Brazilian Journal of Infectious Diseases最新文献

{"title":"Early prediction of 30-day mortality in patients with surgical wound infections following cardiothoracic surgery: Development and validation of the SWICS-30 score utilizing conventional logistic regression and artificial neural network","authors":"Julio Alejandro Cedeno ,&nbsp;Tania Mara Varejão Strabelli ,&nbsp;Bruno Adler Maccagnan Pinheiro Besen ,&nbsp;Rafael de Freitas Souza ,&nbsp;Denise Blini Sierra ,&nbsp;Leticia Rodrigues Goulart de Souza ,&nbsp;Samuel Terra Gallafrio ,&nbsp;Cely Saad Abboud ,&nbsp;Diego Feriani ,&nbsp;Rinaldo Focaccia Siciliano","doi":"10.1016/j.bjid.2025.104510","DOIUrl":"10.1016/j.bjid.2025.104510","url":null,"abstract":"<div><h3>Introduction</h3><div>We aimed to create and validate the 30-day prognostic score for mortality in patients with surgical wound infection (SWICS-30) after cardiothoracic surgery.</div></div><div><h3>Methods</h3><div>This retrospective study enrolled patients with surgical wound infection following cardiothoracic surgery admitted to a Cardiologic Reference Center Hospital between January 2006 and January 2023. Clinical data and commonly used blood tests were analyzed at the time of diagnosis. An independent scoring system was developed through logistic regression analysis and validated using Artificial intelligence.</div></div><div><h3>Results</h3><div>From 1713 patients evaluated (mean age of 60 years (18–89), 55 % female), 143 (8.4 %) experienced 30-day mortality. The SWICS-30 logistic regression score comprised the following variables: age over 65 years, undergoing valve heart surgery, combined coronary and valve heart surgery, heart transplantation, time from surgery to infection diagnosis exceeding 21 days, leukocyte count over 13,000/mm3, lymphocyte count below 1000/mm3, platelet count below 150,000/mm3, and creatinine level exceeding 1.5 mg/dL. These patients were stratified into low (2.7 %), moderate (14.2 %), and high (47.1 %) in-hospital mortality risk categories. Artificial intelligence confirmed accuracy at 90 %.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104510"},"PeriodicalIF":3.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454881","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":"Demographic, epidemiological and clinical profile of patients with post-COVID syndrome followed at a teaching hospital in Brazil","authors":"João Paulo Borges de Melo,&nbsp;Alex Eduardo da Silva,&nbsp;Leandro Resende Yamamoto,&nbsp;Taciana Fernandes Araújo Ferreira,&nbsp;Gustavo José Luvizutto,&nbsp;Fernando Freitas Neves,&nbsp;Kelly Cristina Santos,&nbsp;Roger Lopes Batista,&nbsp;Isabel Cunha Santos,&nbsp;Francielle Schiavoni,&nbsp;Mario León Silva-Vergara","doi":"10.1016/j.bjid.2025.104509","DOIUrl":"10.1016/j.bjid.2025.104509","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-COVID Syndrome (PCS), occurs several weeks after Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2 infection), has a frequency of 10 %‒35 % of cases, presents a wide range of symptoms that can persist for months or years and markedly reduces the quality of life of patients.</div></div><div><h3>Objective</h3><div>To describe clinical, epidemiological and evolutionary aspects of a cohort of patients diagnosed with PCS followed on an outpatient basis.</div></div><div><h3>Methodology</h3><div>Individuals of both sexes, &gt; 18-years old who presented symptoms suggestive of PCS and had previously confirmed SARS-CoV-2 infection were included. Clinical evaluation was carried out monthly by a multidisciplinary team, and if necessary laboratorial exams were performed.</div></div><div><h3>Results</h3><div>From June 2021 to June 2022, 92 cases of PCS were diagnosed, of which 60 (65.2 %) were female and the average age was 49.1 years. In 61 (66.3 %) of the cases, SARS-CoV-2 infection occurred between January and November 2021. In 55 (59.7 %) of the cases the symptoms were mild, while 31 (36.0 %) were moderate or severe cases. Most cases of PCS occurred in individuals with the mild form of COVID-19. The predominant symptoms were chronic fatigue in 59 (68.6 %) cases, brain fog in 68 (73.4 %), myalgias and arthralgias in 44 (47.8 %), cramps and paresthesia's in 40 (46.5 %). The main comorbidities observed were high blood pressure, obesity and diabetes mellitus. The persistence of symptoms was greater in those cases who presented severe forms of COVID-19. Most patients experienced gradual and progressive improvement over the months.