Brazilian Journal of Infectious Diseases最新文献

Increased rates of blaNDM in Pseudomonas aeruginosa in a tertiary care hospital in southern Brazil

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-04-10 DOI: 10.1016/j.bjid.2025.104523

Patricia Orlandi Barth , Dariane Castro Pereira , Camila Mörschbächer Wilhelm , Kellen Figueira Tragnago , Afonso Luís Barth

{"title":"Increased rates of blaNDM in Pseudomonas aeruginosa in a tertiary care hospital in southern Brazil","authors":"Patricia Orlandi Barth , Dariane Castro Pereira , Camila Mörschbächer Wilhelm , Kellen Figueira Tragnago , Afonso Luís Barth","doi":"10.1016/j.bjid.2025.104523","DOIUrl":"10.1016/j.bjid.2025.104523","url":null,"abstract":"<div><div>Carbapenem-Resistant <em>Pseudomonas Aeruginosa</em> (CRPA) is considered as one of the high priority pathogens by the World Health Organization. As CRPA carbapenemase producers have increased worldwide, the aim of this study was to evaluate the carbapenemase prevalence in CRPA at a tertiary care hospital in Brazil”<em>.</em> All 395 CRPA identified in the period of September 2021 to May 2024 were evaluated by multiplex real-time polymerase chain reaction (qPCR-HRM) for the following carbapenemase genes: <em>bla</em><sub>KPC</sub>, <em>bla</em><sub>NDM</sub>, <em>bla</em><sub>OXA-48-like</sub>, <em>bla</em><sub>IMP</sub>, <em>bla</em><sub>VIM,</sub> <em>bla</em><sub>SPM</sub> and <em>bla</em><sub>GES</sub>. In the first period analyzed (September to December 2021), almost 70 % of the isolates were negative for the 7 tested genes, and the <em>bla</em><sub>NDM</sub> was found in 27.3 % of the CRPA. In the following semesters there was an increase of <em>bla</em><sub>NDM</sub> as follows: January to June of 2022 = 29.8 %; July to December of 2022 = 43.8 %; January to June of 2023 = 42.4 %; July to December 2023 = 58.9 % and January to May of 2024 = 59.5 % of <em>bla</em><sub>NDM</sub>. The prevalence of the other carbapenemases remained low. These results indicated an important increase of the <em>bla</em><sub>NDM</sub> gene, overcoming the CRPA non-carbapenemase producers in our institution.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104523"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tuberculosis parenteral therapeutic regimens for critical patients or non-functional intestinal tract: Brief review and proposal of protocol

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-04-07 DOI: 10.1016/j.bjid.2025.104526

Antonio Camargo Martins , Márcia Teixeira Garcia , Mariângela Ribeiro Resende

{"title":"Tuberculosis parenteral therapeutic regimens for critical patients or non-functional intestinal tract: Brief review and proposal of protocol","authors":"Antonio Camargo Martins , Márcia Teixeira Garcia , Mariângela Ribeiro Resende","doi":"10.1016/j.bjid.2025.104526","DOIUrl":"10.1016/j.bjid.2025.104526","url":null,"abstract":"<div><div>Standard anti-tuberculosis regimens (Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol [RHZE]) remain challenging for critically ill patients and those with a non-functioning gastrointestinal tract. In Brazil, these challenges are amplified by the lack of Intravenous (IV) rifampicin, isoniazid, and ethambutol, which often results in suboptimal outcomes. This brief communication synthesized evidence on parenteral therapies and proposed a structured, five-step protocol for critically ill patients unable to receive oral drugs. A narrative review of the guidelines and key studies was also conducted. IV formulations of RHZE are approved in only some countries and are not available everywhere. Alternative IV drug classes, such as fluoroquinolones, aminoglycosides, carbapenems, and oxazolidinones, can address malabsorption or intolerance to oral RHZE. However, no standardized regimen exists for this population. Our five-step protocol advises: (1) Characterizing each TB case, (2) determining IV necessity, (3) Consulting specialized TB services, (4) Designing a safe and effective regimen, and (5) <em>Re</em>-evaluating therapy for transition to oral treatment. Given the morbidity and mortality from severe TB in Intensive Care Units (ICU), a formalized approach is essential. Further research and policy initiatives regarding IV first-line drugs are crucial to improve treatment outcomes in this vulnerable group. This strategy unifies practice across diverse clinical settings.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104526"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gas-forming abscess associated with prosthetic vascular graft infection caused by Bacteroides fragilis

