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ABSTRACT Extended-spectrum beta-lactamase producing and ciprofloxacin-non-susceptible Escherichia coli are clinical and environmental issues. We evaluated the susceptibility profile of fosfomycin in non-susceptible E. coli isolated from urine and the environment. We measured the activity of fosfomycin against 319 and 36 E. coli strains from urine and environmental isolates, respectively, collected from rivers. Fosfomycin resistance profiles were investigated using the minimal inhibitory concentration (MIC), according to the Clinical and Laboratory Standards Institute (CLSI) and the European Committee for Antimicrobial Susceptibility Testing (EUCAST) guidelines. Antibiotic susceptibility testing revealed that 5% and 6.6% of urine samples were non-susceptible to fosfomycin according to CLSI and EUCAST guidelines, respectively. The fosfomycin MIC50/90 was 0.5/4 mg/L. Of the 36 E. coli isolates from river water, 11.1% and 13,8% were non-susceptible to fosfomycin according to CLSI and EUCAST, respectively (range ≤0.25 ≥512 mg/L). All the isolates with MIC ≥512 mg/L for fosfomycin showed the fosA3 gene. Fosfomycin resistance was more frequent in the environment than in clinical samples. Extendedspectrum Extended spectrum betalactamase beta lactamase ciprofloxacinnonsusceptible ciprofloxacin non susceptible issues nonsusceptible E 31 3 rivers MIC, , (MIC) (CLSI (EUCAST guidelines 5 66 6 6.6 MIC5090 MIC50 90 MIC50/9 054 0 4 0.5/ mgL mg L water 111 11 1 11.1 138 13 8 13,8 range 025 25 ≤0.2 512 ≥51 . mg/L) fosA gene (MIC 6. MIC509 MIC5 9 MIC50/ 05 0.5 11. 13, 02 2 ≤0. 51 ≥5 0. ≤0 ≥ ≤

https://doi.org/10.1590/s1678-9946202466005

Antimicrobial Action of a Biodegradable Thermoplastic Impregnated with Vancomycin for Use in 3D Printing Technology D
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Mendonça, Celso Júnio Aguiar

; Dantas, Leticia Ramos

; Soni, Jamil Faissal

; Tuon, Felipe Francisco

Brazilian Archives of Biology and Technology

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2024, Volume 67 elocation e24231110

Abstract: En | Text: En | PDF: En

Abstract This study explores the potential of vancomycin-impregnated polylactic acid (V-PLA) as a novel biomaterial for orthopedic applications. V-PLA combines the biocompatibility of PLA with the antimicrobial properties of vancomycin, making it a promising candidate for managing orthopedic infections. We conducted a comprehensive assessment of V-PLA, including macroscopic characterization, biomechanical analysis, vancomycin release profiles, antimicrobial activity and antibiofilm effects on Staphylococcus aureus ATCCTM 25923. Filaments of V-PLA were manufactured by combining PLA pellets with vancomycin via extrusion and models produced by 3D printer. A biocompatibility test involved the insertion of PLA into a mouse calvaria model to evaluate the inflammatory response. Our results indicate that V-PLA exhibits a distinct macroscopic appearance and sustained vancomycin release over 28 days, surpassing minimal inhibitory concentrations for most Staphylococcus aureus strains. Moreover, V-PLA demonstrated the ability to prevent biofilm formation, a critical concern in orthopedic implant-related infections. While mechanical strength is identified as a limitation in certain applications, V-PLA's suitability varies depending on the clinical context. The V-PLA was biocompatible with a fibrous capsule similar to other prosthetic implants. This study sheds light on the potential of V-PLA for orthopedic spacers and implants, offering clinicians an innovative approach to infection management. Future research may explore its use in specific anatomical locations and clinical scenarios, advancing the field of orthopedic biomaterials. vancomycinimpregnated impregnated VPLA V (V-PLA applications infections VPLA, PLA, characterization analysis profiles 25923 D printer response 2 days strains Moreover formation implantrelated implant related VPLAs s context implants management scenarios biomaterials 2592 259 25

https://doi.org/10.1590/1678-4324-2024231110

Burden of leptospirosis in Brazil in the last decade
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Linhares, Gisele de Paula

; Zequinao, Tiago

; Buso, Gustavo Martini

; Cruz, June Alisson Westarb

; Tuon, Felipe Francisco

Revista de Saúde Pública

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2024, Volume 58 elocation 53

