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Measles, mumps and rubella vaccine 12 months after hematopoietic stem cell transplantation
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Randi, Bruno Azevedo

; Fernandes, Eder Gatti

; Higashino, Hermes Ryoiti

; Lopes, Marta Heloisa

; Rocha, Vanderson Geraldo

; Costa, Silvia Figueiredo

; Sartori, Ana Marli Christovam

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e21

Abstract: En | Text: En | PDF: En

ABSTRACT The measles, mumps and rubella (MMR) vaccine is usually recommended from 24 months after a hematopoietic stem cell transplant (HSCT). Some authors have demonstrated that the MMR vaccination can be safe from 12 months post-HSCT in non-immunosuppressed patients, as recommended by the Brazilian National Immunization Program/Ministry of Health, since 2006. The objectives of this study were to evaluate when patients received MMR vaccine after an HSCT in our care service and if there were reports of any side effects. We retrospectively reviewed the records of HSCT recipients who received at least one MMR dose in our care service, a quaternary teaching hospital in Sao Paulo city, Brazil, from 2017 to 2021. We identified 82 patients: 75.6% (90.1% in the autologous group and 45.1% in the allogeneic group) were vaccinated before 23 months post-transplantation. None reported side effects following the vaccination. Our data support that the MMR vaccination is safe from 12 to 23 months after HSCT.

https://doi.org/10.1590/s1678-9946202365021

Streptococcus constellatus causing concomitant extra and intracranial abscesses complicated with sagittal sinus thrombosis
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Farias, Luís Arthur Brasil Gadelha

; Firmino, Natália Nogueira

; Sousa, Marcos Maciel

; Lira, Mateus Lavor

; Meireles, Leonardo Nogueira

; Stolp, Ângela Maria Veras

; Maia, Kelma Maria

; Costa, Silvia Figueiredo

; Perdigão Neto, Lauro Vieira

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e10

Abstract: En | Text: En | PDF: En

ABSTRACT Streptococcus constellatus is a gram-positive coccus member of the Streptococcus anginosus group (SAG). It can be found in the oral flora, and may cause abscess more commonly in the gastrointestinal tract, lungs, and heart. Brain abscesses are severe neurological infections with high mortality rates. Streptococcus species other than S. pneumoniae are rare causes of brain abscesses. This case report highlights a severe case of extra and intracranial abscesses due to S. constellatus in an immunocompetent host

https://doi.org/10.1590/s1678-9946202365010

Meningitis caused by Capnocytophaga canimorsus in a COVID-19 patient: a rare complication of dog bites
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Farias, Luís Arthur Brasil Gadelha

; Stolp, Ângela Maria Veras

; Bandeira, Silviane Praciano

; Mesquita, Rafael Ferreira

; Bessa, Pedro Pinheiro de Negreiros

; Holanda, Pablo Eliack Linhares de

; Costa, Silvia Figueiredo

; Takeda, Christianne Fernandes Valente

; Perdigão Neto, Lauro Vieira

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e33

Abstract: En | Text: En | PDF: En

ABSTRACT Capnocytophaga canimorsus is a gram-negative rod that is part of the commensal microbiota of dogs’ and cats’ mouths. In this case, we report an 85-year-old man with COVID-19 who had his right arm bitten by a dog. His symptoms were impaired consciousness, agitation and aggressive behavior. Physical examination revealed neck stiffness and Brudzinski’s sign. The cerebrospinal fluid culture was compatible with Capnocytophaga canimorsus. He required intensive care and received a 14-day prescription of meropenem. After 40 days of hospitalization, the patient was fully recovered and was discharged. This case highlights the importance of physician and microbiologist be awareness of this disease, mainly in patients with neurological symptoms after a dog or cat bite.

https://doi.org/10.1590/s1678-9946202264033

COVID-19 and isolation: Risks and implications in the scenario of new variants
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Dias, Viviane Maria de Carvalho Hessel

