EDSON ABDALA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina - Docente
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
- Applying mucosal barrier injury laboratory-confirmed bloodstream infection criteria in patients with solid tumors and hematologic malignancies: A retrospective cohort study looking for the real source of infection(2023) SILVA, Ana Carolina Puin da; VIEIRA, Michely Fernandes; FREIRE, Maristela Pinheiro; VAZ, Lumena; BONAZZI, Patricia Rodrigues; IBRAHIM, Karim Yaqub; DIZ, Maria Del Pilar Esteves; HOFF, Paulo Marcelo; PEREIRA, Juliana; ROCHA, Vanderson Geraldo; ABDALA, EdsonWe evaluated the interference of the mucosal barrier injury (MBI) laboratory-confirmed bloodstream infection (MBI-LCBI) criteria on the central-line-associated bloodstream infection (CLABSI) incidence density, and the proportion of catheter-related bloodstream infections (CRBSIs) among those classified as MBI. We detected 339 CLABSIs: 15.0% were classified as MBI-LCBIs, and among these, 19.6% were classified as CRBSIs.
- Prophylaxis of fungal infections in transplant patients(2012) ABDALA, Edson; COSTA, Silvia Figueiredo; STRABELLI, Tania Mara Varejao; PIERROTTI, Ligia Camera; CARAMORI, Marlova Luzzi; AZEVEDO, Luis Sergio Fonseca de; IBRAHIM, Karim Y.; DULLEY, Frederico Luiz; VARKULJA, Glaucia Fernanda; CASTRO JUNIOR, Gilberto de; ALMEIDA, Gisele Madeira Duboc de; MARQUES, Heloisa Helena de Souza; SHIKANAI-YASUDA, Maria Aparecida
- Role of Lock Therapy for Long-Term Catheter-Related Infections by Multidrug-Resistant Bacteria(2018) FREIRE, Maristela P.; PIERROTTI, Ligia C.; ZERATI, Antonio E.; BENITES, Luciana; MOTTA-LEAL FILHO, Joaquim Mauricio da; IBRAHIM, Karim Y.; ARAUJO, Pedro H.; ABDALA, EdsonThe management of long-term central venous catheter (LTCVC) infections by multidrug-resistant (MDR) bacteria in cancer patient is a challenge. The objectives of this study were to analyze outcomes in cancer patients with LTCVC-associated infection, identify risks for unfavorable outcomes, and determine the impact of MDR bacteria and antibiotic lock therapy (ALT) in managing such infections. We evaluated all LTCVC-associated infections treated between January 2009 and December 2016. Infections were reported in accordance with international guidelines for catheter-related infections. The outcome measures were 30-day mortality and treatment failure. We analyzed risk factors by Cox forward-stepwise regression. We identified 296 LTCVC-associated infections; 212 (71.6%) were classified as bloodstream infections (BSIs). The most common agent was Staphylococcus aureus. Forty-six (21.7%) infections were due to MDR Gram-negative bacteria. ALT was used in 62 (29.2%) patients, with a 75.9% success rate. Risk factors identified for failure of the initial treatment were having a high sequential organ failure assessment (SOFA) score at diagnosis of infection and being in palliative care; introduction of ALT at the start of treatment was identified as a protective factor. Risk factors identified for 30-day mortality after LTCVC-associated infection were a high SOFA score at diagnosis, infection with MDR bacteria, and palliative care; introduction of ALT at the start of treatment, hematological malignancies, and adherence to an institutional protocol for the management of LTCVC-associated infection were identified as protective factors. Despite the high incidence of infection with MDR bacteria, ALT improves the outcome of LTCVC-associated infection in cancer patients.
- Infection with Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae in cancer patients(2015) FREIRE, M. P.; PIERROTTI, L. C.; FILHO, H. H. C.; IBRAHIM, K. Y.; MAGRI, A. S. G. K.; BONAZZI, P. R.; HAJAR, L.; DIZ, M. P. E.; PEREIRA, J.; HOFF, P. M.; ABDALA, E.Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kp) is an emergent pathogen in healthcare-associated infections (HAIs). The aim of this study was to describe HAIs due to KPC-Kp, as well as identify mortality risk factors in cancer patients. In patients diagnosed with HAIs due to KPC-Kp between January 2009 and July 2013, we evaluated only the first infection episode of each patient, analyzing mortality separately for patients treated for a parts per thousand yen48 h with at least one antimicrobial agent proven to display in vitro activity against KPC-Kp. We evaluated variables related to the malignancy, the severity and characteristics of the HAI, and the antimicrobial therapy. We identified 83 HAIs due to KPC-Kp. The 30-day mortality was 57.8 % for all infections and 72.7 % for bacteremic infections. Of the 83 patients, 60 patients received a parts per thousand yen48 h of appropriate treatment and 44 (53 %) developed bacteremia. Ten patients (12 %) were neutropenic at HAI diagnosis and 33 (39.8 %) had infection at the tumor site. The most common HAI was urinary tract infection, seen in 26 patients (31.3 %), followed by primary bloodstream infection, seen in 24 patients (28.9 %). Forty-four patients (73.3 %) received combination antimicrobial therapy, most often including polymyxin (68.3 %). Risk factors for 30-day mortality are high sequential organ failure assessment (SOFA) score, need for intensive care stay at diagnosis of infection, and acute kidney injury; the removal of invasive devices related to infection and treatment with effective antibiotics for KPC-Kp are protective factors. In cancer patients, high mortality is associated with HAI due to KPC-Kp and mortality risk factors are more often related to acute infection than to the underlying disease.