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVES: To correlate the incidence of leptospirosis with sociodemographic data in the Brazilian Unified Health System from 2011 to 2022. METHODS: This ecological study used national health and economic secondary data sources. Secondary analyses summarized the scenario of disease-related hospitalizations among federative units. In total, two analyses were conducted: variable description for relationship analysis and a secondary analysis with population health and sanitation indicators and economic indicators from the Instituto Brasileiro de Geografia e Estatística (IBGE - Brazilian Institute of Geography and Statistics). The statistical analysis following this framework summarized raw data by year-month-federative unit. A time series regression was conducted, comparing the time variable with other national-level variables. Then, several simple linear regressions were performed. RESULTS: Linear regressions show the relationship between the reduction in cases and improved access to treated water and sewage collection, whereas an increase in per capita income seems to be inversely related to leptospirosis incidence. Geospatial distribution shows higher incidence in the Brazilian South and Southeast. Disease lethality varied over time but without significant change during the period. The average treatment cost remained constant over the years, despite its complexity. CONCLUSION: Leptospirosis incidence in Brazil from 2011 to 2021 decreased and was associated with improvements in socioeconomic conditions despite no changes in lethality. OBJECTIVES 201 2022 METHODS sources diseaserelated disease units total conducted IBGE Statistics. Statistics . Statistics) yearmonthfederative year month unit nationallevel level variables Then performed RESULTS collection Southeast period years complexity CONCLUSION 202 20 2

https://doi.org/10.11606/s1518-8787.2024058005859

Burden of leptospirosis in Brazil in the last decade
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Linhares, Gisele de Paula

; Zequinao, Tiago

; Buso, Gustavo Martini

; Cruz, June Alisson Westarb

; Tuon, Felipe Francisco

Revista de Saúde Pública

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2024, Volume 58 elocation 53

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2024058005859

Sonication as a tool for disrupting biofilms and recovering microorganisms in bladder catheters
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Cieslinski, Juliette

; Ribeiro, Victoria Stadler Tasca

; Lima, Camila Kowodzeichak de

; Kraft, Letícia

; Suss, Paula Hansen

; Tuon, Felipe Francisco

Brazilian Journal of Nephrology

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sep 2023, Volume 45 N. 3 Pages 373 - 377

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

Resumo Introdução: A infecção relacionada ao cateter urinário é comumente associada ao biofilme bacteriano. O impacto dos anaeróbios é desconhecido, mas sua detecção no biofilme deste dispositivo não foi relatada anteriormente. Este estudo teve como objetivo avaliar a capacidade de recuperar microrganismos estritos, facultativos e aeróbios em pacientes que utilizam cateteres vesicais de UTIs utilizando cultura convencional, sonicação, análise urinária e espectrometria de massa. Métodos: Paralelamente, foram comparados cateteres vesicais sonicados de 29 pacientes gravemente enfermos com sua urocultura de rotina. A identificação foi realizada utilizando dessorção/ionização a laser assistida por matriz com espectrometria de massa por tempo de voo. Resultados: A taxa de positividade na urina (n = 2; 3,4%) foi inferior à dos cateteres sonicados (n = 7; 13,8%). Conclusão: A sonicação do cateter vesical apresentou resultados de cultura mais positivos do que as amostras de urina para microrganismos anaeróbios e aeróbios. É discutido o papel dos anaeróbios na infecção do trato urinário e no biofilme do cateter. Introdução bacteriano desconhecido anteriormente estritos convencional Métodos Paralelamente 2 rotina dessorçãoionização dessorção ionização voo Resultados n 3,4% 34 3 4 7 13,8%. 138 13,8% . 13 8 13,8%) Conclusão 3,4 13,8 1 3, 13,

Abstract Introduction: Urinary catheter-related infection is commonly associated with bacterial biofilm. The impact of anaerobes is unknown, but their detection in the biofilm on this device has not been previously reported. This study aimed to evaluate the capability to recovery strict, facultative, and aerobic microorganisms in patients using bladder catheters from ICUs using conventional culture, sonication, urinary analysis, and mass spectrometry. Methods: Parallel, sonicated bladder catheters from 29 critically ill patients were compared with their routine urine culture. Identification was performed using matrix-assisted laser desorption/ionization with time-of-flight mass spectrometry. Results: The positivity rate in urine (n = 2, 3.4%) was lower than that in sonicated catheters (n = 7, 13.8%). Conclusion: Bladder catheter sonication showed more positive culture results than urine samples for anaerobic and aerobic microorganisms. The role of anaerobes in urinary tract infection and catheter biofilm is discussed. Introduction catheterrelated related unknown reported strict facultative analysis spectrometry Methods Parallel 2 matrixassisted matrix assisted desorptionionization desorption ionization timeofflight time flight Results n 3.4% 34 3 4 7 13.8%. 138 13.8% . 13 8 13.8%) Conclusion discussed 3.4 13.8 1 3. 13.

