Brazilian Journal of Infectious Diseases最新文献

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

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

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

{"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}