Revista Do Instituto De Medicina Tropical De Sao Paulo最新文献

{"title":"Case series on Zika virus genome detection in cerebrospinal fluid samples from newborns at a Brazilian tertiary hospital.","authors":"Suzana Ferreira Zimmerman, Jamil Pedro de Siqueira Caldas, Rodrigo Gonçalves de Lima, Sandra Helena Alves Bonon, Plínio Trabasso, Sergio Tadeu Martins Marba","doi":"10.1590/S1678-9946202668050","DOIUrl":"10.1590/S1678-9946202668050","url":null,"abstract":"<p><p>Detection of ribonucleic acid (RNA) Zika virus in cerebrospinal fluid (CSF) by molecular methods serves as a marker of the involvement of congenital infection in newborns' central nervous system. This study aims to describe the detection of Zika virus genome in CSF samples from newborns (aged from one to 28 days) using molecular biology and its clinical consequences following the Zika virus epidemic from October 2015 to May 2017, in Brazil. This prospective descriptive study molecularly analyzed 151 CSF samples from neonates at Professor Doutor Jose Aristodemo Pinotti Hospital, collected for cytological and biochemical diagnosis from June 2017 to June 2021. After the consent of legal guardians, signing of free and informed consent forms, and the issuance of these results, the remaining CSF was sent to the Virology Laboratory of School of Medical Sciences in the State University of Campinas (Unicamp) and was subjected to RNA extraction and real-time polymerase chain reaction (RT-PCR). A review of patients' medical records and descriptive statistics were also performed. This study obtained 151 CSF samples, four of which were PCR positive for Zika virus (2.6%, with two presenting congenital malformations). These results suggest the clinical relevance of etiological diagnosis of congenital Zika syndrome by molecular biology in newborns' CSF samples even after the Zika virus epidemic (which occurred from October 2015 to May 2017) in Brazil.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e50"},"PeriodicalIF":1.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686754","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}

{"title":"Zoonotic potential of bovine Sarcocystis species: a challenge for public health and meat inspection.","authors":"Cayuan Tadeu Brandão Pinto, Luciana Regina Meireles","doi":"10.1590/S1678-9946202668049","DOIUrl":"10.1590/S1678-9946202668049","url":null,"abstract":"<p><p>Foodborne parasitic diseases remain a neglected public health issue worldwide. Sarcocystosis, caused by the ingestion of tissue cysts of Sarcocystis species, represents a growing challenge for food safety and public health. Cattle serve as intermediate hosts for several Sarcocystis species, including those with confirmed zoonotic potential such as S. hominis, S. heydorni, and the recently described S. sigmoideus (2024/2025). In humans, intestinal sarcocystosis often presents with gastrointestinal distress, whereas extraintestinal (muscular) infections can lead to severe clinical manifestations, including acute eosinophilic myositis and, rarely, neurosarcocystosis. Despite these risks and the high epidemiological prevalence in beef herds worldwide, current sanitary inspection methods in abattoirs are primarily based on macroscopic visual examination. Said approach frequently fails to detect microscopic cysts, allowing the latent transmission of these pathogens. This review addresses the biology, clinical manifestations across different hosts (humans, bovines, and equines), and epidemiology of bovine sarcocystosis. We discuss the limitations of conventional morphological diagnosis and the critical need for molecular tools to accurately differentiate zoonotic from non-zoonotic species. Finally, we highlight the need for adopting a One Health approach, integrating sensitive diagnostic methods into the meat production chain to mitigate the risk of human infection and ensure global food safety.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e49"},"PeriodicalIF":1.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13405646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622601","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}

