Correction: Frequency of co-seropositivities for certain pathogens and their relationship with clinical and histopathological changes and parasite load in dogs infected with Leishmania infantum.

[This corrects the article DOI: 10.1371/journal.pone.0247560.].

Overview of Q fever in Brazil: an underestimated zoonosis.

This review aims to provide current information about Q fever, elucidating the etiological, epidemiological, pathogenic, clinical, diagnostic, therapeutic, and prophylactic aspects of the disease for the medical community. We discuss the main forms of presentation of the agent, its ability to persist in the body, the infinite possibilities of susceptible hosts, the main known forms of transmission, its importance in populations at occupational risk, and the role of arthropods in the natural history of the disease. Focusing on Brazil, we present the cases already described and studies developed since its first report, and how there is still much to unravel. We are aware of the possibilities of the persistence of the agent and the development of severe clinical pictures and the specific treatments currently instituted. We also wish to raise awareness about the future, the new genotypes that are emerging, the need to study the effects of vaccines, and the impact of Q fever on the population. Q fever is a poorly understood disease in Latin America, and recent studies, especially in Brazil, have revealed the importance of developing new studies.

Overview of Q fever in Brazil: an underestimated zoonosis

ABSTRACT This review aims to provide current information about Q fever, elucidating the etiological, epidemiological, pathogenic, clinical, diagnostic, therapeutic, and prophylactic aspects of the disease for the medical community. We discuss the main forms of presentation of the agent, its ability to persist in the body, the infinite possibilities of susceptible hosts, the main known forms of transmission, its importance in populations at occupational risk, and the role of arthropods in the natural history of the disease. Focusing on Brazil, we present the cases already described and studies developed since its first report, and how there is still much to unravel. We are aware of the possibilities of the persistence of the agent and the development of severe clinical pictures and the specific treatments currently instituted. We also wish to raise awareness about the future, the new genotypes that are emerging, the need to study the effects of vaccines, and the impact of Q fever on the population. Q fever is a poorly understood disease in Latin America, and recent studies, especially in Brazil, have revealed the importance of developing new studies.

Fatal Brazilian spotted fever in a healthy military man during field training in Rio de Janeiro city, southeastern Brazil.

Brazilian spotted fever, a zoonotic disease transmitted by ticks, is caused by Rickettsia rickettsii. We report a fulminant case of this zoonosis in a healthy 46-year-old military man in the urban region of Rio de Janeiro city, in October, 2021. Ticks and capybaras (Amblyomma sculptum, Hydrochoerus hydrochaeris, respectively) were identified in the military fields, pointing to the participation of this large synanthropic rodent, recognized as an efficient amplifier host of Rickettsia rickettsii in Brazil. As the military population is considered a risk group for spotted fever, it is necessary to alert health professionals to the importance of the early detection of the disease and its adequate management, mainly in populations that are particularly at risk of exposure to ticks, in order to avoid fatal outcomes.

Prevalence of Bartonella species in shelter cats and their ectoparasites in southeastern Brazil.

Feline Bartonella can be transmitted to humans through cat scratches or bites, and between cats, by the flea Ctenocephalides felis. The study was carried out in order to investigate the occurrence of Bartonella DNA in cats living in shelters and their ectoparasites and the relationship between the infection status of cats and ectoparasites they host. Bartonella DNA was detected in 47.8% of the cat blood samples, 18.3% of C. felis fleas, 13.3% of flea egg pools and 12.5% of lice pools. B. henselae and B. clarridgeiae DNA were detected in cat fleas, while B. henselae, B. clarridgeiae and B. koehlerae were found in blood samples from bacteremic cats. Cats infested by positive ectoparasites showed approximately twice the odds of being infected. Our results indicate that shelter cats have high prevalence of Bartonella species that are known to be human pathogens. This highlights the importance of controlling infestations by ectoparasites to avoid cat and human infection.

Prevalence of Bartonella species in shelter cats and their ectoparasites in southeastern Brazil / Prevalência de espécies de Bartonella em gatos de abrigos e seus ectoparasitas no Sudeste do Brasil

Abstract Feline Bartonella can be transmitted to humans through cat scratches or bites, and between cats, by the flea Ctenocephalides felis. The study was carried out in order to investigate the occurrence of Bartonella DNA in cats living in shelters and their ectoparasites and the relationship between the infection status of cats and ectoparasites they host. Bartonella DNA was detected in 47.8% of the cat blood samples, 18.3% of C. felis fleas, 13.3% of flea egg pools and 12.5% of lice pools. B. henselae and B. clarridgeiae DNA were detected in cat fleas, while B. henselae, B. clarridgeiae and B. koehlerae were found in blood samples from bacteremic cats. Cats infested by positive ectoparasites showed approximately twice the odds of being infected. Our results indicate that shelter cats have high prevalence of Bartonella species that are known to be human pathogens. This highlights the importance of controlling infestations by ectoparasites to avoid cat and human infection.

