SILVIA FIGUEIREDO COSTA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina - Docente
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina - Líder
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Global point prevalence survey of antimicrobial consumption in Brazilian hospitals(2020) PORTO, A. P. M.; GOOSSENS, H.; VERSPORTEN, A.; COSTA, S. F.; MACHADO, Anna; COCENTINO, Brunno; DONINI, Camila; CARRILHO, Claudia; TAKEDA, Christianne; RODRIGUES, Cristhieni; GIRAO, Evelyne; PEROZIN, Jamile Sardi; CAPOBIANGO, Jaqueline; CARIJO, Julia Herkenhoff; MATOS, Juliana Arruda de; PERDIGAO, Lauro; SAMPAIO, Marcia; MACHADO, Maria Emilia Avelar; ESTEVES, Patricia; COUTINHO, Rosane; GUIMARAES, Thais; FERRAZ, Tiago Luiz; BRANCO, Ursula CasteloBackground: The inappropriate use of antimicrobials and increased rates of antimicrobial resistance is a challenge all over the world. Although antibiotic stewardship is recommended by the Brazilian government, data regarding antibiotic use in Brazilian hospitals are scarce. The aim of this study was to conduct a point prevalence survey of antimicrobial use in 18 Brazilian hospitals. Methods: Eighteen Brazilian hospitals conducted the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) in 2017. The study enrolled inpatients on antimicrobials. Data collection included details on the antimicrobial prescriptions. A web-based programme was used for data-entry, validation and reporting. The Global-PPS was developed by the University of Antwerp and bioMerieux provided funding support. Findings: A total of 1801 patients were evaluated, of which 941 (52.2%) were on antimicrobials. Four hundred (42.5%) patients were given at least two antimicrobials. Out of the 1317 antibacterials for systemic use, 514 (39%) were prescribed for community-acquired infections, 533 (40.5%) for healthcare-associated infections and 248 (18.8%) for prophylactic use. The most frequently used antimicrobials were ceftriaxone (12.8%), meropenem (12.3%) and vancomycin (10.3%). Pneumonia or lower respiratory tract infection was the most common site of infection (29.2%). In general, antimicrobials were given mainly parenterally (91%) and empirically (81.2%). Conclusions: A high prevalence of antibiotic use was observed in the 18 Brazilian hospitals. The antibiotics were prescribed mainly empirically. Intravenous broad-spectrum antibiotics were the most frequent antimicrobials used, showing that reinforcement of de-escalation strategy is needed. The Global-PPS data can be very useful for monitoring stewardship programmes and intervention.
- Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals(2022) BRIZZI, Andrea; WHITTAKER, Charles; SERVO, Luciana M. S.; HAWRYLUK, Iwona; JR, Carlos A. Prete; SOUZA, William M. de; AGUIAR, Renato S.; ARAUJO, Leonardo J. T.; BASTOS, Leonardo S.; BLENKINSOP, Alexandra; BUSS, Lewis F.; CANDIDO, Darlan; CASTRO, Marcia C.; COSTA, Silvia F.; CRODA, Julio; SANTOS, Andreza Aruska de Souza; DYE, Christopher; FLAXMAN, Seth; FONSECA, Paula L. C.; GEDDES, Victor E. V.; GUTIERREZ, Bernardo; LEMEY, Philippe; LEVIN, Anna S.; MELLAN, Thomas; BONFIM, Diego M.; MISCOURIDOU, Xenia; MISHRA, Swapnil; MONOD, Melodie; MOREIRA, Filipe R. R.; NELSON, Bruce; PEREIRA, Rafael H. M.; RANZANI, Otavio; SCHNEKENBERG, Ricardo P.; SEMENOVA, Elizaveta; SONNABEND, Raphael; SOUZA, Renan P.; XI, Xiaoyue; SABINO, Ester C.; FARIA, Nuno R.; BHATT, Samir; RATMANN, OliverAnalysis of individual-level patient records from Brazil reveals that the extensive shocks in COVID-19 mortality rates are associated with pre-pandemic geographic inequities as well as shortages in healthcare capacity during the pandemic. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Gamma variant of concern has spread rapidly across Brazil since late 2020, causing substantial infection and death waves. Here we used individual-level patient records after hospitalization with suspected or confirmed coronavirus disease 2019 (COVID-19) between 20 January 2020 and 26 July 2021 to document temporary, sweeping shocks in hospital fatality rates that followed the spread of Gamma across 14 state capitals, during which typically more than half of hospitalized patients aged 70 years and older died. We show that such extensive shocks in COVID-19 in-hospital fatality rates also existed before the detection of Gamma. Using a Bayesian fatality rate model, we found that the geographic and temporal fluctuations in Brazil's COVID-19 in-hospital fatality rates were primarily associated with geographic inequities and shortages in healthcare capacity. We estimate that approximately half of the COVID-19 deaths in hospitals in the 14 cities could have been avoided without pre-pandemic geographic inequities and without pandemic healthcare pressure. Our results suggest that investments in healthcare resources, healthcare optimization and pandemic preparedness are critical to minimize population-wide mortality and morbidity caused by highly transmissible and deadly pathogens such as SARS-CoV-2, especially in low- and middle-income countries.
