Sirlei Garcia Marques

Zoonotic sporotrichosis has expanded in Brazil as an urban, cat-associated mycosis, but its human clinical-epidemiological profile remains poorly characterized in Maranhao State, Brazil. This study describes a hospital-based cohort from Greater Sao Luis and defines a regional profile not previously established in the state. We conducted an observational study combining retrospective and prospective data from 2022 to 2025 at a reference hospital for infectious diseases in Sao Luis municipality, Maranhao State, Brazil. Confirmed cases were defined by culture and/or compatible histopathological findings supported by clinical-epidemiological criteria. Demographic, exposure, clinical, laboratory, therapeutic, and outcome variables were analyzed using descriptive statistics and appropriate statistical tests. A total of 189 confirmed cases were analyzed. Cases increased sharply after 2022 and peaked in 2024, with 82 cases. Most patients lived in Sao Luis municipality (84.7%), were female (67.2%), and were aged 30-59 years (47.1%). Feline-associated exposure predominated: 70.9% reported having household cats and 81.5% reported scratches or contact with feline lesions or secretions. The lymphocutaneous form was the main presentation (61.9%), followed by fixed cutaneous disease (29.1%); upper limbs were the most frequently affected sites (73.0%). Culture was positive for Sporothrix spp. in 62.2% of tested samples, and suppurative granulomas were frequent findings on histopathological examination. Itraconazole was the first-line therapy in 92.0% of treated patients. Greater Sao Luis shows the profile of an emerging urban epidemic of zoonotic sporotrichosis of feline origin. These findings provide local evidence to guide surveillance, early diagnosis, integration between human and veterinary health services, and One Health-based control strategies in Maranhao State.

A candidíase e a candidemia pediátrica constituem importante causa de morbidade e mortalidade em todo o mundo. Este estudo teve como objetivo analisar a incidência e o perfil de susceptibilidade antifúngica de Candida. spp. isolados de lactentes e crianças internadas em maternidades e hospitais públicos. Trata-se de um estudo observacional retrospectivo, analítico-transversal realizado através da análise de dados de prontuários e do antifungigrama de pacientes com diagnóstico de candidíase ou candidemia admitidos no período de janeiro de 2015 a dezembro de 2021 na cidade de São Luís-MA. Foram detectados 627 episódios de infecção por Candida (45,3% sexo feminino e 54,7% sexo masculino). A maior incidência ocorreu nas faixas etárias de 1 a 3 meses (41,63%) e de 1 a 3 anos (22,65%) e as principais espécies isoladas foram C. albicans, C. parapsilosis e C.tropicalis. A maior diversidade de Candida patogênica foi detectada no sangue, urina jato médio e secreção traqueal (p<0,001) recuperadas principalmente de pacientes hospitalizados na enfermaria e UTI pediátrica. As espécies C. glabrata, C. haemulonii e C. tropicalis apresentaram resistência a 2-3 diferentes antifúngicos (anfotericina B, caspofungina, fluconazol e voriconazol). Este estudo indica a urgência de implementação de medidas de controle mais rigorosas nas maternidades e hospitais pediátricos e serve como guia para orientação dos profissionais de saúde na seleção da terapia antifúngica mais adequada.

Antimicrobial resistance is a global public health threat that has been impacted by the COVID-19 pandemic. The aim of this study was to evaluate the resistance of Acinetobacter spp. isolated from patients with pneumonia in a Brazilian Pre-Amazon region during the pre-pandemic and pandemic periods of COVID-19. Bacterial strains were obtained from tracheal aspiration, sputum and bronchoalveolar lavage for diagnosis and phenotypic characterization. MALD-TOF was used to identify strains. The automated Phoenix and VITEK® 2 Compact system and the disc diffusion method were performed to determine the antimicrobial susceptibility profile. Were analyzed a total of 41,590 samples from patients admitted to hospitals of a Brazilian Pre-Amazon region, from January 2019 to December 2021. Of these, 162 isolates of Acinetobacter spp. were from the pre-pandemic period and 308 from the pandemic COVID-19. A. baumannii was the most prevalent species. Among the samples, 52% were male patients, aged over 60 years, hospitalized in intensive care units. Acinetobacter spp. showed higher rates of resistance to cefepime (79.1%), levofloxacin (77.8%), and ceftazidime (77%) in the pre-pandemic period and during the pandemic to piperacillin (72.4%), imipenem (71.6%) and ciprofloxacin (71.8%). Taken together, the data showed that A. baumannii was the most prevalent species among Acinetobacter spp., being more frequent among elderly patients admitted to the ICU. The strains presented high resistance to most antibiotics tested, mainly carbapenems. In addition, there was an increase in resistance to polymyxin B, which raises an alert since this is a therapeutic choice to treat infections caused by Acinetobacter spp. multidrug resistant.

Healthcare-related infections caused by resistant microorganisms are a severe public health problem and are becoming increasingly prevalent in the hospital environment, especially Pseudomonas aeruginosa. This work aimed to evaluate the resistance profile of Pseudomonas aeruginosa to antimicrobials before the COVID-19 pandemic and during the pandemic period. Bacteria strains were obtained from tracheal aspiration, sputum, and bronchoalveolar lavage for diagnosis and phenotypic characterization. Matrix assisted laser-desorption ionization-time of flight mass spectrometry (MALD-TOF MS) was used to identify strains. Automated Phoenix and VITEK^® 2 Compact system and the disc diffusion method were performed to determine the antimicrobial susceptibility profile. A total of 41,000 medical reports from adult patients with pneumonia were analyzed. Of these, 951 patients were positive for P. aeruginosa, of which 373 were related to the pre-pandemic period and 578 to the pandemic period. Older men (≥60 years) were more prevalent in both periods. P. aeruginosa strains were resistant to imipenem in both periods: 38.8 and 42.5%, respectively, followed by meropenem (34.2 and 39.2%), ciprofloxacin (33.6 and 36.7%), and levofloxacin (34.9 and 43.5%). Intensive care units had the highest percentage of affected patients (62 and 65%) compared with other sectors, with a prevalence of 71% in the public network before COVID-19 and 59% during the pandemic. Our data showed a prevalence of P. aeruginosa in elderly patients in both the pre-pandemic and pandemic periods. In addition, an increase in P. aeruginosa resistance to beta-lactams, quinolones, carbapenems, and cephalosporins was observed during the COVID-19 pandemic compared with the period before the pandemic, especially in ICUs.