{"title":"Congenital toxoplasmosis in a newborn of a chronically infected mother.","authors":"Vitória Schneider Müller, Júlia Sales Machado, Wilson Hoshino, Aida de Fátima Tomé Barbosa Gouvêa, Fabiana Bononi do Carmo, Kelly Simone Almeida Cunegundes, Maria Aparecida Ferrarini, Annelise Pereira Barreto Monteiro, Daisy Maria Machado, Ana Isabel Melo Pereira Monteiro","doi":"10.1590/S1678-9946202668047","DOIUrl":"10.1590/S1678-9946202668047","url":null,"abstract":"<p><p>Congenital toxoplasmosis rarely occurs in infants born to mothers with evidence of prior immunity. We report the case of a preterm infant with severe ocular and neurological manifestations of congenital toxoplasmosis, despite maternal seropositivity (IgG+/IgM-) during pregnancy. This case highlights the potential for reactivation or reinfection with virulent strains and reinforces the need for vigilance and preventive strategies throughout pregnancy.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e47"},"PeriodicalIF":1.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13405636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622659","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}

{"title":"Disseminated sporotrichosis with orbital osteomyelitis in a child: a case report.","authors":"Fabiana Bononi do Carmo, Kimberly Souza Rocha, Caio Vinícius Luís, Aída de Fátima Thomé Barbosa Gouvea, Daisy Maria Machado, Ana Isabel Melo Pereira Monteiro, Érica Regina Cruz Paulino, Marina Gomes Pereira Sardinha, Kelly Simone Almeida Cunegundes, Paulo Gois Manso, Anderson Messias Rodrigues, Pedro Fiorini Pucchini, Marcelo Luiz Abramczyk, Maria Aparecida Gadiani Ferrarini, Carolina Sanchez Aranda Lago, Regina Célia de Menezes Succi","doi":"10.1590/S1678-9946202668046","DOIUrl":"10.1590/S1678-9946202668046","url":null,"abstract":"<p><p>Sporotrichosis is an infection caused by fungi of the Sporothrix complex that can affect both humans and animals. In most cases, it is a benign infection limited to the skin and subcutaneous tissue, rarely disseminating to other organs with systemic involvement. Diagnosis is based on clinical data, epidemiological data, and laboratory tests, with culture being considered the gold standard. The disease generally has a good prognosis and is usually resolved with appropriate antifungal treatment. This case report describes an atypical presentation of sporotrichosis with suppurative nodules and orbital bone involvement in an adolescent followed at the pediatric infectious diseases outpatient clinic of our institution. The patient was followed longitudinally for 12 months due to a lesion on the left upper back with lymphocutaneous involvement, which progressed to osteomyelitis of the left orbit. Deep lesion culture identified Sporothrix spp. The sporotrichosis was considered disseminated, and treatment with oral itraconazole for 12 months was initiated. Complete remission of both cutaneous and bone lesions occurred after five months of treatment. The patient was discharged from outpatient follow-up after one year.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e46"},"PeriodicalIF":1.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13405641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622661","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}