https://doi.org/10.1590/2175-8239-jbn-2022-0129en

COVID-19 in real world: Survival and medical costs of hospitalized patients in Brazils first wave COVID19 COVID 19 COVID-1 world COVID1 1 COVID-
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Rocha, Jaime Luís Lopes

; Riediger, Irina

; Gasparetto, Juliano

; Tuon, Felipe Francisco

Brazilian Journal of Infectious Diseases

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2023, Volume 27 N. 4 elocation 102778

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To evaluate survival and direct medical costs of patients admitted in private hospitals with COVID-19 during the first wave. Methods: A retrospective, observational study analyzing survival and the economic data retrieved on hospitalized patients with COVID-19. Data from March 2020 to December 2020. The direct cost of hospitalization was estimated using the microcosting method with each individual hospitalization. Results: 342 cases were evaluated. Median age of 61.0 (95% CI 57.0-65.0). 194 (56.7%) were men. The mortality rate was higher in the female sex (p = 0.0037), ICU (p < 0.001), mechanical ventilation (p<0.001) and elderly groups. 143 (41.8%) patients were admitted to the ICU (95% CI 36.6%-47.1%), of which 60 (41.9%) required MV (95% CI 34.0%-50.0%). Global LOS presented median of 6.7 days (95% CI 6.0-7.2). Mean costs were US$ 7,060,00 (95% CI 5,300.94-8,819,00) for each patient. Mean cost for patients discharged alive and patients deceased was US$ 5,475.53 (95% CI 3,692.91-7,258.14) and US$ 12,955.19 (95% CI 8,106.61 -17,803.76), respectively (p < 0.001). Conclusions: Patients admitted with COVID-19 in these private hospitals point to great economic impact, mainly in the elderly and high-risk patients. It is key to better understand such costs in order to be prepared to make wise decisions during the current and future global health emergencies. Objective COVID19 COVID 19 COVID-1 wave Methods retrospective COVID19. 19. 202 Results 34 evaluated 610 61 0 61. 95% 95 (95 57.065.0. 570650 57.0 65.0 . 57 65 57.0-65.0) 56.7% 567 56 7 (56.7% men p 0.0037, 00037 0.0037 , 0037 0.0037) 0.001, 0001 0.001 001 0.001) p<0.001 p0001 (p<0.001 groups 14 41.8% 418 41 8 (41.8% 36.6%47.1%, 366471 36.6% 47.1% 36 6 47 1 36.6%-47.1%) 41.9% 419 9 (41.9% 34.0%50.0%. 340500 34.0% 50.0% 50 34.0%-50.0%) 67 6. 6.07.2. 6072 6.0 7.2 2 6.0-7.2) US 706000 060 00 7,060,0 5,300.948,819,00 530094881900 5,300.94 8,819,00 5 300 94 819 5,300.94-8,819,00 patient 547553 475 53 5,475.5 3,692.917,258.14 369291725814 3,692.91 7,258.14 3 692 91 258 3,692.91-7,258.14 1295519 12 955 12,955.1 810661 106 8,106.6 17,803.76, 1780376 17,803.76 17 803 76 -17,803.76) 0.001. Conclusions impact highrisk high risk emergencies COVID1 COVID- 20 (9 065 57.065.0 57065 570 57. 650 65. 57.0-65.0 56.7 (56.7 0003 0.003 003 000 0.00 p<0.00 p000 (p<0.00 41.8 4 (41.8 36.6%47.1% 36647 366 36.6 471 47.1 36.6%-47.1% 41.9 (41.9 34.0%50.0% 34050 340 34.0 500 50.0 34.0%-50.0% 07 6.07.2 607 72 7. 6.0-7.2 70600 06 7,060, 948 5,300.948,819,0 53009488190 530094 5,300.9 881900 8,819,0 30 81 5,300.94-8,819,0 54755 5,475. 917 3,692.917,258.1 36929172581 369291 3,692.9 725814 7,258.1 69 25 3,692.91-7,258.1 129551 12,955. 81066 10 8,106. 178037 17,803.7 80 -17,803.76 ( 57.065. 5706 57.0-65. 56. (56. 0.0 p<0.0 p00 (p<0.0 41. (41. 36.6%47.1 3664 36. 47. 36.6%-47.1 34.0%50.0 3405 34. 50. 34.0%-50.0 6.07. 6.0-7. 7060 7,060 5,300.948,819, 5300948819 53009 5,300. 88190 8,819, 5,300.94-8,819, 5475 5,475 3,692.917,258. 3692917258 36929 3,692. 72581 7,258. 3,692.91-7,258. 12955 12,955 8106 8,106 17803 17,803. -17,803.7 57.065 57.0-65 (56 0. p<0. p0 (p<0. (41 36.6%47. 36.6%-47. 34.0%50. 34.0%-50. 6.07 6.0-7 706 7,06 5,300.948,819 530094881 5300 5,300 8819 8,819 5,300.94-8,819 547 5,47 3,692.917,258 369291725 3692 3,692 7258 7,258 3,692.91-7,258 1295 12,95 810 8,10 1780 17,803 -17,803. 57.06 57.0-6 (5 p<0 (p<0 (4 36.6%47 36.6%-47 34.0%50 34.0%-50 6.0- 70 7,0 5,300.948,81 53009488 530 5,30 881 8,81 5,300.94-8,81 54 5,4 3,692.917,25 36929172 369 3,69 725 7,25 3,692.91-7,25 129 12,9 8,1 178 17,80 -17,803 57.0- p< (p< 36.6%4 36.6%-4 34.0%5 34.0%-5 7, 5,300.948,8 5300948 5,3 88 8,8 5,300.94-8,8 5, 3,692.917,2 3692917 3,6 7,2 3,692.91-7,2 12, 8, 17,8 -17,80 36.6%- 34.0%- 5,300.948, 5,300.94-8, 3,692.917, 3, 3,692.91-7, 17, -17,8 5,300.948 5,300.94-8 3,692.917 3,692.91-7 -17, 5,300.94- 3,692.91- -17 -1 -

