo analisar o perfil epidemiológico da SC no estado do Rio de Janeiro no período de 2010 a 2022. Trata-se de um estudo ecológico retrospectivo que utilizou dados públicos do Sistema de Informações de Agravos de Notificação (SINAN), do Sistema de Informações sobre Nascidos Vivos (SINASC) e do IBGE. Foram analisados os casos confirmados de sífilis congênita, no período de 2010 a 2022, de acordo com o ano de notificação, com a microrregião IBGE de notificação, com a escolaridade materna, com a faixa etária materna, com o tratamento dos parceiros e segundo a classificação final de aborto/natimorto por sífilis. Calculou-se a prevalência de sífilis congênita a cada 100 habitantes das microrregiões do IBGE. Além disso, foram calculadas a incidência de sífilis na gravidez na adolescência e a taxa de letalidade da SC. Durante o período analisado houve 45.875 casos confirmados de sífilis congênita no estado do Rio de Janeiro. A microrregião do IBGE com maior prevalência foi o Rio de Janeiro (0,33 casos/ 100 habitantes). Ademais, foi possível observar que 27% dos casos são de mães que possuem como nível de escolaridade o ensino fundamental incompleto e apenas 0,45% das mulheres possuíam nível superior completo. A análise do tratamento dos parceiros de mulheres com diagnóstico confirmado mostrou que somente 10% realizaram o tratamento para sífilis. Além disso, notou-se que a incidência de SC dentre as gravidezes na adolescência no estado foi de 2,62 casos/ 100 gravidezes de jovens de 10 a 19 anos e dentre os casos de SC confirmados, 25,52% eram mães nesta faixa etária. Por fim, percebeu-se que a taxa de letalidade da SC foi de 1,768 para cada 100 casos confirmados. Notou-se uma forte relação entre os casos de SC e a baixa escolaridade materna e com gravidez na adolescência, enfatizando possíveis correlações entre situações de vulnerabilidade social. A baixa taxa de tratamento de parceiros é alarmante para a saúde pública assim como a taxa de letalidade. A prevenção e o rastreio de SC é essencial, feita pela Estratégia da Saúde da Família, a fim de garantir o diagnóstico e o tratamento precoces. Palavras-chave: Sífilis congênita, Infecções Sexualmente transmissíveis, Treponema pallidum. Conflitos de interesse: Não houve conflitos de interesse. Ética e financiamentos: Declarações de interesse: Nenhum.
{"title":"ESTUDO ECOLÓGICO RETROSPECTIVO DE SÍFILIS CONGÊNITA NO ESTADO DO RIO DE JANEIRO 2010-2022","authors":"Eduarda Raunheitti Giesteira, Maria Eduarda Gonandy Araujo, Gabriella Lima Pereira da Silva, Juliana Dias de Souto Pereira, Emily Perdomo da Silva Santos, Lara Ramos do Prado, Maria Eduarda Cruz do Bonfim de Sena, Andre Ricardo Araújo da Silva","doi":"10.1016/j.bjid.2024.104426","DOIUrl":"10.1016/j.bjid.2024.104426","url":null,"abstract":"<div><div>A sífilis congênita (SC) ocorre em virtude da disseminação hematogênica da bactéria Treponema pallidum, da gestante infectada não tratada ou inadequadamente tratada para o seu concepto por via transplacentária em qualquer fase gestacional ou por meio do contato com o canal de parto, se presença de lesões genitais maternas. O presente estudo tem como objetivo analisar o perfil epidemiológico da SC no estado do Rio de Janeiro no período de 2010 a 2022. Trata-se de um estudo ecológico retrospectivo que utilizou dados públicos do Sistema de Informações de Agravos de Notificação (SINAN), do Sistema de Informações sobre Nascidos Vivos (SINASC) e do IBGE. Foram analisados os casos confirmados de sífilis congênita, no período de 2010 a 2022, de acordo com o ano de notificação, com a microrregião IBGE de notificação, com a escolaridade materna, com a faixa etária materna, com o tratamento dos parceiros e segundo a classificação final de aborto/natimorto por sífilis. Calculou-se a