; Oliveira, Alexandre Ferreira

; Marinho, Ana Karolina Barreto Berselli

; Santos Ferreira, Carlos Eduardo dos

; Domingues, Carlos Eduardo Ferreira

; Fortaleza, Carlos Magno Castelo Branco

; Vidal, Claudia Fernanda de Lacerda

; Carrilho, Claudia Maria Dantas de Maio

; Pinheiro, Debora Otero Britto Passos

; de Assis, Denise Brandão

; Medeiros, Eduardo Alexandrino

; Morejón, Karen Mirna Loro

; Weissmann, Leonardo

; Michelin, Lessandra

; Carneiro, Marcelo

; Nogueira, Maria Dolores Santos da Purificação

; de Oliveira, Priscila Rosalba Domingos

; Buralli, Rafael Junqueira

; Stucchi, Raquel Silveira Bello

; Lins, Rodrigo Schrage

; Costa, Silvia Figueiredo

; Chebabo, Alberto

Brazilian Journal of Infectious Diseases

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2022, Volume 26 N. 5 elocation 102703

Abstract: En | Text: En | PDF: En

Abstract With the emergence of new variants of SARS-CoV-2, questions about transmissibility, vaccine efficacy, and impact on mortality are important to support decision-making in public health measures. Modifications related to transmissibility combined with the fact that much of the population has already been partially exposed to infection and/or vaccination, have stimulated recommendations to reduce the isolation period for COVID-19. However, these new guidelines have raised questions about their effectiveness in reducing contamination and minimizing impact in work environments. Therefore, a collaborative task force was developed to review the subject in a non-systematic manner, answering questions about SARS-CoV-2 variants, COVID-19 vaccines, isolation/quarantine periods, testing to end the isolation period, and the use of masks as mitigation procedures. Overall, COVID-19 vaccines are effective in preventing severe illness and death but are less effective in preventing infection in the case of the Omicron variant. Any strategy that is adopted to reduce the isolation period should take into consideration the epidemiological situation of the geographical region, individual clinical characteristics, and mask for source control. The use of tests for isolation withdrawal should be evaluated with caution, due to results depending on various conditions and may not be reliable.

https://doi.org/10.1016/j.bjid.2022.102703

Evaluation of eleven immunochromatographic assays for SARS-CoV-2 detection: investigating the dengue cross-reaction
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Oliveira, Beatriz Araujo

; Oliveira, Lea Campos de

; Oliveira, Franciane Mendes de

; Pereira, Geovana Maria

; Souza, Regina Maia de

; Manuli, Erika Regina

; Marchini, Fabricio Klerynton

; Espinoza, Evelyn Patrícia Sanchez

; Park, Marcelo

; Taniguchi, Leandro

; Mendes, Pedro Vitale

; Franco, Lucas Augusto Moyses

; Nastri, Ana Catharina

; Oliveira, Maura Salaroli de

; Vieira Junior, José Mauro

; Kallas, Esper Georges

; Levin, Anna Sara

; Sabino, Ester Cerdeira

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e63

Abstract: En | Text: En | PDF: En

ABSTRACT COVID-19 disease is spread worldwide and diagnostic techniques have been studied in order to contain the pandemic. Immunochromatographic (IC) assays are feasible and a low-cost alternative especially in low and middle-income countries, which lack structure to perform certain diagnostic techniques. Here we evaluate the sensitivity and specificity of eleven different IC tests in 145 serum samples from confirmed cases of COVID-19 using RT-PCR and 100 negative serum samples from blood donors collected in February 2019. We also evaluated the cross-reactivity with dengue using 20 serum samples from patients with confirmed diagnosis for dengue collected in early 2019 through four different tests. We found high sensitivity (92%), specificity (100%) and an almost perfect agreement (Kappa 0.92) of IC assay, especially when we evaluated IgG and IgM combined after 10 days from the onset of symptoms with RT-PCR. However, we detected cross-reactivity between dengue and COVID-19 mainly with IgM antibodies (5 to 20% of cross-reaction) and demonstrated the need for better studies about diagnostic techniques for these diseases.

https://doi.org/10.1590/s1678-9946202264063

MRSA outbreak in a Neonatal Intensive Care Unit in a developed country: importance of rapid detection of reservoirs and implementation of intervention measures
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Moura, Maria Luísa

; Rizek, Camila Fonseca

; Aguiar, Elisa

; Barros, Ana Natiele da Silva

; Costa, Sibeli

; Santos, Sania Alves dos

; Marchi, Ana Paula

; Gibelli, Maria Augusta Bento Cicaroni

; Tragante, Carla Regina

; Araújo, Maria Rita Elmor de

; Rossi, Flavia

; Guimaraes, Thais

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e58

Abstract: En | Text: En | PDF: En

ABSTRACT We described a MRSA bloodstream infection outbreak that was rapidly identified and controlled in a Neonatal Intensive Care Unit after implementation of a bundle of measures, including PCR-screening and HCW decolonization. We found 35% of healthcare workers(HCW) colonized with S. aureus by PCR, one of them that presented skin lesion positive for MSSA (same clone and spa type than two patients). Our findings raise the hypothesis that the outbreak could be related to HCW colonization.

