Evaluation of commercial immunodiffusion reagents for detecting serum anti-Paracoccidioides antibodies.

BACKGROUND: Accurate diagnosis of paracoccidioidomycosis is crucial for improving patient outcomes. Paracoccidioides antibody detection by double immunodiffusion (DID) is a convenient diagnostic tool, but testing performance can vary based on certain factors. METHODS: We assessed DID performance using a commercially prepared Paracoccidioides reagents (IMMY, USA), involving 40 serum specimens, including 20 from patients with proven paracoccidioidomycosis and 20 from patients without the disease. The DID test demonstrated a sensitivity of 90% (95% CI=68%-99%) and a specificity of 100% (95% CI=83%-100%). CONCLUSIONS: Our findings suggest that DID using commercial reagents may provide a feasible tool with satisfactory testing performance for anti-Paracoccidioides antibody detection.

Case report: First case of fungemia caused by Papiliotrema laurentii in a patient with SARS-CoV-2 infection.

Previously considered saprobe and non-pathogenic, the fungus Papiliotrema laurentii (formerly known as Cryptococcus laurentii), is rarely associated with human infection. Nevertheless, there has been an increase in reported infections by non-neoformans cryptococci. After a literature search on the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PMC (PubMed Central) databases, we conclude that this is the first case report of fungemia and probable meningitis caused by Papiliotrema laurentii in a previously immunocompetent host with associated COVID-19.

Case report: First case of fungemia caused by Papiliotrema laurentii in a patient with SARS-CoV-2 infection

ABSTRACT Previously considered saprobe and non-pathogenic, the fungus Papiliotrema laurentii (formerly known as Cryptococcus laurentii), is rarely associated with human infection. Nevertheless, there has been an increase in reported infections by non-neoformans cryptococci. After a literature search on the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PMC (PubMed Central) databases, we conclude that this is the first case report of fungemia and probable meningitis caused by Papiliotrema laurentii in a previously immunocompetent host with associated COVID-19.

Evaluation of commercial immunodiffusion reagents for detecting serum anti-Paracoccidioides antibodies

ABSTRACT Background: Accurate diagnosis of paracoccidioidomycosis is crucial for improving patient outcomes. Paracoccidioides antibody detection by double immunodiffusion (DID) is a convenient diagnostic tool, but testing performance can vary based on certain factors. Methods: We assessed DID performance using a commercially prepared Paracoccidioides reagents (IMMY, USA), involving 40 serum specimens, including 20 from patients with proven paracoccidioidomycosis and 20 from patients without the disease. The DID test demonstrated a sensitivity of 90% (95% CI=68%-99%) and a specificity of 100% (95% CI=83%-100%). Conclusions: Our findings suggest that DID using commercial reagents may provide a feasible tool with satisfactory testing performance for anti-Paracoccidioides antibody detection.

Case report: Mycetoma caused by Gordonia soli.

Mycetoma is a neglected tropical disease caused by fungi (eumycetoma) or bacteria (actinomycetoma), with high morbidity. Gordonia spp. are gram-positive bacteria that have previously been reported to cause mycetoma. Here, we report a case of Gordonia soli (initially misidentified as Nocardia spp.) as the etiological agent of actinomycetoma in a 64-year-old patient. After a literature search in the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PubMed Central databases, we concluded that this is the first case report of mycetoma caused by Gordonia soli. The current case highlights the importance of microbiological diagnosis of mycetoma and the challenges in its management.

Case report: Mycetoma caused by Gordonia soli

ABSTRACT Mycetoma is a neglected tropical disease caused by fungi (eumycetoma) or bacteria (actinomycetoma), with high morbidity. Gordonia spp. are gram-positive bacteria that have previously been reported to cause mycetoma. Here, we report a case of Gordonia soli (initially misidentified as Nocardia spp.) as the etiological agent of actinomycetoma in a 64-year-old patient. After a literature search in the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PubMed Central databases, we concluded that this is the first case report of mycetoma caused by Gordonia soli. The current case highlights the importance of microbiological diagnosis of mycetoma and the challenges in its management.

Spread of Sporothrix spp. through respiratory droplets from infected cats: A potential route of transmission.