prevalência de sífilis congênita a cada 100 habitantes das microrregiões do IBGE. Além disso, foram calculadas a incidência de sífilis na gravidez na adolescência e a taxa de letalidade da SC. Durante o período analisado houve 45.875 casos confirmados de sífilis congênita no estado do Rio de Janeiro. A microrregião do IBGE com maior prevalência foi o Rio de Janeiro (0,33 casos/ 100 habitantes). Ademais, foi possível observar que 27% dos casos são de mães que possuem como nível de escolaridade o ensino fundamental incompleto e apenas 0,45% das mulheres possuíam nível superior completo. A análise do tratamento dos parceiros de mulheres com diagnóstico confirmado mostrou que somente 10% realizaram o tratamento para sífilis. Além disso, notou-se que a incidência de SC dentre as gravidezes na adolescência no estado foi de 2,62 casos/ 100 gravidezes de jovens de 10 a 19 anos e dentre os casos de SC confirmados, 25,52% eram mães nesta faixa etária. Por fim, percebeu-se que a taxa de letalidade da SC foi de 1,768 para cada 100 casos confirmados. Notou-se uma forte relação entre os casos de SC e a baixa escolaridade materna e com gravidez na adolescência, enfatizando possíveis correlações entre situações de vulnerabilidade social. A baixa taxa de tratamento de parceiros é alarmante para a saúde pública assim como a taxa de letalidade. A prevenção e o rastreio de SC é essencial, feita pela Estratégia da Saúde da Família, a fim de garantir o diagnóstico e o tratamento precoces. <strong>Palavras-chave:</strong> Sífilis congênita, Infecções Sexualmente transmissíveis, Treponema pallidum. <strong>Conflitos de interesse:</strong> Não houve conflitos de interesse. <strong>Ética e financiamentos: Declarações de interesse:</strong> Nenhum.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"28 ","pages":"Article 104426"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657474","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}
Pub Date : 2024-11-01DOI: 10.1016/j.bjid.2024.104384
Fabiana Siroma , Edson Abdala , Stefanie Lima do Nascimento Castro , Wellington Andraus , Luiz Augusto Carneiro D´Álbuquerque , Alice Tung Wan Song
Background
Liver transplantation is the treatment for many end-stage liver diseases and hepatocellular carcinoma but shortage of available organs poses significant challenge. Many centers have used grafts from donors with positive anti-HBc serology but concerns about potential hepatitis B virus reactivation and de novo hepatitis B infection have raised questions about the safety of this approach. This study aimed to evaluate the survival of liver transplant recipients from anti-HBc-positive-donors and assess the risk of hepatitis B reactivation and de novo hepatitis B.
Patients and methods
A retrospective single-center cohort study was conducted from 2002 to 2018, comparing who received grafts from anti-HBc-positive-donors to those from anti-HBc-negative-donors. The primary outcome was survival and description cases of hepatitis B reactivation/de novo hepatitis B.
Results
We analyzed 1,111 liver transplants, in which 993 (89 %) received grafts from anti-HBc-negative-donors and 118 (11 %) from anti-HBc-positive-donors. Median age of recipients from anti-HBc-positive donors was 56 years and from anti-HBc-negative donors was of 53 years (p = 0.001). Male sex was predominant in both groups. Factors associated with death in multivariate analysis were retransplantation, early allograft dysfunction, high MELD, recipient over 60 years and female donor. The utilization of grafts from anti-HBc-positive-donors did not increase mortality. The majority of HBV reactivation and de novo hepatitis B occurred in anti-HBc positive recipients. The risk of hepatitis B reactivation/de novo hepatitis B was low and manageable.