https://doi.org/10.1590/s1678-9946202264058

Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units
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Mendes, Elisa Teixeira

; Salomão, Matias Chiarastelli

; Tomichi, Lísia Moura

; Oliveira, Maura Salaroli

; Graça, Mariana

; Rossi, Flavia

; Sapadao, Fernanda

; Guimarães, Thais

; Rocha, Vanderson

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e77

Abstract: En | Text: En | PDF: En

ABSTRACT Surveillance strategies to detect colonization are an important tool to prevent and control the spread of microorganisms in hematopoietic stem cell transplant (HSCT) units. The aim of this study was to evaluate routine surveillance cultures for screening colonization and infection by carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPa), and vancomycin-resistant enterococci (VRE). Surveillance cultures were collected (1,323 samples) from 200 patients admitted to an HSCT unit over one year; swabs were taken on admission and then weekly. We compared the positivity of cultures for each site, agent, clinical and epidemiological data according to the colonization status. Infection due to multidrug-resistant organisms (MDROs) occurred in 52 (21.5%) patients, 45 (86.5%) due to blood stream infection; 12 (23%) patients had a positive surveillance culture before the infection. Cultures of 554 (41.8%) samples were performed for CRPa, 413 (31.2%) for VRE and 356 (27%) for CRE. Of these, 179 (13.5%) were positive. Colonization by any MDRO, CRE or CRPa was associated with increased risk of infection (P < 0.05), but not with death. Previous colonization by an MDRO was a significant risk for infection by these pathogens, specially by CRE. Overall, rectal swabs had the highest positivity rate compared with other sites, oropharynx swabs were an option for CRPa, and fecal cultures showed low positivity. Although the impact of the strategy on the mortality of patients undergoing HSCT is not clear, routine VRE surveillance should be questioned with regard to patients undergoing auto-HSCT due to the additional cost and little impact on survival rates.

https://doi.org/10.1590/s1678-9946202163077 50 downloads

Colistin-resistant Escherichia coli belonging to different sequence types: genetic characterization of isolates responsible for colonization, community- and healthcare-acquired infections
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Paiva, Yrving

; Nagano, Debora Satie

; Cotia, Andre Luis Franco

; Guimarães, Thais

; Martins, Roberta Cristina Ruedas

; Perdigão Neto, Lauro Vieira

; Côrtes, Marina Farrel

; Marchi, Ana Paula

; Corscadden, Louise

; Machado, Anna Silva

; Paula, Alexandre Inácio de

; Franco, Lucas Augusto Moyses

; Neves, Patricia Regina

; Levin, Anna Sara

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e38

Abstract: En | Text: En | PDF: En

ABSTRACT The plasmid-mediated colistin-resistance gene named mcr-1 has been recently described in different countries and it became a public health challenge. Of note, few studies have addressed the spread of Escherichia coli harboring the mcr-1 gene in both, community and hospital settings. A total of seven colistin-resistant E. coli carrying mcr-1, collected from 2016 to 2018, from community (n=4), healthcare-acquired infections (n=2) and colonization (n=1) were identified in three high complexity hospitals in Sao Paulo, Brazil. These colistin-resistant isolates were screened for mcr genes by PCR and all strains were submitted to Whole Genome Sequencing and the conjugation experiment. The seven strains belonged to seven distinct sequence types (ST744, ST131, ST69, ST48, ST354, ST57, ST10), and they differ regarding the resistance profiles. Transference of mcr-1 by conjugation to E. coli strain C600 was possible in five of the seven isolates. The mcr-1 gene was found in plasmid types IncX4 or IncI2. Three of the isolates have ESBL-encoding genes (blaCTX-M-2, n=2; blaCTX-M-8, n=1). We hereby report genetically distinct E. coli isolates, belonging to seven STs, harboring the mcr-1 gene, associated to community and healthcare-acquired infections, and colonization in patients from three hospitals in Sao Paulo. These findings point out for the potential spread of plasmid-mediated colistin-resistance mechanism in E. coli strains in Brazil.

