MARINA FARREL CORTES
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Risk factors for bloodstream infection by multidrug-resistant organisms in critically ill patients in a reference trauma hospital(2022) CAMPOS, Luciana Rodrigues Pires de; CORTES, Marina Farrel; DEO, Beatriz; RIZEK, Camila; SANTOS, Sania; PERDIGAO, Lauro; COSTA, Silvia FigueiredoBackground: Bloodstream infections (BSI) by multidrug-resistant (MDR) organisms are responsible for significant mortality in critically ill trauma patients. Our objective is to identify the risk factors for BSI by MDR agents and their resistance mechanisms in a trauma reference hospital. Methods: During 18 months, all patients admitted in our Intensive Care Unit (ICU) were enrolled in this prospective cohort. We included the first episode of BSI by carbapenem-resistant Gram-negative bacteria, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin resistant enterococcus. Demographic and clinical data were compared among patients with and without BSI and variables with P <.05 were tested in a multivariate analysis. We performed PCR for identification of carbapenemase and SCC mec genes and Pulsed-field gel electrophoresis for clonality. Results: Out of 1,528 patients, 302 (19.8%) were trauma and 66 (4.3%) had a MDR-BSI ( 19.5% were trauma). The multivariate analysis showed that mechanical ventilation (OR3.16; 95% CI 1-8; P =.02), hemodialysis (OR3.16; 95% CI 1-5; P =.0003) and surgery (OR1.76; 95% CI 1-3; P =.04) were independent risk factors for MDR- BSI. The most frequent MDR were Klebsiella pneumoniae (n = 26) and MRSA (n = 27). Regarding K pneumoniae strains (n = 24), 20 ( 83.8%) harbored bla KPC gene and 1 bla NDM. The majority of KPC isolates belonged to a predominant clone; while the MRSA were polyclonal and SCC mec type II. Conclusions: Mechanical ventilation, surgery and hemodialysis were independent risk factors for MDR-BSI in our cohort, but trauma was not. KPC was the main mechanism of resistance among carbapenem-resistant K pneumoniae that belonged to a predominant clone which could indicate cross-transmission.
- Epidemiologic case investigation on the zoonotic transmission of Methicillin-resistant Staphylococcus pseudintermedius among dogs and their owners(2023) GUIMARAES, Luciana; TEIXEIRA, Izabel Mello; SILVA, Isabella Thomaz da; ANTUNES, Milena; PESSET, Camilla; FONSECA, Carolina; SANTOS, Ana Luiza; CORTES, Marina Farrel; PENNA, BrunoDogs often carry methicillin-resistant Staphylococci asymptomatically. These bacteria are frequently linked to conditions such as canine pyoderma and otitis. Close interaction between dogs and humans can facilitate the exchange of resistant strains, particularly Methicillin-resistant Staphylococcus pseudintermedius (MRSP). This represents a public health issue, since these strains, in addition to occasionally causing infections in humans, can also serve as a source of resistance and virulence genes for strains of greater importance in human medicine, such as Staphylococcus aureus. Furthermore, MRSP strains are often multidrug resistant, which ends up compromising the treatment of infections. This study aimed to assess the potential transmission of Staphylococcus pseudintermedius among dogs and their owners. We examined a total of one hundred canine samples collected from cases of pyoderma and otitis to detect the presence of staphylococci. Simultaneously, we conducted evaluations on all dog owners. Staphylococci strains were identified using MALDI-TOF MS and PCR targeting the nuc gene. Methicillin resistance screening was also performed by detecting the mecA gene using PCR. Among the sampled dogs, 64 carried S. pseudintermedius. Nine were identified as MRSP. In six instances, dogs and their owners exhibited S. pseudintermedius. These samples underwent genome sequencing and were screened for antimicrobial resistance genes, SCCmec typing, MLST characterization, and Single Nucleotide Polymorphisms (SNP) analyses. The results of the phylogenetic analysis revealed that in three cases, dogs and owners had closely related isolates, suggesting interspecies transmission. Two of these cases involved MRSP and one MSSP. Moreover, in the two MRSP cases, the same SCCmec type (type V) was detected. Additionally, the sequence type was consistent across all three cases involving dogs and owners (MSSP ST2277, MRSP ST2282, and ST2286). These findings strongly indicate a transmission event. Since Staphylococcus pseudintermedius is primarily isolated from canine samples, it is plausible that dogs may have acted as a potential source. In the remaining three cases, despite identifying the same species in both samples, they had notable phylogenetic differences. (c) 2023 The Author(s).
