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
17 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 17
- Surgical site infection after liver transplantation in the era of multidrug-resistant bacteria: what new risks should be considered?(2021) FREIRE, Maristela P.; SONG, Alice T. Wan; OSHIRO, Isabel Cristina Vilela; ANDRAUS, Wellington; D'ALBUQUERQUE, Luiz Augusto Carneiro; ABDALA, EdsonSurgical site infection (SSI) is a frequent infection site after liver transplantation (LT), and multidrug-resistant bacteria are common agents of those infections. This study aimed to analyze risk factors for SSI, including SSI caused by a multidrug-resistant microorganism (MDRO) after LT. We performed a cohort study of patients who underwent an LT from 2010 to 2018. The outcomes were SSI and SSI caused by MDRO. We analyzed features related to surgical procedure, patients' characteristics, and post-LT intercurrence. Surveillance for carbapenemresistant Enterobacteriaceae (CRE), vancomycin-resistant Enterococcus (VRE), and carbapenem-resistant Acinetobacter baumannii (CRAB) was performed through rectal swab at the LT admission and weekly until hospital discharge during all study periods. SSI was identified in 30.1% (229/762) of LTs. We observed a decline in the SSI rate from 37.5% in 2014 to 16.7% in 2018 (P 0.02). SSI caused by MDRO occurred in 109 (14.3%) patients. Klebsiella pneumoniae was the most common agent of both SSI and SSI caused by MDRO. The pre-LT colonization was 98 (12.9%) by CRE, 73 (9.6%) by VRE, and 28 (3.7%) by CRAB. Risk factors for SSI caused by MDRO identified were dialysis after LT (P 0.01), CRAB acquisition before LT (0.03), and CRE acquisition before LT (P 0.004); use of adjusted prophylaxis by MDRO risk was the only protective factor identified (P 0.01). MDROs were frequent agents of SSI after LT, and the carbapenem-resistant Gram-negative colonization before LT increased the risk of SSI by these agents.
- Co-infections and superinfections complicating COVID-19 in cancer patients: A multicentre, international study(2021) GUDIOL, C.; DURA-MIRALLES, X.; AGUILAR-COMPANY, J.; HERNANDEZ-JIMENEZ, P.; MARTINEZ-CUTILLAS, M.; FERNANDEZ-AVILES, F.; MACHADO, M.; VAZQUEZ, L.; MARTIN-DAVILA, P.; CASTRO, N. de; ABDALA, E.; SORLI, L.; ANDERMANN, T. M.; MARQUEZ-GOMEZ, I; MORALES, H.; GABILAN, F.; AYAZ, C. M.; KAYAASLAN, B.; AGUILAR-GUISADO, M.; HERRERA, F.; ROYO-CEBRECOS, C.; PEGHIN, M.; GONZALEZ-RICO, C.; GOIKOETXEA, J.; SALGUEIRA, C.; SILVA-PINTO, A.; GUTIERREZ-GUTIERREZ, B.; CUELLAR, S.; HAIDAR, G.; MALUQUER, C.; MARIN, M.; PALLARES, N.; CARRATALA, J.Background: We aimed to describe the epidemiology, risk factors, and clinical outcomes of co-infections and superinfections in onco-hematological patients with COVID-19. Methods: International, multicentre cohort study of cancer patients with COVID-19. All patients were included in the analysis of co-infections at diagnosis, while only patients admitted at least 48 h were included in the analysis of superinfections. Results: 684 patients were included (384 with solid tumors and 300 with hematological malignancies). Co-infections and superinfections were documented in 7.8% (54/684) and 19.1% (113/590) of patients, respectively. Lower respiratory tract infections were the most frequent infectious complications, most often caused by Streptococcus pneumoniae and Pseudomonas aeruginosa. Only seven patients developed opportunistic infections. Compared to patients without infectious complications, those with infections had worse outcomes, with high rates of acute respiratory distress syndrome, intensive care unit (ICU) admission, and case-fatality rates. Neutropenia, ICU admission and high levels of C-reactive protein (CRP) were independent risk factors for infections. Conclusions: Infectious complications in cancer patients with COVID-19 were lower than expected, affecting mainly neutropenic patients with high levels of CRP and/or ICU admission. The rate of opportunistic infections was unexpectedly low. The use of empiric antimicrobials in cancer patients with COVID-19 needs to be optimized. (C) 2021 The Authors.
- Coronavirus Disease 2019 in the Early Postoperative Period of Liver Transplantation: Is the Outcome Really So Positive?(2021) WAISBERG, Daniel Reis; ABDALA, Edson; NACIF, Lucas Souto; DUCATTI, Liliana; HADDAD, Luciana Bertocco; MARTINO, Rodrigo Bronze; PINHEIRO, Rafael Soares; ARANTES, Rubens Macedo; GALVAO, Flavio Henrique; GOUVEIA, Larissa Nunes; TERRABUIO, Debora Raquel; DARCE, George Felipe; ROCHA-SANTOS, Vinicius; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto
- Management of Hepatocellular Carcinoma during the COVID-19 Pandemic - S(a)over-tildeo Paulo Clinicas Liver Cancer Group Multidisciplinary Consensus Statement (vol 75, e2192, 2020)(2021) ABADALA, Edson; CHAGAS, A. L.; FONSECA, L. G. da; COELHO, F. F.; SAUD, L. R. C.; ABADALA, E.; ANDRAUS, W.