https://doi.org/10.1590/s1678-9946202163038 332 downloads

Are mobile phones part of the chain of transmission of SARS-CoV-2 in hospital settings?
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Espinoza, Evelyn Patricia Sánchez

; Cortes, Marina Farrel

; Noguera, Saidy Vasconez

; Paula, Anderson Vicente de

; Guimarães, Thais

; Boas, Lucy Santos Villas

; Park, Marcelo

; Silva, Cristina Carvalho da

; Morales, Ingra

; Perdigão Neto, Lauro Vieira

; Tozetto-Mendoza, Tania Regina

; Boszczowski, Icaro

; Sabino, Ester Cerdeira

; Mendes-Correa, Maria Cássia

; Levin, Anna Sara

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e74

Abstract: En | Text: En | PDF: En

ABSTRACT Mobile phones (MPs) have become an important work tool around the world including in hospitals. We evaluated whether SARS-CoV-2 can remain on the surface of MPs of first-line healthcare workers (HCW) and also the knowledge of HCWs about SARS-CoV-2 cross-transmission and conceptions on the virus survival on the MPs of HCWs. A cross-sectional study was conducted in the COVID-19 Intensive Care Unit of a teaching hospital. An educational campaign was carried out on cross-transmission of SARS-CoV-2, and its permanence in fomites, in addition to the proper use and disinfection of MPs. Herewith an electronic questionnaire was applied including queried conceptions about hand hygiene and care with MP before and after the pandemic. The MPs were swabbed with a nylon FLOQ Swab™, in an attempt to increase the recovery of SARS-CoV-2. All MP swab samples were subjected to SARS-CoV-2 RT-PCR; RT-PCR positive samples were subjected to viral culture in Vero cells (ATCC® CCL-81™). Fifty-one MPs were swabbed and a questionnaire on hand hygiene and the use and disinfection of MP was applied after an educational campaign. Most HCWs increased adherence to hand hygiene and MP disinfection during the pandemic. Fifty-one MP swabs were collected and two were positive by RT-PCR (4%), with Cycle threshold (Ct ) values of 34-36, however, the cultures of these samples were negative. Although most HCWs believed in the importance of cross-transmission and increased adherence to hand hygiene and disinfection of MP during the pandemic, SARS-CoV-2 RNA was detected in MPs. Our results suggest the need for a universal policy in infection control guidelines on how to care for electronic devices in hospital settings.

https://doi.org/10.1590/s1678-9946202163074 177 downloads

10.

Susceptibility to chlorhexidine and mupirocin among methicillin-resistant Staphylococcus aureus clinical isolates from a teaching hospital
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Bes, Taniela Marli

; Perdigão-Neto, Lauro

; Martins, Roberta Ruedas

; Heijden, Inneke

; Trindade, Priscila de Arruda

; Camilo, Gaspar

; Nagano, Debora Satie

; Mongelos, Diego

; Marchi, Ana Paula

; Tomaz, Mariama

; Oliveira, Larissa Marques de

; Rossi, Flavia

; Levin, Anna Sara

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e27

Abstract: En | Text: En | PDF: En

ABSTRACT Despite the widespread use of chlorhexidine (CHX) to prevent infection, data regarding the in vitro action of CHX against methicillin-resistant Staphylococcus aureus (MRSA) are limited. Clinical isolates from Hospital das Clinicas, Sao Paulo, Brazil, identified during 2002/2003 and 2012/2013 were studied to describe the susceptibility to CHX and mupirocin, molecular characteristics, and virulence profile of MRSA. Susceptibility test to Mupirocin was performed by the disk diffusion method and to CHX by the agar dilution technique. PCR for virulence genes, mecA gene and Staphylococcal Cassette Chromosome mec (SCCmec) types were investigated as well. Mupirocin- and CHX-resistant isolates were sequenced using the IlluminaTM plataform. Two hundred and sixteen MRSA clinical isolates were evaluated: 154 from infected and 62 from colonized patients. Resistance to mupirocin was observed in four isolates assigned as SCCmec type III and STs (ST05; ST239 and ST105) carrying mupA and blaZ, two of them co-harboring the ileS gene. Only one isolate assigned as SCCmec type III was resistant to CHX (MIC of 8.0 μg.mL-1) and harbored the qacA gene. Resistance to chlorhexidine and mupirocin were found in isolates carrying qacA and mupA in our hospital. Since these genes are plasmid-mediated, this finding draws attention to the potential spread of resistance to mupirocin in our hospital.

https://doi.org/10.1590/s1678-9946202163027 431 downloads

11.