- Impact of the COVID-19 pandemic on the incidence of multidrug-resistant bacterial infections in an acute care hospital in Brazil(2022) POLLY, Matheus; ALMEIDA, Bianca L. de; LENNON, Robert P.; CORTES, Marina Farrel; COSTA, Silvia F.; GUIMARAES, ThaisBackground: The impact of COVID-19 on healthcare- associated infections (HCAI) caused by multidrug-resistant (MDR) bacteria that contribute to higher mortality is a growing area of study Methods: This retrospective observational study compares the incidence density (ID) of HCAI caused by MDR bacteria (CRE, CRAB, CRP, MRSA and VRE) pre-COVID (2017-2019) and during the COVID-19 pandemic (2020) in overall hospitalized patients and in intensive care (ICU) units. Results: We identified 8,869 HCAI, of which 2,641 (29.7%) were caused by bacterial MDR, and 1,257 (14.1%) were from ICUs. The overall ID of MDR infections increased 23% (P < .005) during COVID-19. The overall perpathogen analysis shows significant increases in infections by CRAB and MRSA (+108.1%, p<0.005; +94.7%, p<0.005, respectively), but not in CRE, CRP, or VRE. In the ICU, the overall ID of MDR infections decreased during COVID, but that decline was not significant (-6.5%, P = .26). The ICU per-pathogen analysis of ID of infection showed significant increases in CRAB and MRSA (+42.0%, P = .001; +46.2%, P = .04), significant decreases in CRE and CRP (-26.4%, P = .002; -44.2%, P = 0.003, respectively) and no change in VRE. Conclusions: The COVID-19 pandemic correlates to an increase in ID of CRAB and MRSA both in ICU and nonICU setting, and a decrease in ID of CRE and CRP in the ICU setting. Infection control teams should be aware of possible outbreaks of CRAB and MRSA and promote rigorous adherence to infection control measures as practices change to accommodate changes in healthcare needs during and after the pandemic.
- Disinfection of 3D-printed protective face shield during COVID-19 pandemic(2021) NOGUERA, Saidy Vasconez; ESPINOZA, Evelyn Patricia Sanchez; CORTES, Marina Farrel; OSHIRO, Izabel Cristina Vilela; SPADAO, Fernanda de Sousa; BRANDAO, Laura Maria Brasileiro; BARROS, Ana Natiele da Silva; COSTA, Sibeli; ALMEIDA, Bianca Leal de; SORIANO, Paula Gemignani; SALLES, Alessandra Grassi; ESCORCIO, Mirian Elizabete Marques; BARRETTI, Cristina Madeira; BAPTISTA, Fernanda Spadotto; ALVARENGA, Glaura Souza; MARINHO, Igor; LETAIF, Leila Suemi Harima; LI, Ho Ye; BACCHI, Pedro; SANTOS, Ana Rubia Guedes dos; REGADAS, Lucas Borges; BRAGA, Carlos Eduardo Lima; ZSIGMOND, Fabio; SEGURADO, Aluisio Cotrim; GUIMARAES, Thais; LEVIN, Anna Sara; BERTOLDI, Cristiane Aun; CATALANI, Luiz Henrique; ZANCUL, Eduardo de Senzi; COSTA, Silvia FigueiredoThis study assessed the disinfection using 70% ethanol; H2O2-quaternary ammonium salt mixture; 0.1% sodium hypochlorite and autoclaving of four 3D-printed face shields with different designs, visor materials; and visor thickness (0.5-0.75 mm). We also investigated their clinical suitability by applying a questionnaire to health workers (HW) who used them. Each type of disinfection was done 40 times on each type of mask without physical damage. In contrast, autoclaving led to appreciable damage.
- Healthcare Professionals Perception of Mobile Phone Usage and Hand Hygiene Adhesion in Intensive Care Units(2020) SANCHEZ, Evelyn; PERDIGAO-NETO, Lauro; SANTOS, Sania Alves dos; RIZEK, Camila; GOMEZ, Maria Renata; MARTINS, Roberta; OLIVEIRA, Gaspar de; GUIMARAES, Thais; BOSZCZOWSKI, Icaro; ROSSI, Flavia; FREIRE, Maristela; LEVIN, Anna; COSTA, Silvia Figueiredo; FARREL, Marina
- Impact of the COVID-19 pandemic on the incidence of multidrug-resistant bacterial infections in an acute care hospital in Brazil(2022) POLLY, Matheus; ALMEIDA, Bianca L. de; LENNON, Robert P.; CORT, Marina Farrel; COSTA, Silvia F.; GUIMARAES, Thais