JESSICA FERNANDES RAMOS
Projetos de Pesquisa
Unidades Organizacionais
PAHC, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
20 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 20
- Increased Risk of for Cytomegalovirus Reactivation after Allogeneic HSCT in T-Cell Depleted Patients(2020) MOLLA, Vinicius Campos; AZEVEDO, Roberta; RAMOS, Jessica Fernandes; PONCIANO, Danilo Belchior; MORAES, Pedro Henrique Arruda de; FONSECA, Ana Rita Da; SEIWALD, Maria Cristina Nunez; SERPA, Mariana; FERREIRA, Aliana Meneses; SZOR, Roberta Shcolnik; LEONEL, Rayana Bomfim; XAVIER, Erick Menezes; ROCHA, Vanderson; TUCUNDUVA, Luciana; NOVIS, Yana; NUCCI, Marcio; KALLAS, Esper; ARRAIS, Celso
- Cytomegalovirus infection in transplant recipients(2015) AZEVEDO, Luiz Sergio; PIERROTTI, Ligia Camera; ABDALA, Edson; COSTA, Silvia Figueiredo; STRABELLI, Tania Mara Varejao; CAMPOS, Silvia Vidal; RAMOS, Jessica Fernandes; LATIF, Acram Zahredine Abdul; LITVINOV, Nadia; MALUF, Natalya Zaidan; CAIAFFA FILHO, Helio Hehl; PANNUTI, Claudio Sergio; LOPES, Marta Heloisa; SANTOS, Vera Aparecida dos; LINARDI, Camila da Cruz Gouveia; YASUDA, Maria Aparecida Shikanai; MARQUES, Heloisa Helena de SousaCytomegalovirus infection is a frequent complication after transplantation. This infection occurs due to transmission from the transplanted organ, due to reactivation of latent infection, or after a primary infection in seronegative patients and can be defined as follows: latent infection, active infection, viral syndrome or invasive disease. This condition occurs mainly between 30 and 90 days after transplantation. In hematopoietic stem cell transplantation in particular, infection usually occurs within the first 30 days after transplantation and in the presence of graft-versus-host disease. The major risk factors are when the recipient is cytomegalovirus seronegative and the donor is seropositive as well as when lymphocyte-depleting antibodies are used. There are two methods for the diagnosis of cytomegalovirus infection: the pp65 antigenemia assay and polymerase chain reaction. Serology has no value for the diagnosis of active disease, whereas histology of the affected tissue and bronchoalveolar lavage analysis are useful in the diagnosis of invasive disease. Cytomegalovirus disease can be prevented by prophylaxis (the administration of antiviral drugs to all or to a subgroup of patients who are at higher risk of viral replication) or by preemptive therapy (the early diagnosis of viral replication before development of the disease and prescription of antiviral treatment to prevent the appearance of clinical disease). The drug used is intravenous or oral ganciclovir; oral valganciclovir; or, less frequently, valacyclovir. Prophylaxis should continue for 90 to 180 days. Treatment is always indicated in cytomegalovirus disease, and the gold-standard drug is intravenous ganciclovir. Treatment should be given for 2 to 3 weeks and should be continued for an additional 7 days after the first negative result for viremia.