https://doi.org/10.1016/j.bjid.2023.102778

Saprochaete clavata invasive infection: characterization, antifungal susceptibility, and biofilm evaluation of a rare yeast isolated in Brazil infection characterization susceptibility
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Kraft, Letícia

; Ribeiro, Victoria Stadler Tasca

; Petroski, Luiz Pedro

; Herai, Roberto Hirochi

; Peronni, Kamila Chagas

; Figueiredo, David Livingstone Alves

; Motta, Fábio Araujo

; Tuon, Felipe Francisco

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e12

Abstract: En | Text: En | PDF: En

ABSTRACT Rare emerging pathogens such as Saprochaete clavata are associated with invasive fungal diseases, high morbidity, mortality, rapidly fatal infections, and outbreaks. However, little is known about S. clavata infections, epidemiology, risk factors, treatment, biofilms, and disease outcomes. The objective of this study was to describe a new case of severe S. clavata infection in a patient diagnosed at a referral children’s hospital in Brazil, including antifungal minimal inhibitory concentration, S. clavata biofilm characterization, and molecular characterization. The S. clavata isolated from an immunocompromised 11-year-old male patient was characterized using MALDI-TOF, Gram staining, scanning electron microscopy (SEM), and next generation sequencing (NGS) of genomic DNA. Biofilm production was also evaluated in parallel with determining minimal inhibitory concentration (MIC) and biofilm sensitivity to antifungal treatment. We observed small to medium, whitish, farinose, dry, filamentous margin colonies, yeast-like cells with bacillary features, and biofilm formation. The MALDI-TOF system yielded a score of ≥ 2,000, while NGS confirmed S. clavata presence at the nucleotide level. The MIC values (in mg L-1) for tested drugs were as follows: fluconazole = 2, voriconazole ≤ 2, caspofungin ≥ 8, micafungin = 2, amphotericin B = 4, flucytosine ≤ 1, and anidulafungin = 1. Amphotericin B can be active against S. clavata biofilm and the fungus can be susceptible to new azoles. These findings were helpful for understanding the development of novel treatments for S. clavata-induced disease, including combined therapy for biofilm-associated infections. diseases morbidity mortality infections outbreaks However S epidemiology factors treatment biofilms outcomes childrens children s Brazil characterization 11yearold yearold 11 year old MALDITOF, MALDITOF MALDI TOF, TOF staining SEM, SEM , (SEM) (NGS DNA (MIC medium whitish farinose dry colonies yeastlike yeast like features formation 2000 2 000 2,000 level L1 L 1 L-1 follows 8 4 azoles clavatainduced induced biofilmassociated (SEM 200 00 2,00 L- 20 0 2,0

https://doi.org/10.1590/s1678-9946202365012

Detection of Microorganisms in Clinical Sonicated Orthopedic Devices Using Conventional Culture and qPCR
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Ribeiro, Victoria Stadler Tasca

; Cieslinski, Juliette

; Bertol, Julia

; Schumacher, Ana Laura

; Telles, João Paulo

; Tuon, Felipe Francisco

Revista Brasileira de Ortopedia

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aug 2022, Volume 57 N. 4 Pages 689 - 696