Conclusion
The study supports safety of liver grafts from anti-HBc-positive donors when employing antiviral prophylaxis. These findings contribute to expand donor options and improve patient outcomes
{"title":"Survival after liver transplantation from hepatitis B-core positive donors at a quaternary care hospital in Brazil","authors":"Fabiana Siroma , Edson Abdala , Stefanie Lima do Nascimento Castro , Wellington Andraus , Luiz Augusto Carneiro D´Álbuquerque , Alice Tung Wan Song","doi":"10.1016/j.bjid.2024.104384","DOIUrl":"10.1016/j.bjid.2024.104384","url":null,"abstract":"<div><h3>Background</h3><div>Liver transplantation is the treatment for many end-stage liver diseases and hepatocellular carcinoma but shortage of available organs poses significant challenge. Many centers have used grafts from donors with positive anti-HBc serology but concerns about potential hepatitis B virus reactivation and <em>de novo</em> hepatitis B infection have raised questions about the safety of this approach. This study aimed to evaluate the survival of liver transplant recipients from anti-HBc-positive-donors and assess the risk of hepatitis B reactivation and <em>de novo</em> hepatitis B.</div></div><div><h3>Patients and methods</h3><div>A retrospective single-center cohort study was conducted from 2002 to 2018, comparing who received grafts from anti-HBc-positive-donors to those from anti-HBc-negative-donors. The primary outcome was survival and description cases of hepatitis B reactivation/<em>de novo</em> hepatitis B.</div></div><div><h3>Results</h3><div>We analyzed 1,111 liver transplants, in which 993 (89 %) received grafts from anti-HBc-negative-donors and 118 (11 %) from anti-HBc-positive-donors. Median age of recipients from anti-HBc-positive donors was 56 years and from anti-HBc-negative donors was of 53 years (<em>p</em> = 0.001). Male sex was predominant in both groups. Factors associated with death in multivariate analysis were retransplantation, early allograft dysfunction, high MELD, recipient over 60 years and female donor. The utilization of grafts from anti-HBc-positive-donors did not increase mortality. The majority of HBV reactivation and <em>de novo</em> hepatitis B occurred in anti-HBc positive recipients. The risk of hepatitis B reactivation/de novo hepatitis B was low and manageable.</div></div><div><h3>Conclusion</h3><div>The study supports safety of liver grafts from anti-HBc-positive donors when employing antiviral prophylaxis. These findings contribute to expand donor options and improve patient outcomes</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"28 6","pages":"Article 104384"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482051","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}
Pub Date : 2024-11-01DOI: 10.1016/j.bjid.2024.104433
Simone Aranha Nouér , Kaio Nathan Alvarenga , Luiza Leite Carvão , Anna Carla Castiñeiras , Luiz Felipe A. Guimarães , Henrique Leandro Reis Rocha , Maria da Glória Carvalho Barreiros
Introdução e objetivo
infecções fúngicas invasivas continuam sendo um desafio para pacientes hospitalizados, com alta mortalidade. Na pandemia de COVID-19, observou-se um aumento das infecções causadas por leveduras. O objetivo deste trabalho foi avaliar a epidemiologia das candidemias após a diminuição da pandemia.
Material e métodos
De 2017-2019 (período pré-pandemia), 2020-2022 (durante) e 2023-2024 (após), todas as hemoculturas positivas no sistema BactAlert® ao exame direto para leveduras foram encaminhadas ao Laboratório de Micologia para serem identificadas pelos métodos tradicionais (auxanograma e zimograma) e automatizado (Vitek2®). Uso do meio de Chromoagar®, Chromoagar plus® ou Malditof® foram utilizados para determinação da espécie de Candida. Apenas os pacientes assistidos no hospital foram acompanhados; somente a primeira hemocultura de cada paciente foi considerada; dados clínicos e epidemiológicos foram avaliados. A incidência anual de candidemia foi calculada considerando o número de admissões hospitalares. As diferenças entre as incidências foram calculadas pelo método de Poisson; valor de p < 0,05 foram considerados significativos.
Resultados
166 episódios foram acompanhados desde 2017. A incidência de candidemia variou de 1,2 episódios por 1000 admissões (pré-pandemia), 4,3 (durante a pandemia) a 2,7 (após). As espécies mais frequentes continuam sendo C. albicans (n = 57), C. parapsilosis (n = 47), C. tropicalis (n = 41) e C. glabrata (n = 16). Duas cepas de C. haemulonii e uma C. pelliculosa foram confirmadas. Nenhuma cepa foi identificada como C. auris. A incidência de candidemia aumentou desde o início da pandemia (de 1,2 para 2,8; p = 0,0001) e considerando apenas os pacientes que não tiveram COVID-19, manteve-se alta (2,5; p = 0,6). A incidência de C. albicans e C. tropicalis voltou ao nível da pré-pandemia (0,9 e 0,3; respectivamente). Entretanto, a incidência de C. parapsilosis aumentou de 0,3 (pré-pandemia) para 1,2 (pós-pandemia; p = 0,0015). Os pacientes com infecção por C. parapsilosis não tiveram relação temporal ou espacial. Após o início da pandemia, observamos que a maioria destes pacientes foram procedentes de clínicas de hemodiálise.