- Bloodstream infection caused by extensively drug-resistant Acinetobacter baumannii in cancer patients: high mortality associated with delayed treatment rather than with the degree of neutropenia(2016) FREIRE, M. P.; GARCIA, D. de Oliveira; GARCIA, C. P.; BUENO, M. F. Campagnari; CAMARGO, C. H.; MAGRI, A. S. G. Kono; FRANCISCO, G. R.; REGHINI, R.; VIEIRA, M. F.; IBRAHIM, K. Y.; ROSSI, F.; HAJJAR, L.; LEVIN, A. S.; HOFF, P. M.; PIERROTTI, L. C.; ABDALA, E.This study aimed to describe severe infections with extensively drug-resistant Acinetobacter baumannii-calcoaceticus complex (XDR-ABC), as well as to investigate risk factors for mortality, in cancer patients. It was a retrospective study including all patients diagnosed with XDR-ABC bacteraemia during hospitalization in the intensive care unit of a cancer hospital between July 2009 and July 2013. Surveillance cultures were collected weekly during the study period, and clonality was analysed using pulsed field gel electrophoresis (PFGE). We analysed underlying diseases, oncology therapy, neutrophil counts, infection site and management of infection, in terms of their correlation with 30-day mortality. During the study period, 92 patients with XDR-ABC bacteraemia were identified, of whom 35 (38.0%) were patients with haematological malignancy. We identified XDR-ABC strains with four different profile patterns, 91.3% of patients harbouring the predominant PFGE type. Of the 92 patients with XDR-ABC bacteraemia, 66 (71.7%) had central line-associated bloodstream infections; infection occurred during neutropenia in 22 (23.9%); and 58 (63.0%) died before receiving the appropriate therapy. All patients were treated with polymyxin, which was used in combination therapy in 30 of them (32.4%). The 30-day mortality rate was 83.7%. Multivariate analysis revealed that septic shock at diagnosis of XDR-ABC infection was a risk factor for 30-day mortality; protective factors were receiving appropriate therapy and invasive device removal within the first 48 h. Among cancer patients, ineffective management of such infection increases the risk of death, more so than do features such as neutropenia and infection at the tumour site.
conferenceObject The Worth of Surveillance for Vancomycin-Resistant Enterococci in the Hematology-Oncology Unit(2014) BELLESSO, Marcelo; ABDALA, Edson; PEREIRA, Juliana; SANTUCCI, Rodrigo; IBRAHIM, Karim Yaqub; FREIRE, Maristela Pinheiro; FRATELLI, Lumena Vaz Carvalho; MARQUES, Patricia Andrea Crippa- Validation of the North America expert consensus statement on reporting CT findings for COVID-19 in individuals with lung cancer(2022) PEIXOTO, D.; NEVES, Y. C. S.; GENEROSO, G.; LOUREIRO, B. M. C.; CALLIA, J. P. B.; ANASTACIO, V. M.; ALVES, J. L.; OSHIRO, E. M.; LIMA, L. R.; SAWAMURA, M. V. Y.; AUAD, R. V.; BITTENCOURT, M. S.; ABDALA, E.; IBRAHIM, K. Y.The aim of our study was to validate the use of the standardized Radiological Society of North America (RSNA) reporting system in individuals with known lung cancer who presented to the emergency department with suspected COVID-19. We included patients aged 18 years or older from the Cancer Institute of the State of Sao Paulo (ICESP) with a confirmed diagnosis of lung cancer, admitted to the emergency department and undergoing chest computed tomography (CT) for suspicion of COVID-19. Comparison between SARS-CoV2 RT-PCR across RSNA categories was performed in all patients and further stratified by diagnosis of lung cancer progression. Among 58 individuals included in the analysis (65 +/- 9 years, 43% men), 20 had positive RT-PCR. Less than a half (43%) had no new lung findings in the CT. Positive RT-PCR was present in 75% of those with typical findings according to RSNA and in only 9% when these findings were classified as atypical or negative (Po0.001). Diagnostic accuracy was even higher when stratified by the presence or absence of progressive disease (PD). Extent of pulmonary inflammatory changes was strongly associated with higher mortality, reaching a lethality of 83% in patients with >25% of lung involvement and 100% when there was >50% of lung involvement. The lung involvement score was also highly predictive of prognosis in this population as was reported for non-lung cancer individuals. Collectively, our results demonstrated that diagnostic and prognostic values of chest CT findings in COVID-19 are robust to the presence of lung abnormalities related to lung cancer.