- Outcomes and Prognostic Factors in a Large Cohort of Hospitalized Cancer Patients With COVID-19(2021) MARTA, Guilherme Nader; BONADIO, Renata Colombo; SEJAS, Odeli Nicole Encinas; WATARAI, Gabriel; MACHADO, Maria Cecilia Mathias; FRASSON, Lorena Teixeira; MONIZ, Camila Motta Venchiarutti; ITO, Raquel Keiko de Luca; PEIXOTO, Driele; HOFF, Camilla Oliveira; ANASTACIO, Veruska Menegatti; JR, Ulysses Ribeiro; PEREIRA, Juliana; ROCHA, Vanderson; ABDALA, Edson; ESTEVEZ-DIZ, Maria Del Pilar; HOFF, Paulo M.PURPOSE Patients with cancer are at increased risk for unfavorable outcomes from COVID-19. Knowledge about the outcome determinants of severe acute respiratory syndrome coronavirus 2 infection in this population is essential for risk stratification and definition of appropriate management. Our objective was to evaluate prognostic factors for all-cause mortality in patients diagnosed with both cancer and COVID-19. METHODS All consecutive patients with cancer hospitalized at our institution with COVID-19 were included. Electronic medical records were reviewed for clinical and laboratory characteristics potentially associated with outcomes. RESULTS Five hundred seventy-six consecutive patients with cancer and COVID-19 were included in the present study. An overall in-hospital mortality rate of 49.3% was demonstrated. Clinical factors associated with increased risk of death because of COVID-19 were age over 65 years, Eastern Cooperative Oncology Group performance status > 0 zero, best supportive care, primary lung cancer, and the presence of lung metastases. Laboratory findings associated with a higher risk of unfavorable outcomes were neutrophilia, lymphopenia, and elevated levels of D-dimer, creatinine, C-reactive protein, or AST. CONCLUSION A high mortality rate in patients with cancer who were diagnosed with COVID-19 was demonstrated in the present study, emphasizing the need for close surveillance in this group of patients, especially in those with unfavorable prognostic characteristics. (C) 2021 by American Society of Clinical Oncology
- Insights in the approach of long-term liver transplant recipients with COVID-19(2021) TERRABUIO, Debora Raquel Benedita; HADDAD, Luciana; DUCATTI, Liliana; GOUVEIA, Larissa Nunes; ROCHA-SANTOS, Vinicius; FERREIRA, Renee Mignolo Tanaka; DARCE, George Felipe; CARDOSO, Ana Julia Andrade; CARRILHO, Flair Jose; ANDRAUS, Wellington; ABDALA, Edson; D'ALBUQUERQUE, Luiz Augusto Carneiro
- 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.
- Fluoroquinolone treatment as a protective factor for 10-day mortality in Streptococcus pneumoniae bacteremia in cancer patients(2021) FONTANA, Naihma Salum; IBRAHIM, K. I.; BONAZZI, P. R.; ROSSI, F.; ALMEIDA, S. C. G.; TENGAN, F. M.; BRANDILEONE, M. C. C.; ABDALA, E.To evaluate the prognostic factors in adult cancer patients with pneumococcal bacteremia, describe episode features and the phenotypic characteristics of the isolated strains. We evaluated the episodes in patients admitted to a cancer hospital between 2009 and 2015. The outcomes were defined as 48 h mortality and mortality within 10 days after the episode. The variables evaluated were: age, sex, ethnicity, ECOG, Karnofsky score, SOFA, cancer type, metastasis, chemotherapy, radiotherapy, neutropenia, previous antibiotic therapy, community or healthcare-acquired infection, comorbidities, smoking, pneumococcal vaccination, infection site, presence of fever, polymicrobial infection, antimicrobial susceptibility, serotype and treatment. 165 episodes were detected in 161 patients. The mean age was 61.3 years; solid tumors were the most prevalent (75%). 48 h and 10-day mortality were 21% (34/161) and 43% (70/161) respectively. The 48 h mortality- associated risk factors were SOFA and polymicrobial bacteremia; 10-day mortality-associated risk factors were fever, neutropenia, ECOG 3/4, SOFA and fluoroquinolones as a protective factor. Pneumococcal bacteremia presented high mortality in cancer patients, with prognosis related to intrinsic host factors and infection episodes features. Fluoroquinolone treatment, a protective factor in 10-day mortality, has potential use for IPDs and severe community-acquired pneumonia in cancer patients.