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-04-02 DOI: 10.1016/j.bjid.2025.104524

Motoshi Iwao , Takehiro Hashimoto , Ryota Tanaka , Kazufumi Hiramatsu , Hiroki Itoh

{"title":"Gas-forming abscess associated with prosthetic vascular graft infection caused by Bacteroides fragilis","authors":"Motoshi Iwao , Takehiro Hashimoto , Ryota Tanaka , Kazufumi Hiramatsu , Hiroki Itoh","doi":"10.1016/j.bjid.2025.104524","DOIUrl":"10.1016/j.bjid.2025.104524","url":null,"abstract":"<div><h3>Introduction</h3><div>Prosthetic Vascular Graft Infection (PVGI) is a rare but serious complication of open surgical repair of abdominal aortic aneurysm. We report a case of gas-forming abscesses associated with PVGI caused by <em>Bacteroides fragilis</em> identified from the drainage fluid and blood cultures.</div></div><div><h3>Case presentation</h3><div>A 67-year-old man with a complaint of worsening low back pain underwent an emergency open surgery due to abdominal aortic aneurysm. On postoperative day 18, an abdominal CT showed gas formation within the aneurysm. Gram staining of the drainage fluid revealed Gram-negative rods and 16S rRNA gene sequencing performed on the fluid identified <em>B. fragilis</em>, although the culture of the fluid was negative. PVGI caused by anaerobic bacteria such as <em>Bacteroides</em> spp. is relatively rare. The sensitivity of 16S rRNA gene sequencing for culture-negative specimens is generally low, but 16S rRNA sequencing-positive rate increases when a Gram stain of specimen is positive.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104524"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contemporary cohort study in adult patients with infective endocarditis

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-04-02 DOI: 10.1016/j.bjid.2025.104521

Mariana Giorgi Barroso de Carvalho , Thatyane Veloso de Paula Amaral de Almeida , Nicolas de Albuquerque Pereira Feijóo , Rafael Quaresma Garrido , Giovanna lanini Ferraiuoli Barbosa , Wilma Félix Golebiovski , Bruno Zappa , Clara Weksler , Marcelo Goulart Correia , Cristiane da Cruz Lamas