Conclusões
Após a diminuição da pandemia, a incidência de candidemia se manteve alta nos pacientes hospitalizados. Candida parapsilosis emergiu como patógeno mais prevalente.
Palavras-chave
Candidemia, Epidemiologia, COVID-19.
Conflitos de interesse
Nenhum autor tem conflitos de interesse.
Ética e financiamentos
Sem financiamento especifico. Projeto aprovado pelo CEP HUCFF
{"title":"MUDANÇA NA EPIDEMIOLOGIA DE CANDIDEMIA: DADOS DE UM HOSPITAL DE ALTA COMPLEXIDADE","authors":"Simone Aranha Nouér , Kaio Nathan Alvarenga , Luiza Leite Carvão , Anna Carla Castiñeiras , Luiz Felipe A. Guimarães , Henrique Leandro Reis Rocha , Maria da Glória Carvalho Barreiros","doi":"10.1016/j.bjid.2024.104433","DOIUrl":"10.1016/j.bjid.2024.104433","url":null,"abstract":"<div><h3>Introdução e objetivo</h3><div>infecções fúngicas invasivas continuam sendo um desafio para pacientes hospitalizados, com alta mortalidade. Na pandemia de COVID-19, observou-se um aumento das infecções causadas por leveduras. O objetivo deste trabalho foi avaliar a epidemiologia das candidemias após a diminuição da pandemia.</div></div><div><h3>Material e métodos</h3><div>De 2017-2019 (período pré-pandemia), 2020-2022 (durante) e 2023-2024 (após), todas as hemoculturas positivas no sistema BactAlert® ao exame direto para leveduras foram encaminhadas ao Laboratório de Micologia para serem identificadas pelos métodos tradicionais (auxanograma e zimograma) e automatizado (Vitek2®). Uso do meio de Chromoagar®, Chromoagar plus® ou Malditof® foram utilizados para determinação da espécie de Candida. Apenas os pacientes assistidos no hospital foram acompanhados; somente a primeira hemocultura de cada paciente foi considerada; dados clínicos e epidemiológicos foram avaliados. A incidência anual de candidemia foi calculada considerando o número de admissões hospitalares. As diferenças entre as incidências foram calculadas pelo método de Poisson; valor de p < 0,05 foram considerados significativos.</div></div><div><h3>Resultados</h3><div>166 episódios foram acompanhados desde 2017. A incidência de candidemia variou de 1,2 episódios por 1000 admissões (pré-pandemia), 4,3 (durante a pandemia) a 2,7 (após). As espécies mais frequentes continuam sendo C. albicans (n = 57), C. parapsilosis (n = 47), C. tropicalis (n = 41) e C. glabrata (n = 16). Duas cepas de C. haemulonii e uma C. pelliculosa foram confirmadas. Nenhuma cepa foi identificada como C. auris. A incidência de candidemia aumentou desde o início da pandemia (de 1,2 para 2,8; p = 0,0001) e considerando apenas os pacientes que não tiveram COVID-19, manteve-se alta (2,5; p = 0,6). A incidência de C. albicans e C. tropicalis voltou ao nível da pré-pandemia (0,9 e 0,3; respectivamente). Entretanto, a incidência de C. parapsilosis aumentou de 0,3 (pré-pandemia) para 1,2 (pós-pandemia; p = 0,0015). Os pacientes com infecção por C. parapsilosis não tiveram relação temporal ou espacial. Após o início da pandemia, observamos que a maioria destes pacientes foram procedentes de clínicas de hemodiálise.</div></div><div><h3>Conclusões</h3><div>Após a diminuição da pandemia, a incidência de candidemia se manteve alta nos pacientes hospitalizados. Candida parapsilosis emergiu como patógeno mais prevalente.</div></div><div><h3>Palavras-chave</h3><div>Candidemia, Epidemiologia, COVID-19.</div></div><div><h3>Conflitos de interesse</h3><div>Nenhum autor tem conflitos de interesse.</div></div><div><h3>Ética e financiamentos</h3><div>Sem financiamento especifico. Projeto aprovado pelo CEP HUCFF</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"28 ","pages":"Article 104433"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657942","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}
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