</div></div><div><h3>Discussion</h3><div>The profile of patients with PCS in this cohort is similar to other reports. A great number of symptoms is remarkable with variable presentation and evolution and their frequency exceeds that previously described in a large meta-analysis. Inflammatory phenomena mediated by the virus, autoimmunity and direct organic damage have been implicated in the genesis of this syndrome.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104509"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445309","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":"Expression of CD64 and CD69 as biomarkers for late-onset sepsis diagnosis in infants born prematurely","authors":"Alicia Ramírez-Ramírez,&nbsp;Ismael Mancilla-Herrera,&nbsp;Ricardo Figueroa-Damián,&nbsp;Diana Soriano-Becerril,&nbsp;Graciela Villeda-Gabriel","doi":"10.1016/j.bjid.2025.104511","DOIUrl":"10.1016/j.bjid.2025.104511","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of Late-Onset Sepsis (LOS) increases as gestational age decreases in newborns. The clinical signs of neonatal sepsis are not specific for diagnosis in preterm infants. The gold standard for its diagnosis is the blood culture test, which requires more than 24 h to obtain results, with positive results obtained in 10–3 % of cases analysed. As the molecular markers on the lymphocyte surface CD64 and CD69 are involved in early innate immune activation, they may be helpful for faster diagnosis.</div></div><div><h3>Aim</h3><div>Measure the expression of CD64 and CD69 on lymphocytes in clinical and confirmed sepsis patients and compared to that in infants without sepsis.</div></div><div><h3>Methodology</h3><div>We used peripheral blood samples from three groups of preterm babies with suspected sepsis (<em>n</em> = 31), confirmed sepsis (<em>n</em> = 10) and without sepsis (<em>n</em> = 47). Using flow cytometry, we measure the expression of CD64 on neutrophils and CD69 on NK cells.</div></div><div><h3>Results</h3><div>Expression of CD64 on neutrophils and CD69 on NK cells did not increase in the clinical or confirmed sepsis groups compared to the without sepsis group.</div></div><div><h3>Conclusions</h3><div>Leukocytes from infants born prematurely may have tightly regulated mechanisms that control their activation phenotype, rendering them unsuitable for diagnosing sepsis.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104511"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436701","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":"Treatment costs of long-term invasive meningococcal disease sequelae: A literature review and Delphi study in Brazil","authors":"Noemia Teixeira de Siqueira Filha ,&nbsp;Fanny Cortes ,&nbsp;Meline Kron ,&nbsp;Maira Galdino da Rocha Pitta ,&nbsp;Fernando Zanghelini ,&nbsp;Bruna de Veras ,&nbsp;Tatiane Almeida Menezes ,&nbsp;Ana Medina ,&nbsp;Lessandra Michelin ,&nbsp;Thatiana Pinto","doi":"10.1016/j.bjid.2025.104514","DOIUrl":"10.1016/j.bjid.2025.104514","url":null,"abstract":"<div><div>This study describes and estimates the social and economic impact of Invasive Meningococcal Disease (IMD) sequelae globally and in Brazil. An integrative review was conducted to identify IMD sequelae costs estimates worldwide. The evidence identified supported the development of a Delphi survey to estimate medical Resource Use (RU) and caregiver productivity loss during the first Year (Y1) of IMD and the Subsequent Year (SY) in Brazil. Treatment costs of long-term IMD sequelae were estimated through microcosting approach using Brazilian cost reference tables and taking into account the Delphi survey estimates. The review included eight studies from high-income countries. Mean costs of IMD sequelae in high-income countries varied substantially by type of sequelae in Y1 (hearing loss $14,511; amputation $144,087), type of care over a lifetime horizon (outpatient $28,498; inpatient $67,038), and medical procedure over a lifetime horizon (shunt revision $22,794; prosthesis $508,735). The Delphi survey indicated that medical RU was significantly higher in Y1 versus SY. Resource use was highest for patients with multiple limb amputations. In addition, the highest number of outpatient visits (32) were required for patients with skin scars; speech therapy (72) for hearing loss; and the most psychologist sessions (116) for mental health disorders in Y1. Similarly, estimated treatment costs were highest for patients with multiple limb amputations ($4,139.70 in Y1 and $1,874.39 for SY), followed by single limb amputation ($2,803.24 in Y1 and $902.73 for SY) and skin scarring ($2,307.69 in Y1 and $816.19 for SY). All sequelae resulted in multiple workdays lost for caregivers, ranging from 33 (skin scarring) to 85 (multiple limbs amputation) during the first year of treatment. This study informs decision-makers on the healthcare, social and educational services, and social protection needs of patients with long-term sequelae in Brazil and globally.