Conjugative transfer of plasmid p_8N_qac(MN687830.1) carrying qacA gene from Staphylococcus aureus to Escherichia coli C600: potential mechanism for spreading chlorhexidine resistance
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Bes, Taniela Marli

; Nagano, Debora Satie

; Marchi, Ana Paula

; Camilo, Gaspar

; Perdigão-Neto, Lauro Vieira

; Martins, Roberta Ruedas

; Levin, Anna Sara

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e82

Abstract: En | Text: En | PDF: En

ABSTRACT The methicillin resistant Staphylococcus aureus (MRSA) is recognized by its ability to acquire and transferring resistance genes through interspecies conjugative plasmids. However, transference of plasmids from Gram-positive cocci to Gram-negative bacilli is not well characterized. In this report, we describe the transfer of a conjugative plasmid carrying qacA from MRSA to Escherichia coli C600. We performed a conjugation experiment using a chlorhexidine resistant MRSA isolate (ST-105/SCCmec type III) carrying the gene qacA and qacC as the donor and a chlorhexidine susceptible E. coli C600 isolate as the receptor. Transconjugants were selected using MacConkey agar plates containing chlorhexidine in concentrations ranging from 0.25 to 16 g.L-1. To genotypically confirm the transfer of the resistance gene, the transconjugants were screened by Polymerase Chain Reaction (PCR) and submitted to Sanger’s sequencing. MRSA isolates successfully transferred the chlorhexidine resistance gene (qacA) to the recipient E. coli strain C600. The E. coli transconjugant exhibited an important reduction of chlorhexidine susceptibility, with MICs increasing from ≤ 0.25 to ≥ 16 g.L-1 after conjugation. The qacA gene was detected by PCR as well as in the Sanger’s sequencing analysis of DNA from transconjugant plasmids. To the best of our knowledge, this is the first report of the plasmid p_8N_qac(MN687830.1) carrying qacA and its transfer by conjugation from a MRSA to an E. coli. These findings increase concerns on the emergence of resistance dissemination across the genus and emphasizes the importance of continuous antiseptic stewardship.

https://doi.org/10.1590/s1678-9946202163082

12.

Polymerase chain reaction targeting 16S ribosomal RNA for the diagnosis of bacterial meningitis after neurosurgery
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Perdigão Neto, Lauro Vieira

; Medeiros, Micheli

; Ferreira, Suzete Cleusa

; Nishiya, Anna Shoko

; de Assis, Denise Brandão

; Boszczowski, Ícaro

; Costa, Silvia Figueiredo

; Levin, Anna S.

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2021, Volume 76 elocation e2284

Abstract: En | Text: En | PDF: En

OBJECTIVES: Bacterial and aseptic meningitis after neurosurgery can present similar clinical signs and symptoms. The aims of this study were to develop and test a molecular method to diagnose bacterial meningitis (BM) after neurosurgery. METHODS: A 16S ribosomal RNA gene PCR-based strategy was developed using artificially inoculated cerebrospinal fluid (CSF) followed by sequencing. The method was tested using CSF samples from 43 patients who had undergone neurosurgery and were suspected to suffer from meningitis, and from 8 patients without neurosurgery or meningitis. Patients were classified into five groups, confirmed BM, probable BM, possible BM, unlikely BM, and no meningitis. RESULTS: Among the samples from the 51 patients, 21 samples (41%) were culture-negative and PCR-positive. Of these, 3 (14%) were probable BM, 4 (19%) were possible BM, 13 (62%) were unlikely BM, and 1 (5%) was meningitis negative. Enterobacterales, non-fermenters (Pseudomonas aeruginosa and Acinetobacter baumannii), Staphylococcus haemolyticus, Granulicatella, Variovorax, and Enterococcus cecorum could be identified. In the group of patients with meningitis, a good agreement (3 of 4) was observed with the results of cultures, including the identification of species. CONCLUSION: Molecular methods may complement the diagnosis, guide treatment, and identify non-cultivable microorganisms. We suggest the association of methods for suspected cases of BM after neurosurgery, especially for instances in which the culture is negative.

https://doi.org/10.6061/clinics/2021/e2284 506 downloads

13.