Resumo Algumas espécies de Bartonella têm os felinos como principais hospedeiros reservatórios. Tais patógenos são transmitidos ao homem por intermédio da arranhadura ou mordedura de gatos e entre os gatos, por meio da pulga Ctenocephalides felis. O objetivo deste estudo foi investigar a ocorrência de DNA de Bartonella spp. em gatos de abrigos e seus ectoparasitas e a relação entre o estado de infecção dos gatos e dos ectoparasitas albergados por estes. Material genético bacteriano foi detectado em 47,8% das amostras de sangue de gatos, 18,3% das pulgas C. felis, 13,3% dos "pools" de ovos de pulgas e 12,5% dos "pools" de piolhos. DNA de B. henselae e B. clarridgeiae foi detectado em pulgas, e B. henselae, B. clarridgeiae e B. koehlerae, em amostras de sangue de gatos. Gatos infestados por ectoparasitas que carreavam DNA de Bartonella spp. demonstraram aproximadamente o dobro de chance de estarem infectados. Esses resultados indicam que os gatos de abrigos têm alta prevalência de infecção por espécies de Bartonella, capazes de causar doenças no homem. E também destacam a importância do controle e prevenção da infestação por ectoparasitas, no intuito de prevenir a infecção em gatos e humanos.

Fatal Brazilian spotted fever in a healthy military man during field training in Rio de Janeiro city, southeastern Brazil

ABSTRACT Brazilian spotted fever, a zoonotic disease transmitted by ticks, is caused by Rickettsia rickettsii. We report a fulminant case of this zoonosis in a healthy 46-year-old military man in the urban region of Rio de Janeiro city, in October, 2021. Ticks and capybaras (Amblyomma sculptum, Hydrochoerus hydrochaeris, respectively) were identified in the military fields, pointing to the participation of this large synanthropic rodent, recognized as an efficient amplifier host of Rickettsia rickettsii in Brazil. As the military population is considered a risk group for spotted fever, it is necessary to alert health professionals to the importance of the early detection of the disease and its adequate management, mainly in populations that are particularly at risk of exposure to ticks, in order to avoid fatal outcomes.

Serological evidence of Bartonellosis in an indigenous community in the Brazilian Legal Amazonia.

BACKGROUND: Due to immunological susceptibility, close contact with the environment and way of life, indigenous communities are in a highly vulnerable condition to be affected by zoonoses, such as bartonellosis. METHODS: Seventy three paired serum samples were collected from indigenous people from a region of the Brazilian Legal Amazon, in cohorts carried out in 2014 and 2015, with the performance of serological tests by indirect immunofluorescence to detect anti-Bartonella IgG antibodies. The interviews and laboratory results were double entered in the EpiInfo 7 software, and the data processing was performed in the MiniTab 17 software. RESULTS: 5.47% of the indigenous people were seroreagent. The female gender was predominant (65.75%), aged between 20 and 39 years old (39.73%) with complete elementary school (42.47%). As for housing, wooden residences predominated (50.68%). Rodents were seen by 46.58% of the interviewees, and 55.88% of them reported that the animal was close to or inside the house. It was identified that each indigenous family, in its majority, had four to six cats, for the function of hunters of rodents. CONCLUSION: The high concentration of domestic cats, the close contact of indigenous people with wild rodents and the lack of care and poor hygiene of both are aspects that imply the possibility of infection by Bartonella sp. Health surveillance through seroepidemiological studies is essential to find evidence of the circulation of bartonellosis in these populations.

Vacinas / Vaccines

Apresenta breve histórico sobre o desenvolvimento de vacinas, o que são as vacinas e porque vacinamos. Comenta sobre a vanguarda do Brasil nos programas de vacinação no século XXI

Description of COVID-19 cluster: isolation and testing in asymptomatic individuals as strategies to prevent local dissemination in Mato Grosso state, Brazil, 2020. / Descrição de um cluster da COVID-19: o isolamento e a testagem em assintomáticos como estratégias de prevenção da disseminação local em Mato Grosso, 2020.