- Development of a Risk Prediction Model for Carbapenem-resistant Enterobacteriaceae Infection After Liver Transplantation: A Multinational Cohort Study(2021) GIANNELLA, Maddalena; FREIRE, Maristela; RINALDI, Matteo; ABDALA, Edson; RUBIN, Arianna; MULARONI, Alessandra; GRUTTADAURIA, Salvatore; GROSSI, Paolo; SHBAKLO, Nour; TANDOI, Francesco; FERRARESE, Alberto; BURRA, Patrizia; FERNANDES, Ruan; CAMARGO, Luis Fernando Aranha; ASENSIO, Angel; ALAGNA, Laura; BANDERA, Alessandra; SIMKINS, Jacques; ABBO, Lilian; HALPERN, Marcia; GIRAO, Evelyne Santana; VALERIO, Maricela; MUNOZ, Patricia; YUNQUERA, Ainhoa Fernandez; STATLENDER, Liran; YAHAV, Dafna; FRANCESCHINI, Erica; GRAZIANO, Elena; MORELLI, Maria Cristina; CESCON, Matteo; VIALE, Pierluigi; LEWIS, RussellBackground. Patients colonized with carbapenem-resistant Enterobacteriaceae (CRE) are at higher risk of developing CRE infection after liver transplantation (LT), with associated high morbidity and mortality. Prediction model for CRE infection after LT among carriers could be useful to target preventive strategies. Methods. Multinational multicenter cohort study of consecutive adult patients underwent LT and colonized with CRE before or after LT, from January 2010 to December 2017. Risk factors for CRE infection were analyzed by univariate analysis and by Fine-Gray subdistribution hazard model, with death as competing event. A nomogram to predict 30- and 60-day CRE infection risk was created. Results. A total of 840 LT recipients found to be colonized with CRE before (n = 203) or after (n = 637) LT were enrolled. CRE infection was diagnosed in 250 (29.7%) patients within 19 (interquartile range [IQR], 9-42) days after LT. Pre- and post-LT colonization, multisite post-LT colonization, prolonged mechanical ventilation, acute renal injury, and surgical reintervention were retained in the prediction model. Median 30- and 60-day predicted risk was 15% (IQR, 11-24) and 21% (IQR, 15-33), respectively. Discrimination and prediction accuracy for CRE infection was acceptable on derivation (area under the curve [AUC], 74.6; Brier index, 16.3) and bootstrapped validation dataset (AUC, 73.9; Brier index, 16.6). Decision-curve analysis suggested net benefit of model-directed intervention over default strategies (treat all, treat none) when CRE infection probability exceeded 10%. The risk prediction model is freely available as mobile application at https://idbologna.shinyapps.io/CREPostOLTPredictionModel/. Conclusions. Our clinical prediction tool could enable better targeting interventions for CRE infection after transplant.
- Diretrizes brasileiras para o manejo de potenciais doadores de órgãos em morte encefálica. Uma força-tarefa composta por Associação de Medicina Intensiva Brasileira, Associação Brasileira de Transplantes de Órgãos, Brazilian Research in Critical Care Network e Coordenação Geral do Sistema Nacional de Transplantes(2021) WESTPHAL, Glauco Adrieno; ROBINSON, Caroline Cabral; CAVALCANTI, Alexandre Biasi; GONÇALVES, Anderson Ricardo Roman; GUTERRES, Cátia Moreira; TEIXEIRA, Cassiano; STEIN, Cinara; FRANKE, Cristiano Augusto; SILVA, Daiana Barbosa da; PONTES, Daniela Ferreira Salomão; NUNES, Diego Silva Leite; ABDALA, Edson; DAL-PIZZOL, Felipe; BOZZA, Fernando Augusto; MACHADO, Flávia Ribeiro; ANDRADE, Joel de; CRUZ, Luciane Nascimento; AZEVEDO, Luciano César Pontes; MACHADO, Miriam Cristine Vahl; ROSA, Regis Goulart; MANFRO, Roberto Ceratti; NOTHEN, Rosana Reis; LOBO, Suzana Margareth; RECH, Tatiana Helena; LISBOA, Thiago Costa; COLPANI, Verônica; FALAVIGNA, MaiconAbstract Objective: To contribute to updating the recommendations for brain-dead potential organ donor management. Methods: A group of 27 experts, including intensivists, transplant coordinators, transplant surgeons, and epidemiologists, answered questions related to the following topics were divided into mechanical ventilation, hemodynamics, endocrine-metabolic management, infection, body temperature, blood transfusion, and checklists use. The outcomes considered were cardiac arrests, number of organs removed or transplanted as well as function / survival of transplanted organs. The quality of evidence of the recommendations was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system to classify the recommendations. Results: A total of 19 recommendations were drawn from the expert panel. Of these, 7 were classified as strong, 11 as weak and 1 was considered a good clinical practice. Conclusion: Despite the agreement among panel members on most recommendations, the grade of recommendation was mostly weak.