{"title":"Phase-dependent dynamics of circulating cell-free mitochondrial DNA reflect distinct immunometabolic states.","authors":"Karen Alessandra Rodrigues, Emilly Henrique Dos Santos, Gabriel Acca Barreira, Mariana Okay Saippa, Maria Carolina Pires Cruz, Kelly Aparecida Kanunfre, Thelma Suely Okay","doi":"10.1590/S1678-9946202668048","DOIUrl":"10.1590/S1678-9946202668048","url":null,"abstract":"<p><p>Circulating cell-free mitochondrial DNA (ccf-mtDNA) has emerged as a potential biomarker of tissue injury and systemic inflammation, acting as a mitochondrial damage-associated molecular pattern (DAMP) capable of activating innate immune pathways. However, most studies have focused on acute inflammatory conditions, and the behavior of ccf-mtDNA across distinct immunological and metabolic disease states remains poorly characterized, particularly in pediatric populations. This study investigated whether circulating ccf-mtDNA levels vary according to the clinical and immunometabolic context rather than simply reflecting the presence of inflammation. Serum ccf-mtDNA copy number was quantified by quantitative polymerase chain reaction (qPCR) targeting the mitochondrial ND2 gene in 181 clinical samples obtained from five groups: adults with chronic-active and/or treatment-refractory pulmonary tuberculosis (n = 47); asymptomatic children with latent tuberculosis infection confirmed by interferon-gamma release assay (IGRA) without clinical, radiological or microbiological evidence of active disease (n = 11); children with severe chronic underlying diseases in clinically stable condition (n = 41); children undergoing cardiac surgery with cardiopulmonary bypass (CPB), with perioperative serial sampling (n = 52); and healthy young adult blood donors as controls (n = 30). Non-parametric statistical tests were applied due to non normal data distribution. Median ccf-mtDNA levels in controls were 649.3 copies/μL. Adults with chronic-active pulmonary and/or treatment-refractory tuberculosis and children undergoing cardiac surgery with CPB did not exhibit significantly elevated ccf-mtDNA levels compared with controls. In contrast, significantly higher levels were observed in IGRA-positive children with latent tuberculosis infection (median: 1,648.5 copies/μL; p = 0.0004) and in children with severe chronic underlying diseases despite the absence of overt infection or inflammation (median: 2,663.9 copies/μL; p = 0.0001). These findings suggest that circulating ccf-mtDNA does not behave as a simple linear marker of inflammatory intensity. Instead, its levels appear to reflect the interaction between mitochondrial injury, immune activation, metabolic competence, and clearance mechanisms. We propose a phase-dependent model in which mitochondrial DAMP signaling is amplified during sustained but metabolically competent immune engagement, and is attenuated during advanced immunometabolic exhaustion. These findings suggest that ccf-mtDNA levels are shaped by the host's underlying immunometabolic context, rather than simply mirroring the intensity of systemic inflammation.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e48"},"PeriodicalIF":1.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13405644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622623","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}

{"title":"Disseminated tuberculosis with Poncet's disease mimicking childhood-onset systemic lupus erythematosus: a unique case report.","authors":"Matheus Santos França, Fernanda Lima Gomes, Marina de Azambuja Nogueira, Maria Fernanda Bádue Pereira, Heloisa Helena de Sousa Marques, Katia Tomie Kozu, Lucia Maria Arruda Campos, Clovis Artur Silva","doi":"10.1590/S1678-9946202668043","DOIUrl":"10.1590/S1678-9946202668043","url":null,"abstract":"<p><p>Disseminated tuberculosis in children may present with systemic and immunologic features that overlap with autoimmune diseases, complicating diagnosis and treatment. We report the first pediatric case of microbiologically confirmed disseminated tuberculosis involving multiple sites associated with Poncet's disease, mimicking childhood-onset systemic lupus erythematosus (cSLE). A previously healthy five-year-old boy presented with a four-month history of persistent fever, weight loss, and symmetrical oligoarthritis involving both knees and wrists, resulting in loss of mobility. Laboratory tests revealed severe non-hemolytic anemia, leukopenia, elevated inflammatory markers, hypoalbuminemia, hematuria, positive antinuclear antibodies, low complement levels, and lupus anticoagulant positivity. Chest imaging showed bilateral pleural effusion, pulmonary opacities, and lymphadenopathy, fulfilling the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for cSLE. Despite initially negative tuberculin skin test and gastric lavage analysis, lymph node biopsy confirmed Mycobacterium tuberculosis by histology, molecular assay, and culture. Subsequent urine and gastric samples were also positive. The patient had received BCG vaccination at birth. He was treated with rifampicin, isoniazid, pyrazinamide, and pyridoxine, with rapid clinical improvement, complete resolution of arthritis, and full recovery of mobility without sequelae in one month. No immunosuppressive therapy was administered. This case reinforces the diagnostic complexity of distinguishing tuberculosis from childhood-onset systemic autoimmune rheumatic diseases, particularly in endemic regions. To our knowledge, this is the first reported pediatric case of disseminated tuberculosis with Poncet's disease mimicking cSLE. Recognizing this specific condition is crucial to prevent misdiagnosis and unnecessary immunosuppression, while ensuring timely treatment of the underlying infection.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e43"},"PeriodicalIF":1.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551569","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}