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

Resumo Objetivo Avaliar a sensibilidade e a especificidade da reação em cadeia de polimerase em tempo real quantitativa (quantitative real-time polymerase chain reaction, qPCR, em inglês) para a triagem do gene rDNA 16S, com a utilização do fluido sonicado de implantes ortopédicos. Métodos Um estudo retrospectivo foi realizado em 73 fluidos sonicados obtidos de pacientes com infecção associada aos implantes ortopédicos. As amostras foram submetidas a cultura convencional e a teste molecular utilizando ionização e dessorção a laser assistida por matriz com espectrometria de massa por tempo de voo (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, MALDI-TOF MS, em inglês) e qPCR para o gene rDNA 16S. Os valores limiares do ciclo foram usados para definir um ponto de corte para a qPCR do gene rDNA 16S para culturas negativas e positivas. Resultados Não foram observadas diferenças estatísticas entre os grupos de cultura positiva e negativa com base no tempo desde a primeira cirurgia até a infecção (p= 0,958), na idade (p= 0,269), ou nas comorbidades em geral. No entanto, uma diferença estatística foi encontrada entre a duração média do uso de antibióticos antes da remoção do dispositivo (3,41 versus 0,94; p= 0,016). O DNA bacteriano foi identificado em todas as amostras dos fluidos sonicados. Os limiares do ciclo médio de culturas positivas e negativas foram de 25,6 e 27,3, respectivamente (p< 0,001). Como uma ferramenta de diagnóstico, um corte do limite do ciclo de 26,89 demonstrou uma área sob a curva da característica de operação do receptor de 0,877 (p ≤ 0,001). Conclusão A presença de agentes antimicrobianos por mais de 72 horas diminuiu a positividade da cultura, mas não influenciou os resultados da qPCR. Apesar disso, a amplificação do rDNA 16S pode sobrestimar o diagnóstico de infecção.

Abstract Objective To evaluate the sensitivity and specificity of the quantitative real-time polymerase chain reaction (qPCR) for 16S rDNA gene screening using sonicated fluid from orthopedic implants. Methods A retrospective study was conducted on 73 sonicated fluids obtained from patients with infection associated with orthopedic implants. The samples were subjected to conventional culture and molecular testing using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and qPCR for 16S rDNA. The cycle threshold values were used to define a cut-off of the qPCR of the 16S rDNA for negative and positive cultures. Results No statistical differences were observed between the positive and negative culture groups based on the time from the first surgery to infection (p= 0.958), age (p =0.269), or general comorbidities. Nevertheless, a statistical difference was found between the mean duration of antibiotic use before device removal (3.41 versus 0.94; p =0.016). Bacterial DNA was identified in every sample from the sonicated fluids. The median cycle thresholds of the positive and negative cultures were of 25.6 and 27.3 respectively (p< 0.001). As a diagnostic tool, a cycle threshold cut-off of 26.89 demonstrated an area under the curve of the receiver operating characteristic of 0.877 (p≤ 0.001). Conclusion The presence of antimicrobial agents for more than 72 hours decreased culture positivity, but did not influence the qPCR results. Despite this, amplification of the 16S rDNA may overestimate infection diagnosis.

https://doi.org/10.1055/s-0041-1732386

Latent tuberculosis infection and kidney transplantation
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Tuon, Felipe Francisco

Brazilian Journal of Nephrology

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dec 2021, Volume 43 N. 4 Pages 455 - 456

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

https://doi.org/10.1590/2175-8239-jbn-2021-e008 3 downloads

10.

Active surveillance of carbapenem-resistant Gram-negative healthcare-associated infections in a low-middle-income country city
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Dias, Viviane Maria de Carvalho Hessel

; Silva, Daniela Maria Waszak da

; Burger, Marion

; Oliveira, Alcides Augusto Souto de

; Capelo, Patrícia de Jesus

; Specian, Fabio Augusto da Rocha

; Figueiredo, Marianna Cavina de

; Tuon, Felipe Francisco

; Baena, Cristina Pellegrino

Brazilian Journal of Infectious Diseases

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2021, Volume 25 N. 2 elocation 101540

