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ABSTRACT Background: Bloodstream infections (BSI) are a global health issue, leading to high mortality and morbidity among hospitalized patients. Methods: A retrospective, observational and descriptive study was conducted by reviewing blood culture records collected from patients with suspected BSI, between January 2017 and December 2019. Results: The most frequent antimicrobial resistant (AMR) pathogens were methicillin-resistantStaphylococcus aureus(MRSA) (40%), methicillin-resistantS. epidermidis (MRSE) (9.5%), and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (35.3%). Conclusions: Our findings underscore the importance of continued vigilance and advocate for the rational use of antimicrobial agents. Background BSI (BSI issue Methods retrospective 201 2019 Results AMR (AMR methicillinresistantStaphylococcus methicillin resistantStaphylococcus aureusMRSA aureus MRSA aureus(MRSA 40%, 40 40% , (40%) methicillinresistantS. methicillinresistantS resistantS. resistantS methicillin-resistantS MRSE (MRSE 9.5%, 95 9.5% 9 5 (9.5%) extendedspectrum extended spectrum betalactamase beta lactamase ESBLproducing ESBL producing 35.3%. 353 35.3% . 35 3 (35.3%) Conclusions agents 20 4 (40% 9.5 (9.5% 35.3 (35.3% 2 (40 9. (9.5 35. (35.3 (4 (9. (35. ( (9 (35 (3

https://doi.org/10.1590/0037-8682-0382-2023

Importance of cerebrospinal fluid investigation during dengue infection in Brazilian Amazonia Region
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Bastos, Michele de Souza

; Martins, Valquiria do Carmo Alves

; Silva, Natália Lessa da

; Jezine, Samya

; Pinto, Sérgio

; Aprigio, Valderjane

; Monte, Rossicleia Lins

; Fragoso, Silvio

; Puccioni-Sohler, Marzia

Memórias do Instituto Oswaldo Cruz

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2019, Volume 114 elocation e180450

Abstract: En | Text: En | PDF: En

BACKGROUND Amazon, the largest tropical forest of the world, has suffered from dengue outbreaks since 1998. Cerebrospinal fluid (CSF) of patients, from Amazonas state, suspected of central nervous system (CNS) viral infection was studied using molecular and immunological methods. OBJECTIVE To evaluate the importance of CSF investigation in patients with acute dengue virus (DENV) infection of CNS. METHODS CSF samples of 700 patients were analysed by reverse transcription polymerase chain reaction (RT-PCR) to detect the presence of dengue virus (DENV) RNA and by enzyme-linked immunosorbent assay (ELISA) to detect presence of DENV specific IgM. FINDINGS DENV infection was detected in 4.3% of the CSF samples; 85.7% (24/28) by DENV IgM and 14.3% (4/28) by viral RNA. DENV detected by viral RNA were to be found serotypes DENV-2 (three patients) and DENV-1 (one patient). The neurological diagnosis in patients CNS infection of DENV included encephalitis (10), meningoencephalitis (10), meningitis (6), acute myelitis (1), and encephalomyelitis (1). The majority (89.3%) had intrathecal inflammation: pleocytosis, hyperproteinorrachia and DENV IgM antibodies. Hypoglycorrhachia and/or high levels of lactate in CSF were found in 36% of the patients. Co-infection (CMV, HIV, EBV, and/or Mycobacterium tuberculosis) was observed in eight (28.6%) cases. CONCLUSIONS We found intense inflammatory CSF that is unusual in CNS disorders caused by dengue infection. It may be due co-infections or the immunogenetic background of the local Amerindian Brazilian population. CSF examination is an important diagnostic support tool for neurological dengue diagnosis.

https://doi.org/10.1590/0074-02760180450 1922 downloads

Genotypes of clinical varicella-zoster virus isolates from Manaus, Brazil
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Bastos, Michele de Souza

; Folster, Jennifer

; Alvarenga, Otávio Primo de

; Sampaio, Daniele de Araujo

; Rabelo, Ronaldo Marques Pontes

; João, Guilherme Augusto Pivoto

; Lacerda, Marcus Vinícius Guimarães de

; Schmid, D. Scott

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20180166

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Vaccination against varicella-zoster virus (VZV) has been effective and safe in countries that routinely administer the vaccine. Brazil began universal VZV vaccination in 2013. This study aimed to identify VZV genotypes present in Manaus, Brazil prior to widespread immunization. METHODS: Vesicular lesions or cerebral-spinal-fluid samples were collected from patients diagnosed with VZV, herpes zoster, or meningitis/encephalitis. DNA was extracted, amplified, and sequenced. RESULTS: Half the isolates were clade-5 viruses and the remaining were divided between the European clades 1 and 3. CONCLUSIONS: This study provides insights into the circulating VZV genotypes in Manaus prior to widespread vaccination.