{"title":"Contemporary cohort study in adult patients with infective endocarditis","authors":"Mariana Giorgi Barroso de Carvalho , Thatyane Veloso de Paula Amaral de Almeida , Nicolas de Albuquerque Pereira Feijóo , Rafael Quaresma Garrido , Giovanna lanini Ferraiuoli Barbosa , Wilma Félix Golebiovski , Bruno Zappa , Clara Weksler , Marcelo Goulart Correia , Cristiane da Cruz Lamas","doi":"10.1016/j.bjid.2025.104521","DOIUrl":"10.1016/j.bjid.2025.104521","url":null,"abstract":"<div><h3>Background</h3><div>Infective Endocarditis (IE) is a serious disease, with high morbidity and mortality. Few case series come from middle- income countries. Our aim is to describe a case series of patients with IE treated at a reference center in Brazil and compare data to other countries.</div></div><div><h3>Methods</h3><div>A retrospective analysis of a prospectively implemented endocarditis database was conducted, including adult patients with definite IE, January 2006‒June 2023. A literature search and summary were done. Statistical analysis was performed using Jamovi®, version 1.2.2.</div></div><div><h3>Results</h3><div>There were 502 episodes of IE; mean age ± SD was 48.4±17.2 years. Community-acquired IE occurred in 64.7 %. Main predispositions were rheumatic valve disease (30.7 %), prostheses (31.5 %), and congenital heart disease (13.9 %). Transthoracic and transesophageal echocardiograms were performed in 85 % and 78 %, respectively. Left-sided IE predominated. Fever occurred in 90.6 %, new murmurs in 50.7 %, and embolism in 45 %. Blood cultures were negative in 33.1 %; frequent pathogens were oral streptococci (15.6 %), <em>Staphylococcus aureus</em> (10.0 %), and enterococci (12.8 %). Main complications were heart failure (58 %), renal failure (32.8 %), and splenic embolization (35.2 %). Surgery was performed in 83.6 %; overall in-hospital mortality was 25 %; surgical mortality was 21.3 %.</div></div><div><h3>Conclusions</h3><div>Blood culture negative left-sided IE predominated. The mortality rate was high but within the range of reported series. Surgery was performed frequently and patients who were operated on had lower mortality.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104521"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk factors for neurosyphilis in HIV patients: A retrospective cohort study

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-03-28 DOI: 10.1016/j.bjid.2025.104519

Beatriz Arns , Tarsila Vieceli , Eduardo Gomes , Mariana Horn Scherer , Luisa Nakashima , Maria Luisa Santos , Ronara Blos Hepp , Fernanda Greinert , Maria Helena Rigatto

{"title":"Risk factors for neurosyphilis in HIV patients: A retrospective cohort study","authors":"Beatriz Arns , Tarsila Vieceli , Eduardo Gomes , Mariana Horn Scherer , Luisa Nakashima , Maria Luisa Santos , Ronara Blos Hepp , Fernanda Greinert , Maria Helena Rigatto","doi":"10.1016/j.bjid.2025.104519","DOIUrl":"10.1016/j.bjid.2025.104519","url":null,"abstract":"<div><h3>Introduction</h3><div>Syphilis is a highly prevalent sexually transmitted infection worldwide. Patients living with Human Immunodeficiency Virus (HIV) have a higher risk of developing neurosyphilis. Actual guidelines advise to proceed with lumbar puncture only if neurologic symptoms are present. However, asymptomatic neurosyphilis patients are not rare in the HIV population and other risk factors should be defined to guide screening.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort to evaluate risk factors related to neurosyphilis in HIV patients. Adults with HIV infection and laboratory confirmed syphilis between 2011 and 2021 were included. Patients with no record of syphilis treatment, VDRL titers ≤ 1:4, other neurologic diseases or non-HIV related immunological impairment were excluded. The patients were followed for 2-years after syphilis diagnosis.</div></div><div><h3>Results</h3><div>One-hundred and forty patients (190 syphilis episodes) were included, with mean age of 45.0 ± 9.2-years-old, 111 (79.3 %) were male, 48 (25.8 %) had CD4 count ≤ 350 cells/mm<sup>3</sup> at syphilis diagnosis (median: 522.5 cells/mm<sup>3</sup>; IQR: 315.5‒703.5), 127 (66.8 %) of 172 had a HIV viral load ≤ 400 copies/mm<sup>3</sup> and median serum VDRL titer was 1:64 (IQR: 1:16‒1:128). In multivariate analysis, serum VDRL titers ≥ 1:32 and the presence of neurologic symptoms were associated with neurosyphilis, while HIV viral load ≤ 400 copies/mm<sup>3</sup> was a protective factor.</div></div><div><h3>Discussion</h3><div>In addition to the presence of neurological symptoms, HIV viral load > 400 copies/mm<sup>3</sup> and VDRL titers ≥ 1:32 were shown to be risk factors for neurosyphilis in this study and diagnostic lumbar puncture should be considered in these cases.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104519"},"PeriodicalIF":3.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gestational and congenital syphilis in the state of Rio de Janeiro, Brazil, 2021‒2023