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Carbapenem-resistance in healthcare-associated infections (HCAIs) is of great concern, and it is urgent to improve surveillance. We aimed to describe and analyze HCAIs trends on Gram-negative antimicrobial susceptibility in a city from a developing country, following the implementation of an active surveillance program. Methods: This is an aggregated study describing data from 24 hospitals with intensive care units, including a trend analysis by Joinpoint regression between January 2012 and December 2017. Results: There were 23,578 pathogens in 39,832 HCAIs, from which 16,225 were Gram-negatives (68.8%). Carbapenem susceptibility was lowest in A. baumannii (15.4–25.9%), K. pneumoniae (51.0–55.9%), and P. aeruginosa (64.9–84.1%) and highest in E. coli (96.5–99.2%). Only K. pneumoniae showed a significant Joinpoint at 95% confidence interval: −10.71% (−18.02; −2.75) from 2012 to 2014, p = 0.02, and 6.54% (−2.00; 15.83) from 2015 to 2017, p = 0.12, which was most influenced by urinary tract infections: −9.98% (−16.02; −3.48) from 2012 to 2014, p = 0.01, and 9.66% (−1.75; 22.39) from 2015 to 2017, p = 0.09. Conclusion: Although we found a significant change toward an improvement in carbapenem susceptibility in K. pneumoniae, resistance is high for most pathogens. These data should encourage health institutions to improve their prevention and control strategies.

https://doi.org/10.1016/j.bjid.2021.101540 86 downloads

11.

COVID-19: The question of genetic diversity and therapeutic intervention approaches
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Figueiredo, David Livingstone Alves

; Ximenez, João Paulo Bianchi

; Seiva, Fábio Rodrigues Ferreira

; Panis, Carolina

; Bezerra, Rafael dos Santos

; Ferrasa, Adriano

; Cecchini, Alessandra Lourenço

; Medeiros, Alexandra Ivo de

; Almeida, Ana Marisa Fusco

; Ramão, Anelisa

; Boldt, Angelica Beate Winter

; Moya, Carla Fredrichsen

; Chin, Chung Man

; Paula, Daniel de

; Rech, Daniel

; Gradia, Daniela Fiori

; Malheiros, Danielle

; Venturini, Danielle

; Tavares, Eliandro Reis

; Carraro, Emerson

; Ribeiro, Enilze Maria de Souza Fonseca

; Pereira, Evani Marques

; Tuon, Felipe Francisco

; Follador, Franciele Aní Caovilla

; Fernandes, Glaura Scantamburlo Alves

; Volpato, Hélito

; Cólus, Ilce Mara de Syllos

; Oliveira, Jaqueline Carvalho de

; Rodrigues, Jean Henrique da Silva

; Santos, Jean Leandro dos

; Visentainer, Jeane Eliete Laguila

; Brandi, Juliana Cristina

; Serpeloni, Juliana Mara

; Bonini, Juliana Sartori

; Oliveira, Karen Brajão de

; Fiorentin, Karine

; Lucio, Léia Carolina

; Faccin-Galhardi, Ligia Carla

; Ferreto, Lirane Elize Defante

; Lioni, Lucy Megumi Yamauchi

; Consolaro, Marcia Edilaine Lopes

; Vicari, Marcelo Ricardo

; Arbex, Marcos Abdo

; Pileggi, Marcos

; Watanabe, Maria Angelica Ehara

; Costa, Maria Antônia Ramos

; Giannini, Maria José S. Mendes

; Amarante, Marla Karine

; Khalil, Najeh Maissar

; Lima Neto, Quirino Alves de

; Herai, Roberto H.

; Guembarovski, Roberta Losi

; Shinsato, Rogério N.

; Mainardes, Rubiana Mara

; Giuliatti, Silvana

; Yamada-Ogatta, Sueli Fumie

; Gerber, Viviane Knuppel de Quadros

; Pavanelli, Wander Rogério

; Silva, Weber Claudio da

; Petzl-Erler, Maria Luiza

; Valente, Valeria

; Soares, Christiane Pienna

; Cavalli, Luciane Regina

; Silva Jr, Wilson Araujo

Genetics and Molecular Biology

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2021, Volume 44 N. 1 elocation e20200452

Abstract: En | Text: En | PDF: En

Abstract Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China’s Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients’ overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.

https://doi.org/10.1590/1678-4685-gmb-2020-0452

12.

Comparison of intermittent versus continuous-infusion vancomycin for treating severe patients in intensive care units
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Yamada, Carolina Hikari

; Telles, João Paulo

; Oliveira, Dayana dos Santos

; Cieslinski, Juliette

; Ribeiro, Victoria Stadler Tasca

; Gasparetto, Juliano

; Tuon, Felipe Francisco

Brazilian Journal of Infectious Diseases

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aug 2020, Volume 24 N. 4 Pages 356 - 359