Cases of cat-transmitted sporotrichosis in Brazil have increased in recent years. We collected respiratory secretions expelled while sneezing from 28 cats diagnosed with sporotrichosis. We identified the presence of Sporothrix spp. in respiratory droplets expelled in the sneeze of infected cats. The results raise concerns about a new transmission route for cat-transmitted sporotrichosis. Physicians who diagnose and treat human cases of sporotrichosis should be aware of this potential new transmission method to improve clinical suspicion. Approximately half of patients with granulomatous conjunctival sporotrichosis did not report experiencing traumatic injury from cats.

Cat-transmitted sporotrichosis is a zoonosis in geographic expansion from Brazil to other Latin American countries and is considered a public health problem. Data suggest that transmission can occur through the sneeze of an infected cat. The One Health approach is necessary to control the disease.

Cutaneous disseminated sporotrichosis in immunocompetent patient: Case report and literature review.

Sporotrichosis is a global occurring implantation (subcutaneous) mycosis, caused by Sporothrix species, usually affecting the skin and the lymphatic vessels, from where it can disseminate. Nowadays, the vast majority of sporotrichosis infections in Brazil are caused by zoonotic transmission of S. brasiliensis which is the main etiologic agent. We report a cutaneous disseminated case of this disease, observed in an immunocompetent farmer living in southern Brazil, the Sporothrix schenckii-infection was successfully treated with itraconazole.

Severe acute respiratory syndrome coronavirus 2 infection among healthcare workers in a tertiary public hospital in Curitiba, Brazil.

BACKGROUND: We aimed to describe the clinical characteristics of coronavirus disease 2019 (COVID-19) among healthcare workers (HCWs) in Curitiba, Brazil. METHODS: Upper respiratory samples from 1077 HCWs were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using reverse transcription polymerase chain reaction from June 16, 2020 to December 9, 2020. RESULTS: Overall, 32.7% of HCWs were infected. The positivity rates in symptomatic and asymptomatic HCWs were 39.2% and 15.9%, respectively. Hospital departments categorized as high-risk for exposure had the highest number of infected HCWs. CONCLUSIONS: Early diagnosis and isolation of infected HCWs remain key in controlling SARS-CoV-2 transmission because HCWs in close contact with COVID-19 patients are more likely to be infected than those who are not.

Severe acute respiratory syndrome coronavirus 2 infection among healthcare workers in a tertiary public hospital in Curitiba, Brazil

ABSTRACT BACKGROUND: We aimed to describe the clinical characteristics of coronavirus disease 2019 (COVID-19) among healthcare workers (HCWs) in Curitiba, Brazil. METHODS: Upper respiratory samples from 1077 HCWs were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using reverse transcription polymerase chain reaction from June 16, 2020 to December 9, 2020. RESULTS: Overall, 32.7% of HCWs were infected. The positivity rates in symptomatic and asymptomatic HCWs were 39.2% and 15.9%, respectively. Hospital departments categorized as high-risk for exposure had the highest number of infected HCWs. CONCLUSIONS: Early diagnosis and isolation of infected HCWs remain key in controlling SARS-CoV-2 transmission because HCWs in close contact with COVID-19 patients are more likely to be infected than those who are not.

Evaluation of clinical laboratories in diagnosing intestinal parasitic infections

Parasitic infections are an important public health issue due to their high prevalence and widespread incidence. In Brazil there are no data on the performance of clinical laboratories regarding fecal examinations. The purpose of this study was, therefore, to assess the performance of clinical laboratories in Curitiba and its Metropolitan Region, Paraná state, on the diagnosis of intestinal parasitic infections. Samples were sent to laboratories in three semi-permanent preparations on glass slides for microscopy analysis and three samples in diluent solution. The forwarded samples contained ten different parasite species and 22 possible diagnoses. The laboratories were scored very good, good, average or below average according to a predetermined standard. None of the assessed laboratories scored very good regarding the diagnosis of intestinal parasitic infections, 21.1% of laboratories scored good, 15.8% average and 63.2% below average. There were 22% false positives and 24.4% false negative results. The diagnosis of Ascaris lumbricoides eggs was least mistaken. The most common diagnostic failures were in the identification of hookworm larvae, Iodamoeba bütschlli cysts and Fasciola hepatica eggs. The poor performance of laboratories in parasitological diagnosis demonstrated that parasitology laboratories are neglected and professional training is not up to standard