- Point Prevalence Surveys and Customized Interventions Are Good Strategies to Improve Antimicrobial Use: The Brazilian Experience(2020) PORTO, Ana Paula Matos; BOSZCZOWSKI, Icaro; VERSPORTEN, Ann; PAUWELS, Ines; THAIS, Thais; GIRAO, Evelyne; ESTEVES, Patricia; RODRIGUES, Cristhieni; CARRILHO, Claudia; FERRAZ, Tiago Luiz; CAPOBIANCO, Jaqueline; DONINI, Camila; COUTINHO, Rosane; GOOSSENS, Herman; COSTA, Silvia Figueiredo
- Evolution and epidemic spread of SARS-CoV-2 in Brazil(2020) CANDIDO, Darlan S.; CLARO, Ingra M.; JESUS, Jaqueline G. de; SOUZA, William M.; MOREIRA, Filipe R. R.; DELLICOUR, Simon; MELLAN, Thomas A.; PLESSIS, Louis du; PEREIRA, Rafael H. M.; SALES, Flavia C. S.; MANULI, Erika R.; THEZE, Julien; ALMEIDA, Luiz; MENEZES, Mariane T.; VOLOCH, Carolina M.; FUMAGALLI, Marcilio J.; COLETTI, Thais M.; SILVA, Camila A. M.; RAMUNDO, Mariana S.; AMORIM, Mariene R.; HOELTGEBAUM, Henrique H.; MISHRA, Swapnil; GILL, Mandev S.; CARVALHO, Luiz M.; BUSS, Lewis F.; JR, Carlos A. Prete; ASHWORTH, Jordan; I, Helder Nakaya; PEIXOTO, Pedro S.; BRADY, Oliver J.; NICHOLLS, Samuel M.; TANURI, Amilcar; ROSSI, Atila D.; V, Carlos K. Braga; GERBER, Alexandra L.; GUIMARAES, Ana Paula de C.; JR, Nelson Gaburo; ALENCAR, Cecila Salete; FERREIRA, Alessandro C. S.; LIMA, Cristiano X.; LEVI, Jose Eduardo; GRANATO, Celso; FERREIRA, Giulia M.; JR, Ronaldo S. Francisco; GRANJA, Fabiana; GARCIA, Marcia T.; MORETTI, Maria Luiza; JR, Mauricio W. Perroud; CASTINEIRAS, Terezinha M. P. P.; LAZARI, Carolina S.; HILL, Sarah C.; SANTOS, Andreza Aruska de Souza; SIMEONI, Camila L.; FORATO, Julia; SPOSITO, Andrei C.; SCHREIBER, Angelica Z.; SANTOS, Magnun N. N.; SA, Camila Zolini de; SOUZA, Renan P.; RESENDE-MOREIRA, Luciana C.; TEIXEIRA, Mauro M.; HUBNER, Josy; LEME, Patricia A. F.; MOREIRA, Rennan G.; NOGUEIRA, Mauricio L.; FERGUSON, Neil M.; COSTA, Silvia F.; PROENCA-MODENA, Jose Luiz; VASCONCELOS, Ana Tereza R.; BHATT, Samir; LEMEY, Philippe; WU, Chieh-Hsi; RAMBAUT, Andrew; LOMAN, Nick J.; AGUIAR, Renato S.; PYBUS, Oliver G.; SABINO, Ester C.; FARIA, Nuno RodriguesBrazil currently has one of the fastest-growing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemics in the world. Because of limited available data, assessments of the impact of nonpharmaceutical interventions (NPIs) on this virus spread remain challenging. Using a mobility-driven transmission model, we show that NPIs reduced the reproduction number from >3 to 1 to 1.6 in Sao Paulo and Rio de Janeiro. Sequencing of 427 new genomes and analysis of a geographically representative genomic dataset identified >100 international virus introductions in Brazil. We estimate that most (76%) of the Brazilian strains fell in three clades that were introduced from Europe between 22 February and 11 March 2020. During the early epidemic phase, we found that SARS-CoV-2 spread mostly locally and within state borders. After this period, despite sharp decreases in air travel, we estimated multiple exportations from large urban centers that coincided with a 25% increase in average traveled distances in national flights. This study sheds new light on the epidemic transmission and evolutionary trajectories of SARS-CoV-2 lineages in Brazil and provides evidence that current interventions remain insufficient to keep virus transmission under control in this country.