OBJECTIVE: to describe a COVID-19 cluster and the strategies used to contain the virus, in a municipality in the interior region of Mato Grosso state, Brazil. METHODS: this is a descriptive study of documental records of an epidemiological investigation conducted in April 2020. RESULTS: introduction of SARS-CoV-2 in the municipality was identified through a cluster comprised of five people, 4 were symptomatic and 1 was asymptomatic, after the virus was imported by index cases C01 and C02; in addition to household transmission (C03, C04), a physiotherapist (C05) was infected through contact with C02; with the exception of C04, all had an influenza-like symptoms and C02 required hospitalization; as for laboratory tests, all were seroreactive and C01 was RT-PCR positive. CONCLUSION: dissemination of COVID-19 was contained by effective home isolation, an important instrument that should be adopted early by unaffected municipalities to contain virus dissemination, as well as by serological testing that detected infection in asymptomatic patients.

A Retrospective Survey of Rodent-borne Viruses in Rural Populations of Brazilian Amazon.

INTRODUCTION: The Amazon tropical rainforest has the most dense and diverse ecosystem worldwide. A few studies have addressed rodent-borne diseases as potential hazards to humans in this region. METHODS: A retrospective survey was conducted using enzyme-linked immunosorbent assay for detecting mammarenavirus and orthohantavirus antibodies in 206 samples collected from rural settlers of the Brazilian Western Amazonian region. RESULTS: Six (2.91%) individuals in the age group of 16 to 36 years were found to possess antibodies against mammarenavirus. CONCLUSION: Evidence of previous exposure to mammarenavirus in the rural population points to its silent circulation in this region.

Níveis pressóricos de uma comunidade indígena do cerrado brasileiro / Pressorial levels of an indigenous community of the Brazilian closure

Buscou-se analisar os níveis pressóricos dos Haliti-Paresí e sua relação com alguns aspectos sociodemográficos. Trata-se de estudo transversal, descritivo e com abordagem quantitativa, realizado com a comunidade indígena Haliti-Paresí. A coleta de dados foi realizada em dezembro de 2015 com os residentes da terra indígena Utiariti. Realizou-se a análise estatística bivariada da Pressão Arterial (PA), Pressão Arterial Sistólica (PAS) e Pressão Arterial Diastólica (PAD) em função das variáveis independentes, sendo que as variáveis que apresentaram significância estatística com p<0,05 foram utilizadas para construir o modelo de regressão de Poisson robusto. Foi possível identificar o predomínio de jovens e com ensino fundamental incompleto. A hipertensão no estágio 1 apresentou prevalência de PA (21,85%), PAS (14,29%) e PAD (17,65%) (p<0,001). Na análise bivariada foram identificadas significâncias estatísticas para PA e PAS nas variáveis independentes sexo masculino, idade maior que 60 anos e realizar a atividade agrícola, caça, pesca e coleta. No entanto, a PAD apresentou as mesmas significâncias estatísticas supracitadas, porém sem associação com idade. Faz-se necessária a realização de ações de promoção, prevenção e elaboração de planos estratégicos que visam ampliar os hábitos saudáveis e consequente elevação da qualidade de vida desses indígenas.(AU)

The aim was to analyze the pressure levels of the Haliti-Paresí and their relationship with some sociodemographic aspects. It is a cross-sectional, descriptive study with a quantitative approach, carried out with the Haliti-Paresí indigenous community. Data collection was carried out in December 2015 with residents of Utiariti indigenous land. The bivariate statistical analysis of the arterial pressure (BP), systolic arterial pressure (SBP) and diastolic blood pressure (DBP) was performed as a function of the independent variables, and the variables that presented statistical significance with p <0.05, were used to construct the robust Poisson regression model. It was possible to identify the predominance of young people with incomplete primary education. Hypertension in stage 1 presented a prevalence of AP (21.85%), SBP (14.29%) and DBP (17.65%) (p <0.001). In the bivariate analysis, statistical significance was identified for PA and SBP in the independent variables male sex, age > 60 years and to perform the agricultural activity, hunting, fishing and collection. However, PAD presented the same statistical significance as above, but without association with age. It is necessary to carry out actions of promotion, prevention and elaboration of strategic plans that aim to increase the healthy habits and consequent elevation of the quality of life of these natives.(AU)

A Retrospective Survey of Rodent-borne Viruses in Rural Populations of Brazilian Amazon

Abstract INTRODUCTION: The Amazon tropical rainforest has the most dense and diverse ecosystem worldwide. A few studies have addressed rodent-borne diseases as potential hazards to humans in this region. METHODS: A retrospective survey was conducted using enzyme-linked immunosorbent assay for detecting mammarenavirus and orthohantavirus antibodies in 206 samples collected from rural settlers of the Brazilian Western Amazonian region. RESULTS: Six (2.91%) individuals in the age group of 16 to 36 years were found to possess antibodies against mammarenavirus. CONCLUSION: Evidence of previous exposure to mammarenavirus in the rural population points to its silent circulation in this region.