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-03-28 DOI: 10.1016/j.bjid.2025.104522

Rosa Maria Soares Madeira Domingues , Marcos Augusto Bastos Dias , Ana Paula Esteves Pereira , Paula Mendes Luz , Emilia M. Jalil , Angela Cristina Vasconcelos de Andrade Rabello , Ruth Khalili Friedman , Maria do Carmo Leal

{"title":"Gestational and congenital syphilis in the state of Rio de Janeiro, Brazil, 2021‒2023","authors":"Rosa Maria Soares Madeira Domingues , Marcos Augusto Bastos Dias , Ana Paula Esteves Pereira , Paula Mendes Luz , Emilia M. Jalil , Angela Cristina Vasconcelos de Andrade Rabello , Ruth Khalili Friedman , Maria do Carmo Leal","doi":"10.1016/j.bjid.2025.104522","DOIUrl":"10.1016/j.bjid.2025.104522","url":null,"abstract":"<div><div>Gestational (GS) and congenital syphilis (CS) are important public health problems in Brazil. This study aims to estimate the prevalence of GS, the incidence of CS and the rate of vertical transmission (VT) of syphilis, as well as to evaluate the management indicators of GS in the State of Rio de Janeiro (RJS), the Brazilian state with the highest detection rate of GS and incidence of CS in 2022. A hospital-based, cross-sectional study was carried out in public and private hospitals located in RJS, in the period 2021–2023, with interviews with 1,923 women, analysis of prenatal care (PNC) cards and hospital records. The GS management indicators, the prevalence of GS, the incidence of CS and the rate of VT were estimated with the respective 95 % confidence intervals (95 % CI), according to the source of financing for hospitalizations for childbirth or abortion care. PNC was reported by 93.7 % of women, 82.7 % had the first test for syphilis and 52.6 % the second. The prevalence of GS was estimated at 14.5 % (95 % CI 9.2 %- 22.2 %), with higher values in women with public financing (18.2 % public; 3.6 % private). Nearly one-third-of women with GS were diagnosed only during hospitalization for childbirth or abortion care and 13.4 % were appropriately treated during PNC. The incidence of CS was estimated at 53.1 per 1,000 live births (68.4 per 1,000 public; 9.7 per 1,000 LB private) with a VT rate of 33.5 %, with no difference according to the source of financing. The detection rate of GS and the incidence rate of CS were double those reported to the Brazilian Notifiable Diseases Information System. Several missed opportunities for the control of CS were identified. Women with public financing had a higher prevalence of GS and incidence of CS, and should be the priority target of control strategies.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104522"},"PeriodicalIF":3.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unmasking Prototheca wickerhamii: A rare case of cutaneous infection and its implications for clinical practice

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-03-27 DOI: 10.1016/j.bjid.2025.104525

Jing Li , Zeyu Huang , Ruzhi Zhang

{"title":"Unmasking Prototheca wickerhamii: A rare case of cutaneous infection and its implications for clinical practice","authors":"Jing Li , Zeyu Huang , Ruzhi Zhang","doi":"10.1016/j.bjid.2025.104525","DOIUrl":"10.1016/j.bjid.2025.104525","url":null,"abstract":"<div><div><em>Prototheca</em>, an opportunistic pathogenic algae widely found in nature, has emerged as a potential public health concern. Most cases occur in immunocompromised individuals, with infections in immunocompetent patients being relatively rare. Due to their non-specific clinical presentation and limited awareness among clinicians, <em>Prototheca</em> infections are often misdiagnosed, resulting in delayed treatment. Recent advances in species identification and antifungal susceptibility testing have provided important tools for diagnosis and therapy. Here, we report a case of recurrent facial infection in a 76-year-old immunocompetent man. Skin biopsy revealed an infectious granuloma, and fungal culture identified yeast-like colonies. Fluorescence staining and scanning electron microscopy revealed abundant spores, while metagenomic sequencing confirmed the infection as <em>Prototheca wickerhamii</em>. The patient was successfully treated with long-term itraconazole and dipotassium glycyrrhizinate capsules. This case highlights the importance of early and accurate diagnosis in the management of <em>Prototheca</em> skin infections and reviews the therapeutic strategies used.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104525"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating long-term MRSA colonization and household spread: Insights from a community-based study