Abstract: En | Text: En | PDF: En

Abstract Purpose The aim of this study was to compare pharmacokinetic characteristics between intermittent infusion and continuous infusion of vancomycin for critically ill patients admitted to intensive care units. Methods Intermittent therapy was administered for 60 minutes and prescribed as a loading dose of 30 mg/kg and continued with 15 mg/kg q12 h. Continuous infusion was prescribed as a loading dose of 30 mg/kg followed by 30 mg/kg on constant infusion pump. Blood samples from vancomycin intermittent infusion group were collected 1 h before third dose, 1 h, 8 h and 24 h after third dose infusion. Blood samples from vancomycin continuous infusion group were collected 1 h after loading dose, 12 h, 24 h, 36 h, and 48 h after continuous infusion initiation. Results Median serum concentration of continuous infusion group at 24-hour was 23.59 µg/mL [14.52–28.97], while of intermittent infusion group at 23-hour was 12.30 µg/mL [7.27–18.12] and on 25-hour was 17.58 µg/mL [12.5–22.5]. Medians AUC24–48h were 357.2 mg.h/L and 530.2 mg.h/L for intermittent infusion and continuous infusion groups, respectively (p = 0.559). Conclusion Vancomycin CI reached steady state earlier, which guaranteed therapeutic levels from the first day and made it possible to manage therapeutic drug monitoring faster.

https://doi.org/10.1016/j.bjid.2020.07.001 312 downloads

13.

A broad-spectrum beta-lactam-sparing stewardship program in a middle-income country public hospital: antibiotic use and expenditure outcomes and antimicrobial susceptibility profiles
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Zequinao, Tiago

; Gasparetto, Juliano

; Oliveira, Dayana dos Santos

; Silva, Gabriel Takahara

; Telles, João Paulo

; Tuon, Felipe Francisco

Brazilian Journal of Infectious Diseases

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jun 2020, Volume 24 N. 3 Pages 221 - 230

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Antimicrobial stewardship programs are an efficient way to reduce inappropriate use of antimicrobials and costs; however, supporting data are scarce in middle-income countries. The aim of this study was to evaluate antibiotic use, bacterial susceptibility profiles, and the economic impact following implementation of a broad-spectrum beta-lactam-sparing antimicrobial stewardship program. Methods: An interrupted time-series analysis was performed to evaluate antibiotic use and expenditure over a 24-month period (12 months before the antimicrobial stewardship program and in the 12 months after implementation of the antimicrobial stewardship program). Antibiotics were classified into one of two groups: beta-lactam antibiotics and beta-lactam-sparing antibiotics. We also compared the antimicrobial susceptibility profiles of key pathogens in each period. Results: Beta-lactam antibiotics use decreased by 43.04 days of therapy/1000 patient-days (p = 0.04) immediately following antimicrobial stewardship program implementation, whereas beta-lacta-sparing antibiotics use increased during the intervention period (slope change 6.17 days of therapy/1000 patient-days, p < 0.001). Expenditure decreased by $2089.99 (p < 0.001) immediately after intervention and was maintained at this level over the intervention period ($−38.45; p = 0.24). We also observed that a greater proportion of pathogens were susceptible to cephalosporins and aminoglycosides after the antimicrobial stewardship program. Conclusions: The antimicrobial stewardship program significantly reduced the use of broad-spectrum beta-lactam-antibiotics associated with a decrease in expenditure and maintenance of the susceptibility profile in Gram-negative bacteria.

https://doi.org/10.1016/j.bjid.2020.05.005 336 downloads

14.

Evaluation of in vitro activity of ceftolozane-tazobactam against recent clinical bacterial isolates from Brazil - the EM200 study
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Tuon, Felipe Francisco

; Cieslinski, Juliette

; Rodrigues, Suellen da Silva

; Serra, Fernando Brandão

; Paula, Marina Della-Negra de

Brazilian Journal of Infectious Diseases

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apr 2020, Volume 24 N. 2 Pages 96 - 103