- Clinical presentation and in-hospital prognosis of lung cancer patients presenting with suspected and confirmed COVID-19(2022) PEIXOTO, D.; CALLIA, J. P. B.; BITTENCOURT, M. S.; GENEROSO, G.; ANASTACIO, V. M.; ALVES-JR, J. L.; SILVA, T. L. da; BELIZARIO, J. C.; ARAUJO, B. L. M.; HO, W.; DIZ, M. D. P. E.; HOFF, P. M.; ABDALA, E.; IBRAHIM, K. Y.We sought to compare the clinical presentation and prognosis of patients with lung cancer and confirmed COVID-19 infection to those with negative RT-PCR SARS-CoV-2 results. We included patients with confirmed lung cancer and suspected COVID-19 who presented to the emergency department. The primary outcome was in-hospital mortality and secondary outcomes included admission to intensive care unit (ICU) or mechanical ventilation. We analyzed the characteristics according to RT-PCR results and primary outcome. We constructed a logistic regression for each RT-PCR result group to find potential predictors of the primary outcome. Among 110 individuals with confirmed lung cancer (65 +/- 9 years, 51% male), 38 patients had positive RT-PCR and 72 patients had negative RT-PCR. There was no difference between groups for any clinical characteristic or comorbidities though individuals with confirmed COVID-19 had higher functionality in the ECOG scale. Leucocytes and lymphocytes were lower in individuals with positive tests. The primary outcome occurred in 58 (53%) individuals, 37 (34%) were admitted to the ICU, and 29 (26%) required mechanical ventilation. Although mortality was similar between the two groups, individuals with confirmed COVID-19 were significantly more likely to be admitted to the ICU or receive mechanical ventilation. Only lower lymphocytes and higher CRP were significantly associated with higher mortality. The clinical presentation of COVID-19 in lung cancer is not sufficient to identify higher or lower probability groups among symptomatic individuals, the overall mortality is high irrespective of RT-PCR results, and lymphopenia on admission was associated with the diagnosis and prognosis for COVID-19.
- Fluoroquinolone treatment as a protective factor for 10-day mortality in Streptococcus pneumoniae bacteremia in cancer patients (vol 11, 3699, 2021)(2021) FONTANA, Naihma Salum; IBRAHIM, Karim Yaqub; BONAZZI, P. R.; ROSSI, F.; ALMEIDA, S. C. G.; TENGAN, F. M.; BRANDILEONE, M. C. C.; ABDALA, E.
- Rhizopus arrhizus and Fusarium solani Concomitant Infection in an Immunocompromised Host(2016) ALMEIDA JUNIOR, Joao N. de; IBRAHIM, Karim Y.; NEGRO, Gilda M. B. Del; BEZERRA, Evandro D.; DUARTE NETO, Amaro N.; BATISTA, Marjorie V.; SICILIANO, Rinaldo F.; GIUDICE, Mauro C.; MOTTA, Adriana L.; ROSSI, Flavia; PIERROTTI, Ligia C.; FREIRE, Maristela P.; BELLESSO, Marcelo; PEREIRA, Juliana; ABDALA, Edson; BENARD, GilNeutropenic patients are at risk of the development of hyalohyphomycosis and mucormycosis. Correct identification is essential for the initiation of the specific treatment, but concomitant mold infections are rarely reported. We report one unprecedented case of concomitant mucormycosis and fusariosis in a neutropenic patient with acute myeloid leukemia. The patient developed rhino-orbital infection by Rhizopus arrhizus and disseminated infection by Fusarium solani. The first culture from a sinus biopsy grew Rhizopus, which was consistent with the histopathology report of mucormycosis. A second sinus biopsy collected later during the patient's clinical deterioration was reported as hyalohyphomycosis, and the culture yielded F. solani. Due to the discordant reports, the second biopsy was reviewed and two hyphae types suggestive of both hyalohyphomycetes and mucormycetes were found. The dual mold infection was confirmed by PCR assays from paraffinized tissue sections. Increased awareness of the existence of dual mold infections in at-risk patients is necessary. PCR methods in tissue sections may increase the diagnosis of dual mold infections. In case of sequential biopsies showing discrepant results, mixed infections have to be suspected.