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-02-26 DOI: 10.1016/j.bjid.2025.104518

Taniela Marli Bes , Robson Eduardo Soares , Roberta Ruedas Martins , Lauro Perdigao-Neto , Diego Mongelos , Luisa Moreno , Andrea Moreno , Gerson Salvador de Oliveira , Silvia Figueiredo Costa , Anna Sara Levin

{"title":"Evaluating long-term MRSA colonization and household spread: Insights from a community-based study","authors":"Taniela Marli Bes , Robson Eduardo Soares , Roberta Ruedas Martins , Lauro Perdigao-Neto , Diego Mongelos , Luisa Moreno , Andrea Moreno , Gerson Salvador de Oliveira , Silvia Figueiredo Costa , Anna Sara Levin","doi":"10.1016/j.bjid.2025.104518","DOIUrl":"10.1016/j.bjid.2025.104518","url":null,"abstract":"<div><div>Methicillin-Resistant <em>Staphylococcus Aureus</em> (MRSA) is commonly transmitted among hospitalized patients through direct contact or contaminated objects. However, the dynamics of household transmission of MRSA remain unclear, posing challenges for effective prevention. This study evaluates the persistence of MRSA colonization in asymptomatic carriers over a period of at least 17-months and examines the potential for intra-household transmission. We conducted home visits to seven families, each with at least one MRSA-colonized member, to collect nasal swabs from all household members. Phenotypic and genotypic profiles of the isolates were determined through culture, antimicrobial susceptibility testing, and PCR. We compared these new samples with previous samples from a recent study involving the same individuals to assess spontaneous clearance of MRSA. A total of 25 samples were collected, with 56 % (14) identified as <em>S. aureus</em> and 44 % (11) as non-S. aureus; among the <em>S. aureus</em> isolates, four were MRSA. We observed spontaneous clearance of MRSA in six of the original cases. Unexpectedly, there was limited intra-household transmission of MRSA, although all families with MRSA colonization had at least one member with a history of skin disease. In the family where colonization persisted, one individual had recurrent cutaneous abscesses, suggesting a possible link to sustained colonization.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104518"},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evidence-based clinical standard for the diagnosis and treatment of invasive lung aspergillosis in the patient with oncohematologic disease

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-02-24 DOI: 10.1016/j.bjid.2025.104517

Jorge Alberto Cortés , Diego Andrés Rodríguez-Lugo , Martha Carolina Valderrama-Rios , Ricardo Rabagliati , Domenico Capone , Carlos Arturo Álvarez-Moreno , Fabio Varón-Vega , Laura Cristina Nocua-Báez , Cándida Diaz-Brochero , Leonardo Enciso Olivera , Sonia Isabel Cuervo-Maldonado , Luis Thompson , Dora E. Corzo-León , Luis E. Cuéllar , Erika Paola Vergara , Fernando Riera , Patricia Cornejo-Juárez , Rita Rojas , Beatriz L. Gómez , Adriana Marcela Celis-Ramírez , Marcio Nucci

