Long-term surveillance of SARS-CoV-2 in the school community from Campo Grande, Brazil.

BACKGROUND: The COVID-19 pandemic has significantly impacted education systems worldwide, with Brazil being one of the countries with the longest school closures. Over a million children and teenagers have been affected, leading to increased hunger and nutritional deficiencies. This study aimed to implement long-term surveillance of SARS-CoV-2 infections in public and private schools in Campo Grande, Brazil, after returning to in-person classes. METHODS: The study involved testing and genomic surveillance at 23 public and private schools in Campo Grande, Mato Grosso do Sul, Brazil, from October 18, 2021 to November 21, 2022. The participants eligible for enrollment were students aged 6-17 years and staff members from school institutions. At the time of collection, participants were asked if they had symptoms in the last two weeks. Whole-genome sequencing of SARS-CoV-2 was conducted to identify circulating variants and to compare them with those detected in the municipality. The demographic data and clinical history of the participants were described, and a logistic regression model was used to understand how the RT-qPCR results could be related to different characteristics. RESULTS: The study included 999 participants, most of whom were women. A total of 85 tests were positive, with an overall positivity rate of 3.2%. The dynamics of case frequency were consistent with those observed in the municipality during the study period. The most common symptoms reported were cough, rhinorrhea, headache, and sore throat. Symptoms were significantly associated with SARS-CoV-2 infection. Eleven lineages were identified in school community samples, with a frequency of occurrence per period similar to that found in the sequences available for the municipality. The most prevalent lineages within the sampling period were BA.2 (59.3%) and BA.5 (29.6%). CONCLUSIONS: Our findings demonstrate that schools can play a crucial role in epidemiological surveillance, helping trigger rapid responses to pathogens such as SARS-CoV-2. Long-term surveillance can be used to track outbreaks and assess the role of children and adults in transmission. It can also contribute to pandemic preparedness, enabling a rapid response to emergencies, such as COVID-19.

Oral colonization by Candida species in HIV-positive patients: association and antifungal susceptibility study.

OBJECTIVE: To investigate antifungal susceptibility and factors associated with oral colonization by Candida species in HIV-positive patients. METHODS: A prospective study based on convenience sampling of subjects recruited from a pool of confirmed HIV-positive individuals seen at a specialty outpatient service in Rondonópolis, Mato Grosso, Brazil). Oral swabs were collected from 197 patients. Candida species were identified by standard microbiological techniques (phenotypic and molecular methods). Antifungal susceptibility was investigated using the broth microdilution method. RESULTS: A total of 101 (51.3%) patients were Candida spp carriers. Candida albicans was the most prevalent species (80%). Patients aged 45 to 59 years (Prevalence ratios: 1.90; 95%CI: 1.57-6.31) and 60 years or older (Prevalence ratios: 4.43; 95%CI: 1.57-34.18) were at higher risk of oral colonization by Candida species. Resistance to fluconazole and ketoconazole, or to itraconazole, corresponded to 1% and 4%, respectively. CONCLUSION: Age (45 years or older) was the only factor associated with oral colonization by Candida . Low rates of antifungal resistance to azoles were detected in yeast isolates obtained from HIV-positive patients. Findings of this study may contribute to proper therapeutic selection for oral candidiasis in HIV-positive patients.

Oral colonization by Candida species in HIV-positive patients: association and antifungal susceptibility study / Colonização oral por espécies de Candida em pacientes HIV positivo: estudo de associação e suscetibilidade antifúngica

ABSTRACT Objective To investigate antifungal susceptibility and factors associated with oral colonization by Candida species in HIV-positive patients. Methods A prospective study based on convenience sampling of subjects recruited from a pool of confirmed HIV-positive individuals seen at a specialty outpatient service in Rondonópolis, Mato Grosso, Brazil). Oral swabs were collected from 197 patients. Candida species were identified by standard microbiological techniques (phenotypic and molecular methods). Antifungal susceptibility was investigated using the broth microdilution method. Results A total of 101 (51.3%) patients were Candida spp carriers. Candida albicans was the most prevalent species (80%). Patients aged 45 to 59 years (Prevalence ratios: 1.90; 95%CI: 1.57-6.31) and 60 years or older (Prevalence ratios: 4.43; 95%CI: 1.57-34.18) were at higher risk of oral colonization by Candida species. Resistance to fluconazole and ketoconazole, or to itraconazole, corresponded to 1% and 4%, respectively. Conclusion Age (45 years or older) was the only factor associated with oral colonization by Candida . Low rates of antifungal resistance to azoles were detected in yeast isolates obtained from HIV-positive patients. Findings of this study may contribute to proper therapeutic selection for oral candidiasis in HIV-positive patients.

RESUMO Objetivo Investigar a suscetibilidade a antifúngicos e os fatores associados à colonização oral por espécies de Candida isoladas de pacientes HIV positivo. Métodos Estudo prospectivo realizado com amostragem por conveniência de indivíduos HIV positivo, acompanhados por um serviço de atendimento especializado da cidade de Rondonópolis, Mato Grosso, Brasil. Foram coletados swabs orais de 197 pacientes. As espécies de Candida foram identificadas por técnicas microbiológicas fenotípicas padrão e por método molecular. A suscetibilidade antifúngica foi determinada pelo método de microdiluição em caldo. Resultados Cento e um (51,3%) pacientes foram colonizados por Candida spp. Candida albicans foi a espécie mais prevalente (80%). Identificou-se um maior risco de colonização oral por espécies de Candida em pacientes com idade entre 45 e 59 anos (razão de prevalência: 1,90; IC95%: 1,57-6,31) e 60 anos ou mais (razão de prevalência: 4,43; IC95%: 1,57-34,18). A resistência ao fluconazol e ao cetoconazol foi de 1% cada e de 4% ao itraconazol. Conclusão O único fator associado à colonização oral por espécies de Candida foi ter 45 anos ou mais. Identificamos baixa taxa de resistência antifúngica aos azóis entre as leveduras isoladas de pacientes HIV positivo. Estes achados podem contribuir para selecionar o tratamento da candidíase oral em pacientes HIV positivos.