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104514"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445310","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":"Transmission of Dolutegravir resistance in treatment-naive individuals with HIV-1: A cohort study","authors":"Jorge Francisco da Cunha Pinto ,&nbsp;Luiza Brito Gomes ,&nbsp;Natalia Dias Melo ,&nbsp;Fabiana Barbosa Assumpção de Souza ,&nbsp;Debora Viana Freitas ,&nbsp;Sara Gonzalez Viega ,&nbsp;Erica Ramos dos Santos Nascimento ,&nbsp;Lidia Theodoro Boullosa ,&nbsp;Cynthia Chester Cardoso ,&nbsp;Amilcar Tanuri","doi":"10.1016/j.bjid.2025.104513","DOIUrl":"10.1016/j.bjid.2025.104513","url":null,"abstract":"<div><h3>Background</h3><div>Dolutegravir (DTG) is widely used as a first-line Antiretroviral Therapy (ART) due to its high efficacy and safety. However, concerns about DTG resistance persist. This study investigated the prevalence and factors associated with transmitted DTG resistance in treatment-naive HIV-1-infected individuals in Brazil.</div></div><div><h3>Methods</h3><div>The study followed 150 treatment-naive HIV-1 individuals from May 2019 to May 2022 at a reference center for HIV/AIDS in Rio de Janeiro, Brazil. Baseline characteristics, viral load, and CD4 + cell counts were assessed. Genotypic resistance testing was conducted on plasma samples at baseline, and viral load was monitored during follow-up visits.</div></div><div><h3>Results</h3><div>One hundred and thirty-one patients completed the study. The mean age was 37.73-years; 107 were male, and 24 were female. The median baseline of viral load was 4.33 log (21,193 copies/mm³), and CD4 + count was 342 cells/mm³, with the lowest count being 8 cells/mm³. The mean CD4 + count increase was 112 cells/mm³ (<em>p</em> &lt; 0.01). One hundred and nine patients achieved an undetectable viral load three months after starting ART, with only eight patients not reaching undetectable levels by six months (42‒106 copies/mm³). The most common early adverse effect was nausea (12.9 %), and the most common later effect was increased creatinine levels (9.1 %), leading to the suspension or substitution of Tenofovir Disoproxil Fumarate (TDF). Genotyping was successfully performed on 85 patients: 66 were subtype B, 9 subtype C, 8 subtype F, and two CRF47_BF, with no resistance mutations and one accessory mutation (T97A).</div></div><div><h3>Conclusion</h3><div>This study did not demonstrate transmitted DTG resistance among treatment-naive HIV-1-infected individuals. The findings suggest that DTG remains a safe and effective first-line ART option. However, close monitoring of viral load is recommended for all patients on DTG-containing ART regimens. Additionally, genotypic resistance testing should be performed on individuals who experience virological failure or a significant decline in CD4 + cell counts, with close attention to ART adherence.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104513"},"PeriodicalIF":3.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387652","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":"Prevalence and investigation of Cytomegalovirus (HCMV) in blood donors from the main blood establishment in Rio de Janeiro/Brazil","authors":"Agildo da Silva Oliveira ,&nbsp;Jéssica Gonçalves Pereira ,&nbsp;Gabrielle Tantos Nunes ,&nbsp;Ivanildo Pedro de Sousa Junior ,&nbsp;Dmitry José de Santana Sarmento ,&nbsp;Josiane Iole França Lopes ,&nbsp;Luiz Amorim Filho ,&nbsp;Vanessa Salete de Paula","doi":"10.1016/j.bjid.2025.104508","DOIUrl":"10.1016/j.bjid.2025.104508","url":null,"abstract":"<div><h3>Background</h3><div>Human Cytomegalovirus (HCMV) remains a significant cause of morbidity and mortality among pregnant women and immunocompromised patients. HCMV transmission can occur through blood transfusions and typically results in asymptomatic infections in newborns and young individuals or causes symptoms like infectious mononucleosis when symptomatic infections arise. HCMV infection poses a notable risk to transfusion recipients, particularly in vulnerable groups such as premature newborns and immunosuppressed patients. The risk persists even after prophylaxis ends, especially in patients who undergo organ transplantation and receive blood or blood products from a seropositive donor while being seronegative themselves (D+/R-).