Epidemiology of candidemia during COVID-19 pandemic era in a teaching hospital: A non-concurrent cohort study.

During the COVID-19 pandemic, an increase in the incidence of bloodstream infections caused by fungi of the Candida genus, also known as candidemia, was observed in patients with SARS-CoV-2 infection. This study aimed to assess the incidence of candidemia, the factors related to COVID-19-associated candidemia (CAC), and prognostic factors. A non-concurrent cohort of 87 cases of patients aged over 18 years with candidemia between March 2020 and February 2022 was evaluated. Incidence density (ID) was calculated by the number of patient-days during the period. All causes of mortality within 30 days of observation were considered. Logistic regression and Cox proportional hazards regression were used, respectively, to determine factors associated with CAC and prognostic factors. Values <0.05 were considered significant. The ID of CAC was eight times higher than candidemia in patients without COVID-19 [2.40 per 1000 person-days vs. 0.27 per 1000 person-days; P < .01]. The corticosteroid therapy was as an independent factor associated with CAC [OR = 15.98 (3.64-70.03), P < .01], while abdominal surgery was associated with candidemia in patients without COVID-19 [OR = 0.09 (0.01-0.88), P = .04]. Both patients with and without COVID-19 had a high 30 days-mortality rate (80.8% vs. 73.8%, respectively; P = .59). Liver disease [HR = 3.36 (1.22-9.27); P = .02] and the Charlson score [HR = 1.17 (1.01-1.34); P = .03] were independent factors of death, while the use of antifungals [HR = 0.15 (0.07-0.33); P < .01] and removal of the central venous catheter [HR = 0.26 (0.12-0.56); P < .01] independently reduced the risk of death. These findings highlight the high incidence of candidemia in COVID-19 patients and its elevated mortality.

This study found that bloodstream infections by Candida spp. were significantly more common in patients with than without COVID-19, and Candida glabrata played a significant role in these infections. Liver disease and a higher number of comorbidities were associated with an increased risk of death.

Caracterização epidemiológica da hepatite B em idosos / Epidemiologic characterization of hepatitis B among older adults

Resumo Objetivo Caracterizar o perfil e identificar os fatores associados à Hepatite B na população com 60 anos ou mais de idade da região Sudoeste do Paraná, Brasil. Método Trata-se de um estudo epidemiológico descritivo e inferencial que analisou quantitativamente dados secundários obtidos através do Sistema Nacional de Agravos de Notificação (SINAN), entre 2007 a 2017. Resultados A Hepatite B foi mais frequente em homens, com baixa escolaridade e em indivíduos que exerciam atividade ligada à agricultura. A maioria dos casos foi notificada entre 2013 a 2017 e em sujeitos que reportaram exposição a material biológico. No modelo multivariado de regressão logística, as infecções pelos vírus da hepatite B foram associadas à raça/cor não branca (OR: 2,89; IC95% 1,07 - 7,87), ao histórico de realização de transfusão sanguínea (OR: 14,51; IC95% 5,44 - 38,74), em residentes de municípios de 10 a 20 mil habitantes (OR: 4,57; IC95% 1,59 - 13,12) e de municípios entre 20 a 50 mil habitantes (OR: 4,33; IC95% 1,61 - 11,56). Conclusão A caracterização dos possíveis fatores de risco para hepatite B nessa população podem subsidiar ações mais eficazes de prevenção e promoção de saúde, bem como fomentar estudos específicos que possam guiar políticas de atenção integral ao idoso.

Abstract Objective to characterize the epidemiologic profile of Hepatitis B in the population aged 60 years old or more from the southwest region of the state of Paraná, Brazil, between 2007 and 2017. Method an epidemiologic, descriptive, and inferential study was conducted based on notifications obtained from the Notifiable Diseases Information System(or SINAN). Results Hepatitis B was more frequent in men, those with low levels of schooling and among individuals who worked in agriculture. Most of the cases were reported between 2013 and 2017 in subjects who reported having been exposed to biological material. According to logistic regression, hepatitis B infections were associated with non-white ethnicity (OR: 2.89; 95%CI 1.07 - 7.87), a history of blood transfusions (OR: 14.51; 95%CI 5.44 - 38.74), living in municipal regions with 10,000 to 20,000 inhabitants (OR: 4.57; 95%CI 1.59 - 13.12) and also among individuals from municipal regions with 20,000 to 50,000 inhabitants (OR: 4.33; 95%CI 1.61 - 11.56). Conclusion the epidemiological profile reported here represents a risk factor for hepatitis B in this population. The data can support more effective interventions, as well as further studies to guide comprehensive public health policies for older adults.