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
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- A first report of leptospirosis after liver transplantation(2016) SONG, A. T. W.; ABAS, L.; ANDRADE, L. C.; ANDRAUS, W.; D'ALBUQUERQUE, L. A. C.; ABDALA, E.Leptospirosis has been rarely reported in solid organ transplant recipients. We report the first case to our knowledge of leptospirosis in a liver transplant recipient who developed jaundice and renal insufficiency. We describe his favorable clinical progression and discuss the possible mechanisms involved in the more benign disease course. We also review the previously published cases of leptospirosis in solid organ transplant recipients. Although this disease does not appear to present any particularities in this context, we highlight the importance of clinical suspicion in this setting, particularly after liver transplantation.
- Strongyloides infection screening in transplant candidates: What is the best strategy?(2023) GRYSCHEK, Ronaldo Cesar Borges; CORRAL, Marcelo Andreetta; SITTA, Renata Barnabe; GOTTARDI, Maiara; PIERROTTI, Ligia Camera; COSTA, Silvia Figueiredo; ABDALA, Edson; CHIEFFI, Pedro Paulo; PAULA, Fabiana Martins deBackground: The potential that Strongyloides stercoralis infection has to cause major morbidity and high mortality when the disseminated form occurs in transplant patients is of particular concern.Methods: In this study, the objective was to observe S. stercoralis infection in patients who are candidates for transplantation by using parasitological, serological, and molecular techniques and to propose an algorithm for the detection of that infection in transplant candidates.Results: By parasitological techniques, 10% of fecal samples were positive. Anti-Strongyloides antibodies immunoglobulin G were detected in 19.3% and 20.7% of patients by immunofluorescence assay and enzyme-linked immunosorbent assay, respectively. S. stercoralis DNA was observed in 17.3% of samples by conventional polymerase chain reaction and 32.7% of samples by quantitative polymerase chain reaction (qPCR).Conclusion: The set of results allows us to reinforce that a positive result by parasitological techniques and/or qPCR indicates that the specific treatment should be applied. However, the improvement of diagnostic techniques may suggest changes in the screening for strongyloidiasis in these patients. image
- Polymyxin use as a risk factor for colonization or infection with polymyxin-resistant Acinetobacter baumannii after liver transplantation(2014) FREIRE, M. P.; HEIJDEN, I. M. Van Der; PRADO, G. V. B.; CAVALCANTE, L. S.; BOSZCZOWSKI, I.; BONAZZI, P. R.; ROSSI, F.; GUIMARAES, T.; D'ALBUQUERQUE, L. A. C.; COSTA, S. F.; ABDALA, E.Introduction Acinetobacter baumannii is a leading agent of healthcare-associated infection. The objective of this study was to evaluate cases of colonization or infection with polymyxin-resistant A.baumannii (PRAB) in liver transplant recipients and to identify the risk factors for the acquisition of PRAB. Methods We evaluated all patients undergoing liver transplantation (LT) between January and November of 2011. The exclusion criterion was death within the first 72h after transplant. Patients were screened for PRAB through weekly rectal and inguinal swabs during their stay in the intensive care unit (ICU) and at ICU discharge. Patients who came from other hospitals or had been treated in the emergency room for >72h were screened at ICU admission. The minimum inhibitory concentrations (MICs) for polymyxins were determined by broth microdilution, and clonality was determined by pulsed-field gel electrophoresis. The stepwise logistic regression was used to identify risk factors related to acquisition of PRAB, and Cox forward regression used to identify risk factors for 60-day mortality. Results We evaluated 65 patients submitted to LT, among whom PRAB was isolated in 7, 4 of whom developed infection. The MICs for polymyxin E ranged from 16 to 128mg/mL. All patients with PRAB required dialysis. The median time of polymyxin use before PRAB isolation was 21days. These 4 included 1 case of primary bloodstream infection (BSI), which was treated with the carbapenem-polymyxin combination; 1 case of surgical site infection, which was treated with gentamicin, polymyxin, ampicillin-sulbactam, and tigecycline; and 2 cases of pneumonia, treated with the combination of carbapenem-polymyxin. In the case of BSI and in 1 of the cases of pneumonia, the treatment was considered successful. Mortality was 71% among the cases, compared with 33% among the non-cases. Conclusion In the final model of the survival analysis, PRAB colonization or infection after LT was independently associated with mortality. One predominant clone was identified. The only risk factor identified in the multivariate analysis was polymyxin use. PRAB was an agent with high mortality, and the most important risk factor associated with colonization or infection for such bacterium was polymyxin use.