</div></div><div><h3>Materials and methods</h3><div>Here, we investigated the serological and molecular prevalence of HCMV among 980 blood donors from the main blood bank in Rio de Janeiro, Brazil, using chemiluminescence and real-time PCR (TaqMan). The data underwent univariate, bivariate, and multivariate statistical analyses using the SPSS program, version 20.0.</div></div><div><h3>Results</h3><div>The average age of donors was 38.53 years, with a majority being male (53.9 %). The prevalence of cytomegalovirus was 88.5 %, and HCMV DNA was detected in 1.2 % of the samples.</div></div><div><h3>Discussion</h3><div>Given that there are approximately 100,000 blood donations per year, this prevalence rate is considerably high compared to that in developed countries. These findings underscore the critical need for ongoing surveillance and molecular testing to ensure the safety of blood supplies.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104508"},"PeriodicalIF":3.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143236277","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":"A post-pandemic snapshot of the magnitude of COVID-19 in Brazil: A countrywide study","authors":"Eduardo Ribes Kohn ,&nbsp;Maristela Bohlke ,&nbsp;Antônia Almeida ,&nbsp;Leandro Janelli ,&nbsp;Luciana Monteiro Vasconcelos Sardinha ,&nbsp;Fernando C. Wehrmeister ,&nbsp;Pedro Curi Hallal","doi":"10.1016/j.bjid.2024.104496","DOIUrl":"10.1016/j.bjid.2024.104496","url":null,"abstract":"<div><h3>Objective</h3><div>To outline the features of COVID-19 in Brazil through a countrywide telephone survey.</div></div><div><h3>Methods</h3><div>Data from the Telephone Survey of Risk Factors for Chronic Noncommunicable Diseases During the Pandemic (Covitel), a telephone survey of individuals aged 18 years or older from all macro-regions of Brazil, were used. The questionnaire included sociodemographic characteristics and outcomes related to COVID-19 infection, severity, vaccination, and use of masks.</div></div><div><h3>Results</h3><div>Data revealed that 34.7 % (95 %CI 32.4 – 37.1) of the population had been diagnosed with COVID-19, and 10.1 % (95 %CI 7.9 – 12.7) of those required hospital admission. The prevalence of COVID-19 diagnosis increased with education level: &lt;8 years (26.6 % [95 %CI 23.1 – 30.7]), 9–11 years (33.4 % [95 %CI 29.4 – 37.7]), and &gt;11 years (53.2 % [95 % CI 49.7 – 56.8]). Nevertheless, the hospitalization rate of Brazilians with more than eleven years of education was lower (5.8 % [95 %CI 4.3 – 7.6]). In 2023, 92.9 % (95 %CI 90.9 – 94.4) of the Brazilian population was fully vaccinated against COVID-19, but only 37.2 % (95 %CI 33.5 – 40.9) have received the updated vaccinal scheme (two doses and two boosters). During the pandemic outbreak, 81.9 % (95 %CI 79.4 – 84.2) reported always using face masks. However, only 16.1 % (95 %CI 13.5 – 19.0) maintained this practice in 2023.</div></div><div><h3>Conclusion</h3><div>There were inequalities in COVID-19 testing in Brazil. Testing and vaccination policies implemented in the COVID-19 pandemic must be reevaluated by the Brazilian government.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104496"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878685","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 need for novel influenza vaccines in low- and middle-income countries: A narrative review","authors":"Julia R. Spinardi ,&nbsp;Karan B. Thakkar ,&nbsp;Verna L. Welch ,&nbsp;Oladayo Jagun ,&nbsp;Moe H. Kyaw","doi":"10.1016/j.bjid.2024.104465","DOIUrl":"10.1016/j.bjid.2024.104465","url":null,"abstract":"<div><div>Influenza viruses cause 3–5 million severe cases and 300,000–600,000 deaths worldwide. Most of the disease burden is in Low- and Middle-Income Countries (LMICs) owing to factors such as high population density, infrastructure challenges, poor quality healthcare, lack of consistent recommendations, less prioritization of all high-risk groups, and prevalent use of trivalent influenza vaccines. Although influenza vaccines are effective in reducing the annual influenza disease burden, existing vaccines have several limitations. In this narrative review, we address the unmet needs of existing influenza vaccines in LMICs in Africa, Asia Pacific, Latin America and the Middle East and discuss the characteristics of novel vaccines in clinical development. We also describe features of a successful vaccination program that LMICs could emulate to improve their current vaccination coverage and reduce the public health burden of influenza.