{"title":"Evidence-based clinical standard for the diagnosis and treatment of invasive lung aspergillosis in the patient with oncohematologic disease","authors":"Jorge Alberto Cortés , Diego Andrés Rodríguez-Lugo , Martha Carolina Valderrama-Rios , Ricardo Rabagliati , Domenico Capone , Carlos Arturo Álvarez-Moreno , Fabio Varón-Vega , Laura Cristina Nocua-Báez , Cándida Diaz-Brochero , Leonardo Enciso Olivera , Sonia Isabel Cuervo-Maldonado , Luis Thompson , Dora E. Corzo-León , Luis E. Cuéllar , Erika Paola Vergara , Fernando Riera , Patricia Cornejo-Juárez , Rita Rojas , Beatriz L. Gómez , Adriana Marcela Celis-Ramírez , Marcio Nucci","doi":"10.1016/j.bjid.2025.104517","DOIUrl":"10.1016/j.bjid.2025.104517","url":null,"abstract":"<div><div>Aspergillosis is a disease caused by the filamentous fungus <em>Aspergillus</em> spp. with a spectrum of clinical presentation that includes invasive and noninvasive forms. The invasive clinical presentation of aspergillosis most frequently affects people with compromised immune systems. In patients with oncohematologic pathology, invasive lung aspergillosis is a significant opportunistic mycosis, because it occurs frequently and has a major impact on morbidity, mortality, and high costs. The global problem of antimicrobial resistance, to which improper use of antifungals contributes, has put <em>Aspergilus</em> spp. in the spotlight, so it is important to generate guidelines for guidance in the proper use of antifungals in the management of invasive lung aspergillosis, to obtain better clinical outcomes and promote rational use of antifungals. This guideline contains recommendations for diagnosing and treating invasive lung aspergillosis in patients with oncohematologic disease, based on evidence and defined through a participatory process of expert consensus, for the Latin American context.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104517"},"PeriodicalIF":3.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Crimean-Congo hemorrhagic fever: Strategies for diagnosis at initial admission

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-02-22 DOI: 10.1016/j.bjid.2025.104516

Ahmet Melih Şahin, Emrullah Ataş, Sinan Çetin

{"title":"Crimean-Congo hemorrhagic fever: Strategies for diagnosis at initial admission","authors":"Ahmet Melih Şahin, Emrullah Ataş, Sinan Çetin","doi":"10.1016/j.bjid.2025.104516","DOIUrl":"10.1016/j.bjid.2025.104516","url":null,"abstract":"<div><div>Crimean-Congo Hemorrhagic Fever (CCHF) is a viral hemorrhagic fever common in many regions of the world. There are many diseases in the differential diagnosis of CCHF. In our study, we aimed to predict the diagnosis of CCHF at the time of initial presentation by using clinical and laboratory findings in patients with a preliminary diagnosis of CCHF. In our study, 74 patients with a definitive diagnosis of CCHF and 43 patients with a preliminary diagnosis of CCHF but not diagnosed with CCHF were compared in terms of demographic, clinical and laboratory findings. Multivariate logistic regression analysis and Receiver Operating Characteristics (ROC) curve were used to determine variables to predict the diagnosis of CCHF. Living in an endemic area, tick bite, fever, CRP below 48 mg/L and PCT below 0.52 ng/mL were determined as independent risk factors for CCHF diagnosis. The specificity for cut off values of 2485 mm<sup>3</sup> for WBC and 970 mm<sup>3</sup> for neutrophil count were 86 % and 93 %, respectively. The sensitivity for cut off values of 48 mg/L for CRP and 0.52 ng/mL for PCT were 90.5 % and 82.4 %, respectively. In-hospital and 28-day mortality were higher in the non-CCHF group. The differential diagnosis of CCHF is important for planning appropriate isolation procedures and treatments for patients. Additionally, by excluding CCHF, it allows for the early consideration of other diseases in the non-CCHF group that show high mortality. In patients living in endemic areas with tick bites and clinical findings compatible with CCHF, easily accessible tests such as WBC, neutrophil count, CRP and PCT, within the cut-off values identified in our study, will assist in diagnosing CCHF at the initial presentation.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104516"},"PeriodicalIF":3.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0