https://doi.org/10.1590/0037-8682-0166-2018 1379 downloads

Increasing awareness of human T-lymphotropic virus type-1 infection: a serious, invisible, and neglected health problem in Brazil
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Puccioni-Sohler, Marzia

; Grassi, Maria Fernanda Rios

; Galvão-Castro, Bernardo

; Caterino, Adele

; Proietti, Anna Bárbara de Freitas Carneiro

; Vicente, Ana Carolina Paulo

; Galvão-Castro, Ana Verena

; Vallinoto, Antonio Carlos

; Paiva, Arthur

; Penalva, Augusto

; Rosadas, Carolina

; Miyashiro, Denis

; Barbosa, Edel Figueiredo

; Carvalho, Edgar Marcelino de

; Batista, Everton da Silva

; Smid, Jerusa

; Casseb, Jorge

; Vidal, Jose

; Sousa, Maisa Silva

; Viana, Maria Graça de Castro

; Bastos, Michele de Souza

; Lírio, Monique

; Boa-Sorte, Ney

; Ferreira Jr, Orlando C.

; Takayanagui, Osvaldo

; Moura, Patrícia

; Rocco, Regina

; Cunha, Rodrigo Guimaraes

; Haddad, Simone Kashima

; Assone, Tatiane

; Araújo, Thessika Hialla Almeida

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20190343

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0037-8682-0343-2019 953 downloads

Arboviral diseases in the Western Brazilian Amazon: a perspective and analysis from a tertiary health & research center in Manaus, State of Amazonas
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Mourão, Maria Paula Gomes

; Bastos, Michele de Souza

; Figueiredo, Regina Maria Pinto de

; Gimaque, João Bosco de Lima

; Alves, Valquíria do Carmo Rodrigues

; Saraiva, Maria das Graças Gomes

; Figueiredo, Mário Luis Garcia

; Ramasawmy, Rajendranath

; Nogueira, Maurício Lacerda

; Figueiredo, Luiz Tadeu Moraes

Revista da Sociedade Brasileira de Medicina Tropical

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jun 2015, Volume 48 Suppl. 1 Pages 20 - 26

Abstract: En | Text: En | PDF: En

The Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), located in Manaus, the capital of the State of Amazonas (Western Brazilian Amazon), is a pioneering institution in this region regarding the syndromic surveillance of acute febrile illness, including arboviral infections. Based on the data from patients at the FMT-HVD, we have detected recurrent outbreaks in Manaus by the four dengue serotypes in the past 15 years, with increasing severity of the disease. This endemicity has culminated in the simultaneous circulation of all four serotypes in 2011, the first time this has been reported in Brazil. Between 1996 and 2009, 42 cases of yellow fever (YF) were registered in the State of Amazonas, and 71.4% (30/42) were fatal. Since 2010, no cases have been reported. Because the introduction of the yellow fever virus into a large city such as Manaus, which is widely infested by Aedes mosquitoes, may pose a real risk of a yellow fever outbreak, efforts to maintain an appropriate immunization policy for the populace are critical. Manaus has also suffered silent outbreaks of Mayaro and Oropouche fevers lately, most of which were misdiagnosed as dengue fever. The tropical conditions of the State of Amazonas favor the existence of other arboviruses capable of producing human disease. Under this real threat, represented by at least 4 arboviruses producing human infections in Manaus and in other neighboring countries, it is important to develop an efficient public health surveillance strategy, including laboratories that are able to make proper diagnoses of arboviruses.

https://doi.org/10.1590/0037-8682-0133-2013 6541 downloads

Epidemiology of infectious meningitis in the State of Amazonas, Brazil
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Saraiva, Maria das Graças Gomes

; Santos, Eyde Cristianne Saraiva

; Saraceni, Valéria

; Rocha, Lívia Laura dos Santos

; Monte, Rossicléia Lins

; Albuquerque, Bernardino Cláudio de

; Bastos, Michele de Souza

; Santos, Marcelo Cordeiro dos

; Monteiro, Wuelton Marcelo

; Mourão, Maria Paula Gomes

; Guerra, Marcus Vinitius de Farias

; Lacerda, Marcus Vinícius Guimarães de

Revista da Sociedade Brasileira de Medicina Tropical

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jun 2015, Volume 48 Suppl. 1 Pages 79 - 86

Abstract: En | Text: En | PDF: En

INTRODUCTION: In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present study reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. METHODS: Since the 1970s, the (currently named) Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD)] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. RESULTS: The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV) and varicella zoster virus (VZV) prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS), cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. CONCLUSIONS: Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination.

https://doi.org/10.1590/0037-8682-0116-2014 14417 downloads

Simultaneous circulation of all four dengue serotypes in Manaus, State of Amazonas, Brazil in 2011
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Bastos, Michele de Souza