Descrição de um cluster da COVID-19: o isolamento e a testagem em assintomáticos como estratégias de prevenção da disseminação local em Mato Grosso, 2020 / Descripción de un grupo de COVID-19: aislamiento y pruebas en individuos asintomáticos como estrategias para prevenir la diseminación local en Mato Grosso, Brasil, 2020 / Description of COVID-19 cluster: isolation and testing in asymptomatic individuals as strategies to prevent local dissemination in Mato Grosso state, Brazil, 2020

Objetivo: descrever um cluster da COVID-19 e as estratégias utilizadas para a contenção do vírus, num município do interior de Mato Grosso, Brasil. Métodos: estudo descritivo com dados dos registros documentais da investigação epidemiológica realizada em abril de 2020. Resultados: a introdução do vírus SARS-CoV-2 no município foi identificada a partir do cluster com cinco pessoas, sendo quatro sintomáticas e uma assintomática, consequente à importação pelos casos índices C01 e C02; além da transmissão intradomiciliar (C03 e C04), uma fisioterapeuta (C05) foi infectada por C02; com exceção do C04, todos apresentaram um quadro influenza símile e somente C02 necessitou de internação; quanto aos testes laboratoriais, todos foram sororreativos, e somente C01 foi RT-PCR positivo. Conclusão: a disseminação da COVID-19 foi contida pelo isolamento domiciliar, uma importante estratégia que deve ser adotada precocemente pelos municípios indenes na contenção da disseminação viral, e pelo teste sorológico, que detectou a infecção em assintomáticos.

Objetivo: describir un grupo de COVID-19 y las estrategias para contener el virus, en el interior de Mato Grosso, Brasil. Métodos: estudio descriptivo de los registros documentales de la investigación epidemiológica realizada en abril de 2020. Resultados: la introducción del SARS-CoV-2 en el municipio se identificó del grupo con cinco personas, cuatro sintomáticas y una asintomática, como consecuencia de la importación por los casos índices C01 y C02; además de la transmisión domiciliaria (C03 y C04), una fisioterapeuta (C05) infectada con C02; con excepción de C04, todos presentaron un cuadro influenza símile y solamente C02 requería hospitalización; en cuanto a las pruebas de laboratorio, todas fueron serorreactivas y sólo C01 fue RT-PCR positivo. Conclusión: la diseminación de COVID-19 fue contenida por el aislamiento domiciliario efectivo, un instrumento importante que los municipios indemnes deben adoptar con anticipación a la diseminación viral, y mediante la prueba serológica que detectó la infección en pacientes asintomáticos.

Objective: to describe a COVID-19 cluster and the strategies used to contain the virus, in a municipality in the interior region of Mato Grosso state, Brazil. Methods: this is a descriptive study of documental records of an epidemiological investigation conducted in April 2020. Results: introduction of SARS-CoV-2 in the municipality was identified through a cluster comprised of five people, 4 were symptomatic and 1 was asymptomatic, after the virus was imported by index cases C01 and C02; in addition to household transmission (C03, C04), a physiotherapist (C05) was infected through contact with C02; with the exception of C04, all had an influenza-like symptoms and C02 required hospitalization; as for laboratory tests, all were seroreactive and C01 was RT-PCR positive. Conclusion: dissemination of COVID-19 was contained by effective home isolation, an important instrument that should be adopted early by unaffected municipalities to contain virus dissemination, as well as by serological testing that detected infection in asymptomatic patients.

Identification and validation of specific B-cell epitopes of hantaviruses associated to hemorrhagic fever and renal syndrome.