{"title":"Association between atmospheric SO2 exposure and severity of respiratory infections in infants: a systematic review.","authors":"Sandra Elisabete Vieira, Alexandre Archanjo Ferraro","doi":"10.1590/S1678-9946202668045","DOIUrl":"10.1590/S1678-9946202668045","url":null,"abstract":"<p><p>Environmental factors may influence the severity of lower respiratory infections, a major cause of morbidity and mortality in infants. Sulfur dioxide (SO2) has biologically plausible pro-inflammatory and epithelial effects. This PRISMA 2020-compliant systematic review synthesized observational studies published between 2015 and 2025, selected to ensure methodological comparability and contemporary relevance, examining the association between atmospheric SO2 exposure and severity-related respiratory outcomes in infants. Thirteen studies met eligibility criteria. Most evaluated short-term exposure using daily lag structures (lag01 to lag03) or 1-2 week averages, whereas one birth cohort assessed annual exposure during the first year of life. All studies adjusted for meteorological variables, and most incorporated multipollutant regression models. Owing to substantial heterogeneity in exposure metrics, increments, lag structures, and effect scales, a meta-analysis was not performed. Across studies, short-term SO2 exposure was most consistently associated with increased hospitalization for ALRIs, longer length of stay, and progression to severe disease. Effect estimates per 10 µg/m3 were modest but statistically significant in specific lag windows. In one cohort, higher annual exposure was associated with severe ALRI (IRR 2.81; 95% CI 1.35-5.83), and one hospital-based study reported increased mortality (OR 2.04; 95% CI 1.33-3.13). Associations were less consistent in low-exposure settings or in models with strong multipollutant collinearity. Overall, the evidence suggests context-dependent associations between short-term SO2 exposure and increased severity of respiratory infections in infants, particularly hospitalization, longer length of stay, and progression to severe disease. Given the observational and heterogeneous nature of the data, findings should be interpreted cautiously.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e45"},"PeriodicalIF":1.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551532","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}

{"title":"Temporal trends and spatial distribution of leishmaniasis based on biomes in Brazil, 2007 to 2020.","authors":"Geisa Bezerra Ferreira, Leonardo Augusto Kohara Melchior, Andreia Fernandes Brilhante","doi":"10.1590/S1678-9946202668044","DOIUrl":"10.1590/S1678-9946202668044","url":null,"abstract":"<p><p>Analyses based on biomes provide a less fragmented view than usual studies and help the understanding of epidemiological characteristics from different perspectives. We describe the temporal trends and spatial distribution of American cutaneous leishmaniasis (ACL) and visceral leishmaniasis (VL) in Brazilian biomes, from 2007 to 2020. This ecological survey used data from the Brazilian Notifiable Diseases Information System. The Prais-Winsten method was used for temporal analyses. ACL and VL incidences were calculated based on sex and age groups, relative risk considering these two variables, and mortality, lethality, cure, and treatment abandonment rates per biome. The Amazon, Atlantic Forest, Cerrado, and Caatinga biomes showed a decreasing temporal trend, varying from -1% to -3% for ACL and VL, respectively. Other biomes showed a stationary temporal trend for both diseases. VL had a similar transmission profile in all biomes, affecting children aged 0-4 years regardless of sex. In contrast, ACL mainly affected older adults, except in the Amazon and Pampa, where working-age males were most commonly affected. In all biomes, being a man constituted a risk factor for acquiring these diseases, abandoning treatment, and dying, whereas being a woman configured a factor that favored cure and protected against lethality. Our findings showed a decrease in ACL and VL incidence in most biomes and a stable incidence in other biomes. The results of our study showed that the distinct transmission profiles of ACL and VL have persisted across different biomes with minute differences.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e44"},"PeriodicalIF":1.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551495","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}