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104465"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792736","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":"Evidence-based clinical standard for the diagnosis and treatment of candidemia in critically ill patients in the intensive care unit","authors":"Jorge Alberto Cortés ,&nbsp;Martha Carolina Valderrama-Rios ,&nbsp;Paula M. Peçanha-Pietrobom ,&nbsp;Moacyr Silva Júnior ,&nbsp;Cándida Diaz-Brochero ,&nbsp;Rafael Ricardo Robles-Torres ,&nbsp;Carmelo José Espinosa-Almanza ,&nbsp;Laura Cristina Nocua-Báez ,&nbsp;Marcio Nucci ,&nbsp;Carlos Arturo Álvarez-Moreno ,&nbsp;Flavio Queiroz-Telles ,&nbsp;Ricardo Rabagliati ,&nbsp;Rita Rojas-Fermín ,&nbsp;Jorge L. Finquelievich ,&nbsp;Fernando Riera ,&nbsp;Patricia Cornejo-Juárez ,&nbsp;Dora E. Corzo-León ,&nbsp;Luis E. Cuéllar ,&nbsp;Jeannete Zurita ,&nbsp;Augusto Raúl Hernández ,&nbsp;Arnaldo Lopes Colombo","doi":"10.1016/j.bjid.2024.104495","DOIUrl":"10.1016/j.bjid.2024.104495","url":null,"abstract":"<div><div>Candidemia is the predominant form of invasive candidiasis and the most frequently occurring serious fungal infection in critically ill patients in Intensive Care Units (ICU). Studies carried out in Latin America reveal a higher incidence of candidemia and higher mortality rates when compared to North America or Europe. This highlights the need to develop guidelines for correctly diagnosing and treating candidemia in critically ill patients in the ICU. These guidelines are part of the efforts to implement antifungal optimization programs in the region to obtain better clinical outcomes and promote rational antifungal use. This evidence-based clinical standard, established through expert consensus for the Latin American context, contains recommendations and algorithms for diagnosing and treating candidemia in critically ill ICU patients.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104495"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878688","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":"Activity of ceftolozane/tazobactam and comparators against gram-negative bacilli: Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART – Brazil), 2018‒2021","authors":"Amanda Azevedo Bittencourt ,&nbsp;Vinicius Lima Faustino ,&nbsp;Paula de Mendonça Batista ,&nbsp;Lays Paulino Leonel ,&nbsp;Marina Della Negra de Paula ,&nbsp;Thales José Polis","doi":"10.1016/j.bjid.2024.104497","DOIUrl":"10.1016/j.bjid.2024.104497","url":null,"abstract":"<div><div>Increased spread of antimicrobial resistance by Gram-Negative Bacilli (GNB) poses a global challenge, with exacerbated burden post-pandemic. The aim of this study was to investigate the <em>in vitro</em> activity of ceftolozane/tazobactam and its comparators against the frequently identified GNB isolated from patients admitted to Brazilian medical sites between the year 2018‒2019 and 2020‒2021. The impact of pandemic on antimicrobial resistance and presence of β-lactamase genes were also evaluated. Antimicrobial susceptibility testing and molecular characterization of ß-lactamase encoding genes using Polymerase Chain Reaction (PCR) and DNA sequencing were carried out from GNB isolated mostly from intra-abdominal, respiratory, and urinary tract infections and interpreted following BrCAST/EUCAST guidelines. A total of 3994 GNB isolates were evaluated which mostly included <em>E. coli, K. pneumoniae</em> and <em>P. aeruginosa.</em> Ceftolozane/tazobactam remained highly active against <em>E. coli</em> isolates during both 2018‒2019 (96.0 %) and 2020‒2021 (98.5 %). Among <em>K. pneumoniae</em>, ceftolozane/tazobactam (47.6 % and 43.0 % susceptible during 2018‒2019 and 2020‒2021, respectively) showed poor activity due to <em>bla</em>_KPC-2. Colistin and ceftolozane/tazobactam were the most active β-lactam agents tested against <em>P. aeruginosa</em> in 2018‒2019 (99.3 % and 88.8 %) and 2020‒2021 (100 % and 92.8 %), including ceftazidime and meropenem resistant isolates. β-lactamase encoding gene characterization was carried out and both carbapenemases and Extended-Spectrum β-Lactamase (ESBL) producers were found in <em>E. coli, K. pneumoniae</em> and <em>P. aeruginosa</em> isolates. Ceftolozane/tazobactam documented remarkable <em>in vitro</em> activity against <em>E. coli and P. aeruginosa</em> isolates in Brazil, both pre- and post-pandemic periods and could constitute an effective therapeutic option for the treatment of urinary tract infections, intra-abdominal infections, and respiratory tract infections.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 1","pages":"Article 104497"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820276","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}