BACKGROUND: Orthohantavirus infection is a neglected global health problem affecting approximately 200,000 people/year, spread by rodent hosts and associated to fatal human diseases, such as hemorrhagic fever with renal syndrome (HFRS) and orthohantavirus cardiopulmonary syndrome (HCPS). Circulation of HFRS-associated orthohantaviruses, such as Seoul, Gou, Amur, Dobrava and Hantaan, are supposed to be restricted to Eurasian countries even though their hosts can be a worldwide distribution. Few confirmed HFRS orthohantavirus infections in humans have been reported in American countries, but due to lower medical awareness of the symptoms of this zoonosis, it could be associated to viral underreporting or to misdiagnosis with several tropical hemorrhagic diseases. Serological evidence of orthohantavirus infections, using enzyme-linked immunosorbent assay for the presence of immunoglobulin M and G against recombinant nucleoprotein protein, remains as an essential assay for viral surveillance. In this study, we aimed to identify in silico immunogenic B-cell linear epitopes present on orthohantavirus nucleoprotein that are exclusive to HFRS-related species. METHODOLOGY/PRINCIPAL FINDINGS: In silico analysis were performed using Seoul orthohantavirus nucleoprotein (SHNP) sequence as a model. Linear B-cell-epitopes on SHNP and its immunogenicity were predicted by BepiPred-2.0 and Vaxijen algorithms, respectively. The conservancy of predicted epitopes was compared with the most clinically relevant HFRS or HCPS-associated orthohantavirus, aiming to identify specific sequences from HFRS-orthohantavirus. Peptide validation was carried out by ELISA using Balb/c mice sera immunized with purified recombinant rSHNP. Peptides cross-reactivity against HCPS orthohantavirus were evaluated using immunized sera from mice injected with recombinant Juquitiba orthohantavirus nucleoprotein (rJHNP). CONCLUSION/SIGNIFICANCE: In silico analysis revealed nine potential immunogenic linear B-cell epitopes from SHNP; among them, SHNP(G72-D110) and SHNP(P251-D264) showed a high degree of sequence conservation among HFRS-related orthohantavirus and were experimentally validated against rSHNP-IMS and negatively validated against rJHNP-IMS. Taken together, we identified and validated two potential antigenic B-cell epitopes on SHNP, which were conserved among HFRS-associated orthohantavirus and could be applied to the development of novel immunodiagnostic tools for orthohantavirus surveillance.

Hantavirus pulmonary syndrome in children: case report and case series from an endemic area of Brazil.

Hantavirus Cardiopulmonary Syndrome (HCPS) is an important emergent zoonosis associated with wild rodents in Brazil, where this viral infection in children is generally rare. We present HCPS in a child from the Pantanal Biome and a review of all reported pediatric cases in Mato Grosso State, an endemic area for HCPS in Brazil. The investigation used the Information System for Notifiable Diseases database (SINAN). A 12-year-old boy was hospitalized with fever and respiratory failure and hantavirus IgM and IgG antibodies were detected by ELISA in serum samples. During the period of 1999 to 2016, 32 HCPS pediatric cases confirmed by serology were reported to SINAN with a mortality rate of 34.4%. The possibility of hantavirus infection in children with acute febrile illness associated with respiratory failure should be considered mainly in recognized endemic areas as Mato Grosso State, contradicting a hypothesis that children are more protected from lung involvement.

Seroprevalence of rodent-borne viruses in Afro-descendent communities in Brazil.

During the Brazilian slavery period, many African migrants were brought to the American continent. Historically, some of these migrants escaped from the Brazilian gold mines and farms to which they had been brought and settled in remote valleys and this was the main mode of resistance to the slavery system. These runaway-slave descendant communities are called quilombos, a group with distinct ethnic identity, specific behavioral habits, including geographic isolation and conservative practices. The objective of this study was to investigate the prevalence of rodent-borne viruses in two Afro-descendent communities from Mato Grosso do Sul State, Midwestern Brazil. A total of 319 individuals from rural and urban quilombola communities were enrolled. Twelve (3.76%) had anti-rodent-borne virus IgG antibodies. Seven (2.19%) were anti-mammarenavirus reactive and nine (2.82%) had anti-orthohantavirus antibodies. The literature includes limited data on the health status of quilombola communities, but all the studies emphasize the disparity of attention of local healthcare personnel to these communities compared to the general population. The findings of this study highlight the vulnerability and the precarious health conditions of quilombola groups, especially those living in rural areas and thus, point to the need of preventive measures to improve access to healthcare for this ethnic group.