Limiar de positividade e sensibilidade dos métodos de Faust et al. e Lutz para detecção de cistos de Giardia duodenalis / Positivity threshold and sensitivity of methods of Faust et al. and Lutz for detection of Giardia duodenalis cysts

Objetivo: O presente estudo teve como objetivo determinar e comparar o limiar de positividade e a sensibilidade dos métodos de centrífugo-flutuação em sulfato de zinco (Faust et al.) e sedimentação espontânea (Lutz) para o diagnóstico de cistos de Giardia duodenalis. Métodos: Para obtenção de amostras fecais com quantidades conhecidas de cistos de G. duodenalis, amostras positivas para o parasito foram purificadas e quantificadas, e posteriormente alíquotas com diferentes quantidades foram adicionadas a amostras fecais negativas para parasitos. Após a contaminação de oito amostras negativas com quantidades variando entre 1.000 e 200.000 cistos por grama de fezes (c/g/f), as mesmas foram submetidas aos métodos de Faust et al. e Lutz, onde o primeiro se mostrou mais sensível para a detecção de cistos de G. duodenalis. Resultados: O limiar de positividade do método de Faust et al. foi de 11.000 c/g/f, e do método de Lutz foi de 100.000 c/g/f, portanto, cargas parasitárias inferiores a esses limiares levariam a resultados falso-negativos. Conclusão: O método de Lutz não é adequado para o diagnóstico de giardíase, portanto deve ser sempre utilizado em conjunto com o método de Faust et al.

Objective: The present study aimed to determine and compare the positivity threshold and sensitivity of the methods of zinc sulfate centrifugal flotation (Faust et al.) and spontaneous sedimentation (Lutz) for the diagnosis of Giardia duodenalis. Methods: To obtain fecal samples containing known amounts of G. duodenalis cysts, the samples with the parasite were purified and quantified, then aliquots with different amounts were added to fecal samples negative for parasites. After the contamination of eight negative samples with amounts ranging between 1.000 and 200.000 cysts per gram of feces, they were subjected to methods of Faust et al. and Lutz, where the first was more sensitive for the detection of G. duodenalis cysts. Results: The positivity threshold of the method of Faust et al. was 11.000 c/g/f, and the method of Lutz was 100.000 c/g/f, so parasitic loads below those thresholds would lead to false-negative results. Conclusion: The method of Lutz is not suitable for the diagnosis of giardiasis, therefore must always be associated with the method Faust et al.

Evaluation of pleural and ascitic fluid analysis on the Sysmex XE-5000 hematology analyzer / Avaliação da análise dos líquidos pleural e ascítico no analisador hematológico Sysmex XE-5000

ABSTRACT Introduction: Body fluid (BF) analysis is critical to the diagnosis and monitoring of several pathological conditions. The limitations of manual cell counts have led to greater interest in the development of automated BF analysis. Objective: To evaluate the analytical performance of the Sysmex XE-5000 hematology analyzer in the analysis of pleural and ascitic fluids in the laboratory routine of a large university hospital. Methods: A total of 56 samples (35 ascitic and 21 pleural fluids) were analyzed by manual optical microscopy (OM) and XE-5000. Analytical performance includes linearity, carryover, functional sensitivity and comparison of patient samples. Results: Performance studies showed linearity up to 25,825 WBC-BF/µl (r2 = 0.999), WBC-BF showed carryover of 0.18%, and the lower limit of quantitation was set at 22 WBC-BF/µl. Good correlations between the methods were observed just for total cell (TC-BF) and white blood cell (WBC-BF) counts in pleural and ascitic fluids. The high-fluorescence cell count (HF-BF) showed poor correlation but high positive predictive value (PPV) for both fluids (94.74% for pleural and 96.97% for ascitic fluid). Conclusion: XE-5000 provides accurate and precise count for TC-BF, WBC-BF and polymorphonuclear cells (PMN-BF) in pleural and ascitic fluids in medical decision levels, but the morphological differentiation should continue to be held by OM. Histogram and scattergram displayed on XE-5000 must always be analyzed to assess if there is any interference or flag. The HF-BF parameter is a potential tool for screening.