; Figueiredo, Regina Maria Pinto de

; Ramasawmy, Rajendranath

; Itapirema, Evaulino

; Gimaque, João Bosco Lima

; Santos, Lucilaide Oliveira

; Figueiredo, Luiz Tadeu Moraes

; Mourão, Maria Paula Gomes

Revista da Sociedade Brasileira de Medicina Tropical

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jun 2012, Volume 45 N. 3 Pages 393 - 394

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

INTRODUÇÃO: Manaus, capital do Estado do Amazonas, com quase 2 milhões de habitantes, está localizada no meio da floresta Amazônica e vem sofrendo surtos de dengue desde 1998. MÉTODOS: Neste estudo, amostras de sangue foram investigadas pela Transcriptase reversa-reação em cadeia da polimerase (RT-PCR), visando identificar os sorotipos de vírus da dengue. RESULTADOS: Soros de fase aguda de 432 pacientes foram testados para a presença do vírus da dengue. Destes, 137 (31,3%) foram considerados positivos. Todos os quatro sorotipos do vírus da dengue foram observados. CONCLUSÕES: A circulação simultânea dos quatro sorotipos da dengue é descrita pela primeira vez em Manaus e no Brasil.

INTRODUCTION: Manaus, the capital city of the state of Amazon with nearly 2 million inhabitants, is located in the middle of the Amazon rain forest and has suffered dengue outbreaks since 1998. METHODS: In this study, blood samples were investigated using reverse transcriptase-polymerase chain reaction (RT-PCR), aimed at identifying dengue virus serotypes. RESULTS: Acute phase sera from 432 patients were tested for the presence of dengue virus. Out of the 432 patients, 137 (31.3%) were found to be positive. All the four dengue virus serotypes were observed. CONCLUSIONS: The simultaneous circulation of the four dengue serotypes is described for the first time in Manaus and in Brazil.

4548 downloads

Serological evidence of hantavirus infection in rural and urban regions in the state of Amazonas, Brazil
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Gimaque, João Bosco Lima

; Bastos, Michele de Souza

; Braga, Wornei Silva Miranda

; Oliveira, Cintia Mara Costa de

; Castilho, Márcia da Costa

; Figueiredo, Regina Maria Pinto de

; Galusso, Elizabeth dos Santos

; Itapirema, Evaulino Ferreira

; Figueiredo, Luiz Tadeu Moraes de

; Mourão, Maria Paula Gomes

Memórias do Instituto Oswaldo Cruz

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feb 2012, Volume 107 N. 1 Pages 135 - 137

Abstract: En | Text: En | PDF: En

Hantavirus disease is caused by the hantavirus, which is an RNA virus belonging to the family Bunyaviridae. Hantavirus disease is an anthropozoonotic infection transmitted through the inhalation of aerosols from the excreta of hantavirus-infected rodents. In the county of Itacoatiara in the state of Amazonas (AM), Brazil, the first human cases of hantavirus pulmonary and cardiovascular syndrome were described in July 2004. These first cases were followed by two fatal cases, one in the municipality of Maués in 2005 and another in Itacoatiara in 2007. In this study, we investigated the antibody levels to hantavirus in a population of 1,731 individuals from four different counties of AM. Sera were tested by IgG/IgM- enzyme-linked immune-sorbent assay using a recombinant nucleocapsid protein of the Araraquara hantavirus as an antigen. Ten sera were IgG positive to hantavirus (0.6%). Among the positive sera, 0.8% (1/122), 0.4% (1/256), 0.2% (1/556) and 0.9% (7/797) were from Atalaia do Norte, Careiro Castanho, Itacoatiara and Lábrea, respectively. None of the sera in this survey were IgM-positive. Because these counties are distributed in different areas of AM, we can assume that infected individuals are found throughout the entire state, which suggests that hantavirus disease could be a local emerging health problem.

3012 downloads

Co-infection of Dengue virus by serotypes 3 and 4 in patients from Amazonas, Brazil
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Figueiredo, Regina M.P. de

; Naveca, Felipe Gomes

; Oliveira, Cintia Mara

; Bastos, Michele de Souza

; Mourão, Maria Paula Gomes

; Viana, Suziane de S.

; Melo, Miriam do N.

; Itapirema, Evaulino F.

; Saatkamp, Cassiano J.

; Farias, Izeni P.

Revista do Instituto de Medicina Tropical de São Paulo

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dec 2011, Volume 53 N. 6 Pages 321 - 323

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A co-infecção natural com os vírus dengue pode ocorre em áreas altamente endêmicas onde diferentes sorotipos têm sido transmitidos por muitos anos. Relatamos aqui quatro casos de co-infecção com DENV-3/DENV-4 detectados por testes sorológicos e moleculares entre 674 pacientes com febre indiferenciada aguda, atendidos em um centro de medicina tropical de referência da cidade de Manaus, Brasil, entre 2005 e 2010. As análises das sequências obtidas indicaram a presença dos genotipos 3 e 1 para DENV-3 e DENV-4 respectivamente.