Prevalence of enteroparasitosis in the indigenous community of Mato Grosso, Brazil: a look into the sanitation and ethno-development / Prevalência de enteroparasitoses em comunidade indígena de Mato Grosso, Brasil: um olhar sobre o saneamento e etnodesenvolvimento

The intestinal parasitic diseases directly affect the quality of life of indigenous populations, because of vulnerabilities they experience. This study aimed to understand the prevalence of intestinal parasites among the Haliti-Paresí and relate with sanitation and ethno-development. It is a quantitative and cross-sectional study on indigenous Utiaritiland where reside the Haliti-Paresí, in the middle region northern Mato Grosso, Brazil. Data collection occurred in 2015, from interview with application of semi-structured form and collection of feces for coprological survey.Forty-three indigenous people participated in the study, of an average age of 30.9 years old, mostly women, and a predominance of basic education. The prevalence of enteroparasitosis was 46.6%, predominantly among men, reaching all adolescents, followed by children, without the influence of schooling in the rate of infection. Nine species were detected, being six pathogenic, Giardia duodenalis, Entamoebahistolytica, Ancilostomídeo, Blastocystishominis, Hymenolepis nana and Rodentolepis nana, in addition to three non-pathogenic, Iodamoebabutschlii, Entamoeba coli and Endolimax nana.The sanitation conditions, associated with cultural habits, point to the need for improvement in sanitation, since we detected a high prevalence of intestinal parasitoses in this study. The ethno-development may be crucial as strategies for the maintenance of culture in balance with health and sanitary development.

As doenças parasitárias intestinais impactam diretamente na qualidade de vida das populações indígenas, em decorrência das vulnerabilidades que vivenciam. Objetivou-se conhecer a prevalência das parasitoses intestinais entre os Haliti-Paresí e relacionar com o saneamento e etnodesenvolvimento. Trata-se de um estudo quantitativo e transversal na terra indígena Utiariti onde residem os Haliti-Paresí, na região médio Norte de Mato Grosso, Brasil. A coleta de dados ocorreu em 2015, a partir de entrevista com aplicação de formulário semiestruturado e coleta de fezes para inquérito coprológico. Participaram do estudo 43 indígenas, com idade média de 30,9 anos, maioria mulheres e predomínio do ensino fundamental. A prevalência de enteroparasitoses foi de 46,6%, predominando entre os homens, atingindo todos os adolescentes, seguido pelas crianças, sem influência da escolaridade na taxa de infecção. Nove espécies foram detectadas, sendo seis patogênicos, Giardiaduodenalis, Entamoebahistolytica, Ancilostomídeo, Blastocystishominis, Hymenolepis nana e Rodentolepis nana, além de três não patogênicas, Iodamoebabutschlii, Entamoeba coli e Endolimax nana. As condições de saneamento associadas aos hábitos culturais apontam para necessidade de melhoria no saneamento, uma vez que detectamos alta prevalência de parasitoses intestinais neste estudo. O etnodesenvolvimento poderá ser fundamental como estratégias de manutenção da cultura em equilíbrio com a saúde e desenvolvimento sanitário.

Epidemiological and clinical profile of infective endocarditis at a Brazilian tertiary care center: an eight-year prospective study.

INTRODUCTION: Infective endocarditis (IE) is a systemic infectious disease requiring a multidisciplinary team for treatment. This study presents the epidemiological and clinical data of 73 cases of IE in Rio de Janeiro, Brazil. METHODS: This observational prospective cohort study of endocarditis patients during an eight-year study period described 73 episodes of IE in 70 patients (three had IE twice). Community-associated (CAIE) and healthcare-acquired infective endocarditis (HAIE) were diagnosed according to the modified Duke criteria. The collected data included demographic, epidemiologic, and clinical characteristics, including results of blood cultures, echocardiographic findings, surgical interventions, and outcome. RESULTS: Analysis of data from the eight-year study period and 73 cases (70 patients) of IE showed a mean age of 46 years (SD=2.5 years; 1-84 years) and that 65.7% were male patients. The prevalence of CAIE and HAIE was 32.9% and 67.1%, respectively. Staphylococcus aureus (30.1%), Enterococcus spp. (19.1%), and Streptococcus spp. (15.0%) were the prevalent microorganisms. The relevant signals and symptoms were fever (97.2%; mean 38.6 + 0.05°C) and heart murmur (87.6%). Vegetations were observed in the mitral (41.1%) and aortic (27.4%) valves. The mortality rate of the cases was 47.9%. CONCLUSIONS: In multivariate analysis, chronic renal failure (relative risk [RR]= 1.60; 95% confidence interval [CI] 1.01-2.55), septic shock (RR= 2.19; 95% CI 1.499-3.22), and age over 60 years (RR= 2.28; 95% CI 1.44-3.59) were indirectly associated with in-hospital mortality. The best prognosis was related to the performance of cardiovascular surgery (hazard ratio [HR]= 0.51; 95% CI 0.26-0.99).