RESUMO Introdução: A análise de líquidos corporais é fundamental para o diagnóstico e o acompanhamento de várias condições patológicas. Devido às limitações da contagem manual de células, tem ocorrido maior interesse no desenvolvimento da análise automatizada de líquidos corporais. Objetivo: Verificar o desempenho analítico do analisador hematológico Sysmex XE-5000 na análise de fluidos pleurais e ascíticos na rotina laboratorial de um hospital universitário de grande porte. Métodos: Um total de 56 amostras (35 de líquidos ascíticos e 21 de líquidos pleurais) foi analisado por microscopia ótica manual (MOM) e pelo XE-5000. O estudo de verificação incluiu linearidade, carryover, limite de quantificação e comparação de amostras de pacientes. Resultados: O estudo de verificação mostrou linearidade de até 25.825 WBC-BF/ml (r2 = 0,999); WBC-BF, carryover de 0,18%; e o menor limite de quantificação foi fixado em 22 WBC-BF/ml. Boas correlações entre o método manual e o automatizado foram observadas apenas para as contagens de total de células nucleadas (TC-BF) e glóbulos brancos (WBC-BF) em líquidos pleurais e ascíticos. A contagem de células de alta fluorescência (HF-BF) mostrou correlação fraca, porém valor preditivo positivo (VPP) elevado para ambos os líquidos corporais (94,74% pleural; 96,97% ascítico). Conclusão: O XE-5000 fornece contagem confiável para TC-BF, WBC-BF e células polimorfonucleares (PMN-BF) em fluidos pleurais e ascíticos em níveis de decisão médica, contudo a diferenciação morfológica deve continuar a ser realizada por MOM. O histograma e o diagrama de dispersão exibidos no XE-5000 devem ser sempre avaliados quanto à existência de qualquer interferência ou alerta suspeito. A contagem de HF-BF constitui uma potencial ferramenta para triagem.

High occurrence of Calodium hepaticum (syn. Capillaria hepatica) spurious infection in a village in the Atlantic Forest of southern Brazil

Calodium hepaticum (syn. Capillaria hepatica) is a nematode of the Capillariidae family that infects rodents and other mammals. In Brazil, human spurious infections of C. hepaticum have been detected in indigenous or rural communities from the Amazon Basin, but not in the southern states of the country. Here, we report the highest occurrence (13.5% of 37 residents) of C. hepaticum human spurious infection detected in Brazil and the first record in a southern region, Guaraqueçaba. The finding is explained by the area being located in the Atlantic Forest of the state of Paraná, surrounded by preserved forests and because the inhabitants consume the meat of wild mammals.

High occurrence of Calodium hepaticum (syn. Capillaria hepatica) spurious infection in a village in the Atlantic Forest of southern Brazil.

Calodium hepaticum (syn. Capillaria hepatica) is a nematode of the Capillariidae family that infects rodents and other mammals. In Brazil, human spurious infections of C. hepaticum have been detected in indigenous or rural communities from the Amazon Basin, but not in the southern states of the country. Here, we report the highest occurrence (13.5% of 37 residents) of C. hepaticum human spurious infection detected in Brazil and the first record in a southern region, Guaraqueçaba. The finding is explained by the area being located in the Atlantic Forest of the state of Paraná, surrounded by preserved forests and because the inhabitants consume the meat of wild mammals.

Exopolysaccharide from surface-liquid culture of Clonostachys rosea originates from autolysis of the biomass.

We describe the purification and chemical characterization of galactomannans that appear both in the biomass and the culture broth during surface-liquid culture of the fungus Clonostachys rosea, a common facultative saprophyte that has potential to be used as a biological control agent against several plant pathogenic fungi, insects and nematodes. The galactomannans from both sources had comparable ratios of Man, Gal and Glc and the similarity were confirmed by (1)H, (13)C NMR, HMQC, and COSY spectra. We propose that the galactomannan in the culture broth originates from autolysis of the biomass, based not only on the similarity that it has with the galactomannan extracted from the biomass but also on the fact that its concentration increased rapidly after glucose depletion from the medium, when biomass concentration was falling. Polysaccharides from C. rosea have not previously been characterized; we show that the characteristics of the galactomannans are consistent with those that have been reported for other members of the Bionectriaceae, the family to which C. rosea belongs.