The natural co-infection with dengue virus can occur in highly endemic areas where different serotypes have been observed for many years. We report here four cases of DENV-3/DENV-4 co-infection detected by serological and molecular tests among 674 patients with acute undifferentiated fever from the tropical medicine reference center of Manaus City, Brazil, between 2005 and 2010. Analysis of the sequences obtained indicated the presence of genotype 3 and 1 for DENV-3 and DENV-4 respectively.

5697 downloads Cited 1 time in SciELO

10.

Presença de parvovírus B19 em Manaus, AM
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Figueiredo, Regina Maria Pinto de

; Lima, Mário Lira de

; Almeida, Tânia Maria Carvalho

; Bastos, Michele de Souza

Revista da Sociedade Brasileira de Medicina Tropical

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oct 2005, Volume 38 N. 5 Pages 396 - 398

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A investigação de 1.107 casos de doenças exantemáticas em Manaus permitiu a identificação dos primeiros 47 casos de parvovírus humano B19 na cidade. O parvovírus B19 foi caracterizado por uma combinação de sinais e sintomas como febre, cefaléia, artralgia, mialgia e exantema. A freqüência de exantema foi maior em indivíduos menores de quinze anos e, no adulto, prevaleceram a febre e artropatias. O maior número de casos foi registrado em 1999. Quanto à faixa etária, nos menores de 15 anos, predominou o sexo masculino e, entre os adultos, o feminino. Este estudo, portanto, ressalta a necessidade de se elucidar a causa de doenças exantemáticas que ocorrem no Estado do Amazonas e indica que estudos são necessários, no que concerne à atividade viral.

Investigation of 1,107 cases of exanthematous diseases in Manaus allowed the identification of the first 47 cases of human parvovirus B19 in the city. Parvovirus B19 was characterized by a combination of signs and symptoms such as fever, chronic headache, arthralgia, myalgia and exanthema. The frequency of exanthema was higher in individuals less than fifteen years old. In adults, fever and arthropathy were the most frequent symptoms. The highest number of cases was registered in 1999. Regarding gender, male sex was predominant among infected individuals younger than fifteen years old, and female sex in adults. This study, therefore, underscores the necessity for clarifying the causes of exanthematous illnesses that occur in the State of Amazonas and investigation of the viral activity.

4563 downloads

11.

Dengue hemorrhagic fever and acute hepatitis: a case report
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Mourão, Maria Paula Gomes

; Lacerda, Marcus Vinícius Guimarães de

; Bastos, Michele de Souza

; Albuquerque, Bernardino Cláudio de

; Alecrim, Wilson Duarte

Brazilian Journal of Infectious Diseases

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dec 2004, Volume 8 N. 6 Pages 461 - 464

Abstract: En | Text: En | PDF: En

Dengue fever is the world's most important viral hemorrhagic fever disease, the most geographically wide-spread of the arthropod-born viruses, and it causes a wide clinical spectrum of disease. We report a case of dengue hemorrhagic fever complicated by acute hepatitis. The initial picture of classical dengue fever was followed by painful liver enlargement, vomiting, hematemesis, epistaxis and diarrhea. Severe liver injury was detected by laboratory investigation, according to a syndromic surveillance protocol, expressed in a self-limiting pattern and the patient had a complete recovery. The serological tests for hepatitis and yellow fever viruses were negative. MAC-ELISA for dengue was positive.

17582 downloads

12.

Febre hemorrágica do dengue em lactentes: relato de dois casos
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Mourão, Maria Paula Gomes

; Lacerda, Marcus Vinícius Guimarães de

; Bastos, Michele de Souza

; Albuquerque, Bernardino Cláudio de

; Alecrim, Wilson Duarte

Revista da Sociedade Brasileira de Medicina Tropical

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mar 2004, Volume 37 N. 2 Pages 175 - 176

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Dois casos de lactentes atendidos na Fundação de Medicina Tropical do Amazonas, com síndrome febril exantemática aguda, extravasamento capilar e manifestações hemorrágicas de pequena magnitude, caracterizando quadro de febre hemorrágica do dengue. O diagnóstico etiológico foi confirmado pelo MAC-ELISA e pelo ELISA de inibição para IgG, realizados nos lactentes e nas respectivas mães.

Two cases of infants assisted at the Tropical Medicine Foundation of Amazonas with febrile exanthematic syndrome and mild hemorrhagic manifestations, defining a picture of dengue hemorrhagic fever. The etiologic diagnose was confirmed by the MAC-ELISA and the Inhibition - ELISA, performed in both infants and respective mothers.

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