Clinical and microbiological characteristics of patients colonized or infected by Stenotrophomonas maltophilia: is resistance to sulfamethoxazole/trimethoprim a problem?
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Mendes, Elisa Teixeira

; Paez, Jorge Isaac Garcia

; Ferraz, Juliana Rosa

; Marchi, Ana Paula

; Silva, Ivan Leonardo Avelino França e

; Batista, Marjorie Vieira

; Lima, Ana Lucia Munhoz de

; Rossi, Flávia

; Levin, Anna Sara

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e96

Abstract: En | Text: En | PDF: En

ABSTRACT Stenotrophomonas maltophilia has emerged as an important opportunistic pathogen in the last decade. Increased resistance to sulfamethoxazole/trimethoprim (SMX/TMP) has been reported in S. maltophilia strains in the past few years, leading to few therapeutic options. We conducted a prospective multicenter study at two Brazilian teaching hospitals that identified S. maltophilia isolates and evaluated their antimicrobial susceptibility profile, SMX/TMP resistance genes and their clonality profile. A total of 106 non-repeated clinical samples of S. maltophilia were evaluated. Resistance to SMX/TMP was identified in 21.6% of the samples, and previous use of SMX/TMP occurred in 19 (82.6%). PCR detected the sul1 gene in 14 of 106 strains (13.2%). Of these isolates, nine displayed resistance to SMX/TMP. The resistant strains presented a polyclonal profile. This opportunistic pathogen has emerged in immunocompromised hosts, with few therapeutic options, which is aggravated by the description of emerging resistance mechanisms, although with a polyclonal distribution profile.

https://doi.org/10.1590/s1678-9946202062096 518 downloads

14.

Capnocytophaga sputigena bloodstream infection in hematopoietic stem cell transplantations: two cases report and review of the literature
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Mendes, Fernanda Rodrigues

; Bruniera, Felipe Ribeiro

; Schmidt, Jayir

; Cury, Ana Paula

; Rizeck, Camila

; Higashino, Hermes

; Oliveira, Fernando Nivaldo

; Rossi, Flavia

; Rocha, Vanderson

; Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e48

Abstract: En | Text: En | PDF: En

ABSTRACT Capnocytophaga is a group of facultative anaerobic gram-negative bacteria present in the oral cavity of humans, dogs and cats, as part of their normal oral flora. Here, we described two cases of bloodstream infections (BSI) caused by Capnocytophaga in neutropenic autologous hematopoietic stem cell transplantation (auto-HSCT) patients with mucositis (Grade I and Grade III) identified by Maldi-Tof. They were successfully treated with β-lactam (meropenem and piperacillin-tazobactam). The species C. sputigena was confirmed by 16S rRNA gene sequencing in one patient. The review of literature showed that C. ochraceae was the most frequent species causing BSI in auto-HSCT patients and that the patients usually presented mucositis and were neutropenic at the onset of the infection.

https://doi.org/10.1590/s1678-9946202062048 788 downloads

15.

A Brazilian university hospital position regarding transplantation criteria for HIV-positive patients according to the current literature
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Pierrotti, Lígia Camera

; Litvinov, Nadia

; Costa, Silvia Figueiredo

; Azevedo, Luiz Sérgio Fonseca de

; Strabelli, Tânia Mara Varejão

; Campos, Silvia Vidal

; Odongo, Fatuma Catherine Atieno

; Reusing-Junior, Jose Otto

; Song, Alice Tung Wan

; Lopes, Max Igor Banks Ferreira

; Batista, Marjorie Vieira

; Lopes, Marta Heloisa

; Maluf, Natalya Zaidan

; Caiaffa-Filho, Hélio Helh

; de Oliveira, Maura Salarolli

; Sousa Marques, Heloisa Helena de

; Abdala, Edson

Clinics

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2019, Volume 74 elocation e941

Abstract: En | Text: En | PDF: En

Human immunodeficiency virus (HIV) infection was considered a contraindication for solid organ transplantation (SOT) in the past. However, HIV management has improved since highly active antiretroviral therapy (HAART) became available in 1996, and the long-term survival of patients living with HIV has led many transplant programs to reevaluate their policies regarding the exclusion of patients with HIV infection. Based on the available data in the medical literature and the cumulative experience of transplantation in HIV-positive patients at our hospital, the aim of the present article is to outline the criteria for transplantation in HIV-positive patients as recommended by the Immunocompromised Host Committee of the Hospital das Clínicas of the University of São Paulo.

https://doi.org/10.6061/clinics/2019/e941 688 downloads

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