CECILIA EUGENIA CHARBEL

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina

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    Gastrointestinal Multiplex Polymerase Chain Reaction, Patterns of Bowel Histology and The Etiologic Diagnosis of Diarrhea in Common Variable Immunodeficiency
    (2023) TODT, Beatriz; KOKRON, Cristina; TOLEDO-BARROS, Myrthes; PINHO, Joao Renato; CHARBEL, Cecilia; SAIHG, Priscila; GRECCO, Octavio; MARINHO, Ana Karolina BB.; SILVA, Carlos Felipe; KALIL, Jorge; LIMA, Fabiana
  • article 13 Citação(ões) na Scopus
    The effect of a rapid molecular blood test on the use of antibiotics for nosocomial sepsis: a randomized clinical trial
    (2019) RODRIGUES, Cristhieni; SICILIANO, Rinaldo Focaccia; CAIAFFA FILHO, Helio; CHARBEL, Cecilia Eugenia; SILVA, Luciane de Carvalho Sarahyba da; REDAELLI, Martina Baiardo; PASSETTI, Ana Paula de Paula Rosa; FRANCO, Maria Renata Gomes; ROSSI, Flavia; ZEIGLER, Rogerio; BACKER, Daniel De; FRANCO, Rafael Alves; ALMEIDA, Juliano Pinheiro de; RIZK, Stephanie Itala; FUKUSHIMA, Julia Tizue; LANDONI, Giovanni; UIP, David Everson; HAJJAR, Ludhmila Abrahao; STRABELLI, Tania Mara Varejao
    Background: Appropriate use of antimicrobials is essential to improve outcomes in sepsis. The aim of this study was to determine whether the use of a rapid molecular blood test-SeptiFast (SF) reduces the antibiotic consumption through early de-escalation in patients with nosocomial sepsis compared with conventional blood cultures (BCs). Methods: This was a prospective, randomized, superiority, controlled trial conducted at Sao Paulo Heart Institute in the period October 2012-May 2016. Adult patients admitted to the hospital for at least 48h with a diagnosis of nosocomial sepsis underwent microorganism identification by both SF test and BCs. Patients randomized into the intervention group received antibiotic therapy adjustment according to the results of SF. Patients randomized into the control group received standard antibiotic adjustment according to the results of BCs. The primary endpoint was antimicrobial consumption during the first 14days after randomization. Results: A total of 200 patients were included (100 in each group). The intention to treat analysis found no significant differences in median antibiotic consumption. In the subgroup of patients with positive SF and blood cultures (19 and 25 respectively), we found a statistically significant reduction in the median antimicrobial consumption which was 1429 (1071-2000) days of therapy (DOT)/1000 patients-day in the intervention group and 1889 (1357-2563) DOT/1000 patients-day in the control group (p=0.017), in the median time of antimicrobial de-escalation (8 versus 54h-p<0.001), in the duration of antimicrobial therapy (p=0.039) and in anti-gram-positive antimicrobial costs (p=0.002). Microorganism identification was possible in 24.5% of patients (45/184) by SF and 21.2% (39/184) by BC (p=0.45). Conclusion: This randomized clinical trial showed that the use of a rapid molecular-based pathogen identification test does not reduce the median antibiotic consumption in nosocomial sepsis. However, in patients with positive microbiological tests, the use of SeptiFast reduced antimicrobial consumption through early de-escalation compared to conventional blood cultures. These results were driven by a reduction in the consumption of antimicrobials used for Gram-positive bacteria.
  • article 4 Citação(ões) na Scopus
    Investigation of superficial mycosis in cutaneous allergy patients using topical or systemic corticosteroids
    (2017) FREITAS, Roseli S. de; NEVES, Paula S.; CHARBEL, Cecilia E.; CRIADO, Paulo R.; NUNES, Ricardo S.; SANTOS-FILHO, Antonio M.; VASCONCELLOS, Cidia