Abstract: En | Text: En | PDF: En

ABSTRACT Background: The emergence of antibiotic resistance is increasing and there are few effective antibiotics to treat infections caused by resistant and multidrug resistant bacterial pathogens. This study aimed to evaluate the in vitro activity of ceftolozane-tazobactam against clinical bacterial isolates from Brazil. Methods: A total of 673 Gram-negative bacterial isolates including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and other Enterobacterales collected from 2016 to 2017 were tested, most of them isolated from patients in intensive care units. Minimum inhibitory concentrations (MIC50/90) were determined by broth microdilution for amikacin, aztreonam, cefepime, cefotaxime, cefoxitin, ceftolozane-tazobactam, ceftazidime, ceftriaxone, ciprofloxacin, colistin, ertapenem, imipenem, levofloxacin, meropenem, and piperacillin-tazobactam using dried panels. Antimicrobial susceptibility results were interpreted according to Clinical and Laboratory Standards Institute criteria. Results: Susceptibility rates to ceftolozane-tazobactam ranged from 40.4% to 94.9%. P. aeruginosa susceptibility rate to ceftolozane-tazobactam was 84.9% (MIC50/90, 1/16 µg/mL) and 99.2% to colistin. For E. coli, ceftolozane-tazobactam inhibited 94.9% (MIC50/90, 0.25/1 µg/mL) of the microorganisms. The susceptibility rate of K. pneumoniae to ceftolozane-tazobactam was 40.4% (MIC50/90, 16/>32 µg/mL). Other Enterobacterales have shown susceptibility rates of 81.1% (MIC50/90, 0.5/16 µg/mL) to ceftolozane-tazobactam, 93.9% to meropenem, 90.9% to amikacin (90.9%), and 88.6% to ertapenem. In non-carbapenemase producing isolates, AmpC mutations were found three isolates. Conclusions: Ceftolozane-tazobactam has shown relevant activity against a large variety of the analyzed microorganisms collected from multiple centers in Brazil, showing promising results even in multidrug resistant strains.

https://doi.org/10.1016/j.bjid.2020.04.004 443 downloads

15.

Infectious keratitis in southern Brazil: a comparison culture negative and culture positive patients
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Duarte, Maria Cecília Barros

; Becker, Guilherme Nardi

; Muller, Guilherme Gubert

; Tuon, Felipe Francisco

Revista Brasileira de Oftalmologia

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jan 2020, Volume 79 N. 1 Pages 46 - 52

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

Resumo Objetivo: Comparar os perfis clinico-epidemiológicos e os desfechos entre pacientes com ceratite com cultura positiva e pacientes com ceratite com cultura negativa. Métodos: Pacientes com ceratite infecciosa, atendidos em dois hospitais oftalmológicos em Curitiba, Brasil, entre junho de 2014 e abril de 2016, foram estudados prospectivamente. Exame oftalmológico, raspado de córnea e exames microbiológicos foram realizados no primeiro atendimento. Os dados quanto a seguimento e desfecho foram coletados após 12 semanas do primeiro atendimento através de revisão de prontuário. A partir dos resultados das culturas, dois grupos foram formados: ceratite com cultura negativa e ceratite com cultura positiva. Resultados: Vinte e um pacientes foram classificados como ceratite com cultura negativa e 20 como ceratite com cultura positiva. O número de pacientes em uso de colírio antibiótico no primeiro atendimento foi maior no grupo de cultura negativa (90,5% versus 60%; p=0,032). Sete pacientes (37%) no grupo cultura positiva precisaram de procedimentos cirúrgicos no manejo da ceratite, versus 3 pacientes (15%) do grupo cultura negativa (p=0,155). Oitenta e cinco por cento (17/20) dos pacientes do grupo cultura negativa alcançaram sucesso no tratamento, contra 61% (11/18) dos pacientes no grupo cultura positiva (p=0,144). Não houve diferença entre os grupos quanto a idade, gênero, local de procedência, presença de comorbidades, fatores de risco, duração dos sintomas e características da úlcera de córnea. Conclusão: Tratamento prévio com colírio de antibiótico correlaciona-se com resultados negativos de cultura. Não houve diferença no desfecho após tratamento entre os pacientes com cultura negativa e cultura positiva.

Abstract Purpose: To compare clinical-epidemiological profile and treatment outcome between culture negative and culture positive keratitis patients. Methods: Patients with suspected infectious keratitis seen at two ophthalmic hospitals in Curitiba, Brazil, between June 2014 and April 2016, were prospectively studied. Ophthalmological exam with corneal scraping and microbiological tests were performed. Data regarding follow up, surgical interventions and treatment outcome were collected after 12 weeks of the first visit trough medical chart review. From the results of the culture, two groups were formed: culture negative keratitis (CNK) and culture positive keratitis (CPK). Results: According to inclusion criteria 21 patients were classified as culture negative keratitis and 20 patients as culture positive keratitis. The number of patients on antibiotic drops at the first visit was greater in CNK group (90.5% versus 60%; p=0.032). Surgical procedures were necessary in 3 patients (15%) in CNK group and in 7 patients (36,8%) in CPK group (p=0.155). Treatment success was achieved by 85% (17/20) of the patients in CNK group and by 61% (11/18) of the patients in CPK group (p=0.144). There was no significant difference between groups regarding age, gender, place of residence, presence of comorbidities, risk factors for infectious keratitis, duration of symptoms and characteristics of corneal ulcer. Conclusions: Previous treatment with antibiotics correlates with negative culture results. There was no significant difference in treatment outcome between culture negative and culture positive keratitis patients.

https://doi.org/10.5935/0034-7280.20200009 490 downloads

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