{"title":"Emergence of difficult-to-treat lymphocutaneous sporotrichosis? Analysis based on three cases with high and low MIC Sporothrix brasiliensis isolates.","authors":"Juliana Carreiro Avila, Ana Paula Carvalho Reis, Kaique Arriel, Amanda Azevedo Bittencourt, Livia Vieira Almeida, Rita de Cassia Soler, Giovanna Azevedo Celestrino, Ana Paula Cordeiro Lima, Maria Gloria Teixeira Sousa, José Angelo Lauletta Lindoso, Gil Benard","doi":"10.1590/S1678-9946202668041","DOIUrl":"10.1590/S1678-9946202668041","url":null,"abstract":"<p><p>Sporotrichosis, caused by a Sporothrix schenckii complex species, is historically viewed as an easily manageable mycosis. However, the current zoonotic epidemic in Brazil due to the more virulent Sporothrix brasiliensis poses some challenges. We describe three cases of lymphocutaneous sporotrichosis (LC) in non-immunocompromised patients, which proved refractory to standard treatment, and suggest that closer epidemic surveillance would be advisable to detect whether more difficult-to-treat cases are --emerging. All cases required prolonged treatment, escalating doses, and therapeutic changes for resolution. Patients' isolates were molecularly identified as S. brasiliensis. Antifungal susceptibility testing (AST) revealed high itraconazole MICs in two of the three isolates. Management required high-dose itraconazole (400 mg/day) in two cases and Amphotericin B in one. These cases challenge the perception of sporotrichosis as an always easily treatable disease. The difficulties observed may be linked to the increased S. brasiliensis virulence, the emergence of drug-resistant strains, and/or the rise in severe and atypical presentations. Lack of standardized protocols for refractory cases complicates effective management. These findings underscore the urgent need for enhanced epidemiological surveillance, efforts to isolate and perform AST on clinical strains, and standardization of treatment guidelines for patients failing initial therapy.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e41"},"PeriodicalIF":1.3,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407014","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}

{"title":"The potential of molecular testing and mutation analysis for detecting isoniazid and rifampicin-resistant Mycobacterium tuberculosis in Thailand.","authors":"Janisara Rudeeaneksin, Benjawan Phetsuksiri, Sopa Srisungngam, Supranee Bunchoo, Payu Bhakdeenuan, Wiphat Klayut","doi":"10.1590/S1678-9946202668040","DOIUrl":"10.1590/S1678-9946202668040","url":null,"abstract":"<p><p>Drug-resistant tuberculosis (TB) poses a significant threat, and drug-susceptibility testing (DST) is essential for effective TB treatment and control. Genotypic DST has been used for the early detection of drug-resistant TB, and the detection of isoniazid (INH) resistance is increasingly important. This study aims to determine the potential of genotypic DST using the AnyplexTM II MTB/MDR real-time polymerase chain reaction (PCR) kit and analyze the mutations associated with INH and rifampicin (RIF) resistance in Mycobacterium tuberculosis (MTB). DST and DNA sequencing of the katG, inhA, and rpoB genes were performed in 146 MTB isolates. Compared with phenotypic DST, the Anyplex real-time PCR assay showed the sensitivity of 84.0%, 83.3%, 85.7%, and 94.6%; and the specificity of 96.9%, 96.4%, 98.2%, and 92.3% for the detection of INH resistance, RIF resistance, multidrug-resistant TB (MDR-TB), and drug-susceptible MTB, respectively. Substantial agreement with DNA sequencing was observed. For INH resistance, 91.8% had mutations in the katG or inhA; the katG gene accounted for 71.8%, and the inhA promoter region accounted for 20.0%. S315T was predominant in the katG mutation, and only C(-15)T was present in the inhA mutation. For RIF resistance, 95.1% harbored the rpoB mutation, with S531L and D516V being the two most common. The association of mutations with INH and RIF resistance was high. The study highlighted the significance of data on the genetic determinants of INH and RIF resistance, and suggested the potential of using genotypic DST, such as the Anyplex II MTB/MDR assay, in the country and similar settings.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e40"},"PeriodicalIF":1.3,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406845","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}