conferenceObject Hepatitis B Virus Prophylaxis and Treatment among Hematopoietic Stem Cell Transplant Recipients: Impact on Engraftment and Outcomes(2020) BUZO, B.; RAMOS, J. Fernandes; ROSSETTI, R. Marques; SALLES, N.; MENDRONE-JUNIOR, A.; ROCHA, V.; NASTRI, A. de Seixas Santos- Epidemiology, clinical aspects, outcomes and prognostic factors associated with Trichosporon fungaemia: results of an international multicentre study carried out at 23 medical centres(2021) JR, Joao Nobrega de Almeida; FRANCISCO, Elaine Cristina; RUIZ, Alexis Holguin; CUELLAR, Luis E.; AQUINO, Valerio Rodrigues; MENDES, Ana Verena; QUEIROZ-TELLES, Flavio; SANTOS, Daniel Wagner; GUIMARAES, Thais; CHAVES, Guilherme Maranhao; MIRANDA, Bianca Grassi de; MOTTA, Fabio Araujo; SCHWARZBOLD, Alexandre Vargas; OLIVEIRA, Marcio; RIERA, Fernando; PEROZIN, Jamile Sardi; NEVES, Rejane Pereira; SILVA, Ivan Leonardo A. Franca E.; SZTAJNBOK, Jaques; RAMOS, Jessica Fernandes; BOTURA, Monica Borges; CARLESSE, Fabianne; CASTRO, Paulo de Tarso de O. E.; NYIRENDA, Themba; COLOMBO, Arnaldo L.Background: Trichosporon fungaemia (TF) episodes have increased in recent years and mortality rates remain high despite the advances in the management of sepsis. New concepts about its clinical course, treatment and microbiology need to be investigated for the better management of this infection. Objectives: To describe the aetiology, natural history, clinical management and prognostic factors of TF. Methods: TF episodes documented between 2005 and 2018 in 23 South American centres were retrospectively investigated by using a standard clinical form. Molecular identification, antifungal susceptibility testing and biofilm production were also performed. Results: Eighty-eight TF episodes were studied. Patients had several underlying conditions, including haematological diseases (47.7%), post-operative status (34%), solid organ transplants (n = 7, 7.9%), among others. Seventy-three (82.9%) patients had a central venous catheter (CVC) at TF diagnosis. The 30 day mortality rate was 51.1%. Voriconazole-based therapy was given to 34 patients (38.6%), with a 30 day mortality rate of 38.2%. Multivariate predictors of 30 day mortality were age (OR 1.036), mechanical ventilation (OR 8.25) and persistent neutropenia (OR 9.299). CVC removal was associated with over 75% decreased risk of 30 day mortality (OR 0.241). Microbiological analyses revealed that 77.7% of the strains were identified as Trichosporon asahii, and voriconazole showed the strongest in vitro activity against Trichosporon spp. Most of the strains (63%) were considered medium or high biofilm producers. Conclusions: Older age, mechanical ventilation and persistent neutropenia were associated with poor prognosis. CVC may play a role in the pathogenicity of TF and its removal was associated with a better prognosis.
- Clinical outcome from hematopoietic cell transplant patients with bloodstream infection caused by carbapenem-resistant P. aeruginosa and the impact of antimicrobial combination in vitro(2022) RAMOS, Jessica Fernandes; LEITE, Gleice; MARTINS, Roberta Cristina Ruedas; RIZEK, Camila; SANABANI, Sabri Saeed Al; ROSSI, Flavia; GUIMARAES, Thais; LEVIN, Anna Sara; ROCHA, Vanderson; COSTA, Silvia FigueiredoBloodstream infection (BSI) caused by carbapenem-resistant P. aeruginosa (CRPA) has high mortality in hematopoietic stem cell transplant (HSCT) recipients. We performed MIC, checkerboard, time-kill assay, PFGE, PCR, and whole genome sequence and described the clinical outcome through Epi Info comparing the antimicrobial combination in vitro. Mortality was higher in BSI caused by CRPA carrying the lasB virulence gene. The isolates were 97% resistant to meropenem displaying synergistic effect to 57% in combination with colistin. Seventy-three percent of the isolates harbored bla(SPM-1) and Tn4371 and belonged to ST277. The synergistic effect in vitro with meropenem with colistin appeared to be a better therapeutic option.
- Disseminated Fusarium infection in autologous stem cell transplant recipient(2015) AVELINO-SILVA, Vivian Iida; RAMOS, Jessica Fernandes; LEAL, Fabio Eudes; TESTAGROSSA, Leonardo; NOVIS, Yana SarkisDisseminated infection by Fusarium is a rare, frequently lethal condition in severely immunocompromised patients, including bone marrow transplant recipients. However, autologous bone marrow transplant recipients are not expected to be at high risk to develop fusariosis. We report a rare case of lethal disseminated Fusarium infection in an autologous bone marrow transplant recipient during pre-engraftment phase. (C) 2014 Elsevier Editora Ltda.