- Prediction models for carbapenem-resistant Enterobacterales carriage at liver transplantation: A multicenter retrospective study(2022) FREIRE, Maristela Pinheiro; RINALDI, Matteo; TERRABUIO, Debora Raquel Benedita; FURTADO, Mariane; PASQUINI, Zeno; BARTOLETTI, Michele; OLIVEIRA, Tiago Almeida de; NUNES, Nathalia Neves; LEMOS, Gabriela Takeshigue; MACCARO, Angelo; SINISCALCHI, Antonio; LAICI, Cristiana; CESCON, Matteo; DT'ALBUQUERQUE, Luiz Augusto Carneiro; MORELLI, Maria Cristina; SONG, Alice T. W.; ABDALA, Edson; VIALE, Pierluigi; CHIAVEGATTO FILHO, Alexandre Dias Porto; GIANNELLA, MaddalenaBackground: Carbapenem-resistant Enterobacterales (CRE) colonisation at liver transplantation (LT) increases the risk of CRE infection after LT, which impacts on recipients' survival. Colonization status usually becomes evident only near LT. Thus, predictive models can be useful to guide antibiotic prophylaxis in endemic centres. Aims: This study aimed to identify risk factors for CRE colonisation at LT in order to build a predictive model. Methods: Retrospective multicentre study including consecutive adult patients who underwent LT, from 2010 to 2019, at two large teaching hospitals. We excluded patients who had CRE infections within 90 days before LT. CRE screening was performed in all patients on the day of LT. Exposure variables were considered within 90 days before LT and included cirrhosis complications, underlying disease, time on the waiting list, MELD and CLIF-SOFA scores, antibiotic use, intensive care unit and hospital stay, and infections. A machine learning model was trained to detect the probability of a patient being colonized with CRE at LT. Results: A total of 1544 patients were analyzed, 116 (7.5%) patients were colonized by CRE at LT. The median time from CRE isolation to LT was 5 days. Use of antibiotics, hepato-renal syndrome, worst CLIF sofa score, and use of beta-lactam/beta-lactamase inhibitor increased the probability of a patient having pre-LT CRE. The proposed algorithm had a sensitivity of 66% and a specificity of 83% with a negative predictive value of 97%. Conclusions: We created a model able to predict CRE colonization at LT based on easyto-obtain features that could guide antibiotic prophylaxis
- Molecular diagnosis of Strongyloides stercoralis among transplant candidates(2018) PAULA, Fabiana M.; MALTA, Fernanda M.; MARQUES, Priscilla D.; MELO, Gessica B.; CORRAL, Marcelo A.; GOTTARDI, Maiara; PINHO, Joao R. R.; GONCALVES, Elenice M. N.; CASTILHO, Vera L. P.; PIERROTTI, Ligia C.; ABDALA, Edson; COSTA, Silvia F.; CHIEFFI, Pedro P.; GRYSCHEK, Ronaldo C. B.Strongyloidiasis can occur without any symptoms or as a potentially fatal hyperinfection or disseminated infection, principally in immunosuppressed patients. Our study aimed to evaluate the application of conventional polymerase chain reaction (cPCR) and real-time PCR (qPCR). Polymerase chain reaction (PCR) and real-time PCR (qPCR) targeting the 18S rRNA gene for detection of Strongyloides stercoralis infection among transplant candidates were applied in stool samples obtained from 150 transplant candidates, preliminarily analyzed by parasitological methods. S.stercoralis larvae were visualized in 15/150 (10.0%) transplant candidates by parasitological methods. DNA from S.stercoralis was amplified in 26/150 (17.3%) and 49/150 (32.7%) stool samples of transplant candidates, using cPCR and qPCR, respectively. The results suggest that molecular methods, especially qPCR, should be used as an additional tool for diagnostic of S.stercoralis infection among transplant candidates.
- 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
- Liver transplant recipients infected with SARS-CoV-2 in the early postoperative period: Lessons from a single center in the epicenter of the pandemic(2021) WAISBERG, Daniel Reis; ABDALA, Edson; NACIF, Lucas Souto; HADDAD, Luciana Bertocco; DUCATTI, Liliana; SANTOS, Vinicius Rocha; GOUVEIA, Larissa Nunes; LAZARI, Carolina Santos; MARTINO, Rodrigo Bronze; PINHEIRO, Rafael Soares; ARANTES, Rubens Macedo; TERRABUIO, Debora Raquel; MALBOUISSON, Luiz Marcelo; GALVAO, Flavio Henrique; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, Luiz AugustoThe impact of coronavirus disease-19 (COVID-19) in liver recipients remains largely unknown. Most data derive from small retrospective series of patients transplanted years ago. We aimed to report a single-center case series of five consecutive patients in the early postoperative period of deceased-donor liver transplantation who developed nosocomial COVID-19. Two patients presented important respiratory discomfort and eventually died. One was 69 years old and had severe coronary disease. She rapidly worsened after COVID-19 diagnosis on 9th postoperative day. The other was 67 years old with non-alcoholic steatohepatitis, who experienced prolonged postoperative course, complicated with cytomegalovirus infection and kidney failure. He was diagnosed on 36th postoperative day and remained on mechanical ventilation for 20 days, ultimately succumbing of secondary bacterial infection. The third, fourth, and fifth patients were diagnosed on 10th, 11th, and 18th postoperative day, respectively, and presented satisfactory clinical evolution. These last two patients were severely immunosuppressed, since one underwent steroid bolus for acute cellular rejection and another also used anti-thymocyte globulin for treating steroid-resistant rejection. Our novel experience highlights that COVID-19 may negatively impact the postoperative course, especially in elder and obese patients with comorbidities, and draws attention to COVID-19 nosocomial spread in the early postoperative period.