conferenceObject Epidemiological and clinical characteristics of presumed ocular tuberculosis: a 12-year experience in a tertiary center in Brazil(2014) CONTIN, Inara; RAMOS, Jessica F.; LEITE, Olavo H.; HIRATA, Carlos E.; YAMAMOTO, Joyce H.- MAIT cells are activated in acute Dengue virus infection and after in vitro Zika virus infection(2018) PAQUIN-PROULX, Dominic; AVELINO-SILVA, Vivian I.; SANTOS, Bianca A. N.; BARSOTTI, Nathalia Silveira; SIROMA, Fabiana; RAMOS, Jessica Fernandes; TONACIO, Adriana Coracini; SONG, Alice; MAESTRI, Alvino; CERQUEIRA, Natalia Barros; FELIX, Alvina Clara; LEVI, Jose Eduardo; GREENSPUN, Benjamin C.; ROUGVIE, Miguel de Mulder; ROSENBERG, Michael G.; NIXON, Douglas F.; KALLAS, Esper G.Dengue virus (DENV) and Zika virus (ZIKV) are members of the Flaviviridae and are pre-dominantly transmitted via mosquito bites. Both viruses are responsible for a growing number of infections in tropical and subtropical regions. DENV infection can cause lethargy with severe morbidity and dengue shock syndrome leading to death in some cases. ZIKV is now linked with Guillain-Barre A syndrome and fetal malformations including microcephaly and developmental disorders (congenital Zika syndrome). The protective and pathogenic roles played by the immune response in these infections is unknown. Mucosal-associated invariant T (MAIT) cells are a population of innate T cells with potent anti-bacterial activity. MAIT cells have also been postulated to play a role in the immune response to viral infections. In this study, we evaluated MAIT cell frequency, phenotype, and function in samples from subjects with acute and convalescent DENV infection. We found that in acute DENV infection, MAIT cells had elevated co-expression of the activation markers CD38 and HLA-DR and had a poor IFN gamma response following bacterial stimulation. Furthermore, we found that MAIT cells can produce IFN gamma in response to in vitro infection with ZIKV. This MAIT cell response was independent of MR1, but dependent on IL-12 and IL-18. Our results suggest that MAIT cells may play an important role in the immune response to Flavivirus infections.
- High mortality of bloodstream infection outbreak caused by carbapenem-resistant P. aeruginosa producing SPM-1 in a bone marrow transplant unit(2017) CHAVES, Lucas; TOMICH, Lisia Moura; SALOMAO, Matias; LEITE, Gleice Cristina; RAMOS, Jessica; MARTINS, Roberta Ruedas; RIZEK, Camila; NEVES, Patricia; BATISTA, Marjorie Vieira; AMIGO, Ulysses; GUIMARAES, Thais; LEVIN, Anna Sara; COSTA, Silvia FigueiredoPurpose. Carbapenem resistance in P. aeruginosa is increasing worldwide. In Brazil, SPM-1 is the main P. aeruginosa carbapenemase identified. Little is known about the virulence factor in SPM-1 clones. Methodolgy. We describe a carbapenem-resistant P. aeruginosa bloodstream infection (CRPa-BSI) outbreak in a bone marrow transplant Unit (BMT). Twenty-nine CRPa-BSI cases were compared to 58 controls. Microbiological characteristics of isolates, such as sensitivity, carbapenemase gene PCR for P. aeruginosa, and PFGE are described, as well as the whole-genome sequence (WGS) of three strains. Results/Key findings. The cultures from environmental and healthcare workers were negative. Some isolates harboured KPC and SPM. The WGS showed that the 03 strains belonged to ST277, presented the same mutations in outer membrane protein, efflux pump, and virulence genes such as those involved in adhesion, biofilm, quorum-sensing and the type III secretion system, but differ regarding the carbapenemase profile. A predominant clone-producing SPM harbouring Tn 4371 was identified and showed cross-transmission; no common source was found. Overall mortality rate among cases was 79 %. The first multivariate analysis model showed that neutropenia (P=0.018), GVHD prophylaxis (P=0.016) and prior use of carbapenems (P=0.0089) were associated with CRPa-BSI. However, when MASCC >= 21 points and platelets were added in the final multivariate analysis, only prior use of carbapenems remained as an independent risk factor for CRPa-BSI (P=0.043). Conclusions. The predominant clone belonging to ST277 showed high mortality. Carbapenem use was the only risk factor associated with CRPa-BSI. This finding is a wake-up call for the need to improve management in BMT units.
- Low Rates of Vancomycin Use in Febrile Neutropenia: A Multicenter Study(2019) PEREIRA, Andre Domingues; RAMOS, Jessica Fernandes; GUARANA, Mariana; NOUER, Simone A.; NUCCI, Marcio; ARRAIS-RODRIGUES, Celso