INNEKE MARIE VAN DER HEIJDEN NATARIO
Projetos de Pesquisa
Unidades Organizacionais
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
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Agora exibindo 1 - 8 de 8
- Transferable Vancomycin Resistance in a Community-Associated MRSA Lineage(2014) ROSSI, Flavia; DIAZ, Lorena; WOLLAM, Aye; PANESSO, Diana; ZHOU, Yanjiao; RINCON, Sandra; NARECHANIA, Apurva; XING, Galen; GIOIA, Thais S. R. Di; DOI, Andre; TRAN, Truc T.; REYES, Jinnethe; MUNITA, Jose M.; CARVAJAL, Lina P.; HERNANDEZ-ROLDAN, Alejandra; BRANDAO, Denise; HEIJDEN, Inneke Marie van der; MURRAY, Barbara E.; PLANET, Paul J.; WEINSTOCK, George M.; ARIAS, Cesar A.We report the case of a patient from Brazil with a bloodstream infection caused by a strain of methicillin-resistant Staphylococcus aureus (MRSA) that was susceptible to vancomycin (designated BR-VSSA) but that acquired the vanA gene cluster during antibiotic therapy and became resistant to vancomycin (designated BR-VRSA). Both strains belong to the sequence type (ST) 8 community-associated genetic lineage that carries the staphylococcal chromosomal cassette mec (SCCmec) type IVa and the S. aureus protein A gene (spa) type t292 and are phylogenetically related to MRSA lineage USA300. A conjugative plasmid of 55,706 bp (pBRZ01) carrying the vanA cluster was identified and readily transferred to other staphylococci. The pBRZ01 plasmid harbors DNA sequences that are typical of the plasmid-associated replication genes rep24 or rep21 described in community-associated MRSA strains from Australia (pWBG745). The presence and dissemination of community-associated MRSA containing vanA could become a serious public health concern.
- Immunogenicity of a meningococcal serogroup C conjugate vaccine in HIV-infected children, adolescents, and young adults(2012) BERTOLINI, Daniela Vinhas; COSTA, Luciana Scarlazzari; HEIJDEN, Inneke Marie van der; SATO, Helena Keiko; MARQUES, Heloisa Helena de SousaChildren and adolescents infected with HIV typically have a lower response to immunization than do those in the general population. In most developed countries, meningococcal serogroup C conjugate vaccine is one of the recommended vaccines for such individuals. However, there have been no studies evaluating the antibody response to this vaccine in HIV-infected children, adolescents or young adults. In this study, we evaluated that response using serum bactericidal antibody (SBA) and enzyme-linked immunosorbent assay, comparing HIV-infected with non-HIV-infected patients, as well as analysing the occurrence of side effects. In non-responders, we assessed the antibody response to revaccination. This clinical trial involved 92 patients between 10 and 20 years of age: 43 HIV-infected patients (HIV+ group) and 49 non-HIV-infected patients (HIV- group). After one dose of the vaccine, 72.1% of the HIV+ group patients and 100% of the HIV- group patients were considered protected. Of the HIV+ group patients who received a second dose of the vaccine, only 40% acquired protection. Overall, 81.4% of the HIV+ group patients acquired protection (after one or two doses of the vaccine). Side effects occurred in 16.3% and 44% of the HIV+ group and HIV- group patients, respectively. Therefore, the meningococcal serogroup C conjugate vaccine proved to be safe and effective for use in HIV-infected children, adolescents, and young adults, although their antibody response was weaker than that shown by non-HIV-infected patients. This indicates the need to discuss changes to the immunization schedule for children, adolescents, and young adults infected with HIV, in order to ensure more effective protection against meningococcal disease.
- Staphylococcus aureus isolates colonizing and infecting cirrhotic and liver-transplantation patients: comparison of molecular typing and virulence factors(2015) OLIVEIRA, Larissa Marques de; HEIJDEN, Inneke Marie van der; GOLDING, George R.; ABDALA, Edson; FREIRE, Maristela P.; ROSSI, Flavia; D'ALBURQUERQUE, Luiz C.; LEVIN, Anna S.; COSTA, Silvia F.Background: S. aureus is an important agent of colonization and infection in liver transplant patients. It harbors several virulence factors that can increase its pathogenicity. However, studies of virulence and molecular typing of MRSA in cirrhotic and liver transplantation patients are scarce. Results: Here we use SCCmec, PFGE, spa typing, MLST and virulence factors to characterize MRSA isolates in pre and post liver transplantation patients. Sixteen (13 %) of 126 cirrhotic and 15 of the 64 liver-transplanted patients (23 %) were colonized by MRSA (p = 0.091). SCCmec types I, II and III that are generally associated with nosocomial infections were identified in 91 % of the isolates. None of the isolates carried PVL, adhesion factors and fib gene. Only three MRSA colonized isolates carried tst gene and were characterized as SCCmec type I and t149. Ten spa types and five STs were identified; t002 and ST105 were the most frequent profiles. Spa types and ST1510 never described in Brazil and a new spa type t14789 were identified. Nineteen PFGE subtypes were found and grouped into nine types. There was a predominant cluster, which was related to the New York/Japanese epidemic clone and harboured SCCmec type II identified in both cirrhotic and post-transplantation patients. Based on SCCmec and virulence factors the MRSA isolates belonged to NY/Jpn clone seen be more similar to the USA100 MRSA isolates. Conclusions: Although without significance, liver-transplantation was more frequently colonized by MRSA than cirrhotic patients. The most frequent SCCmec was type II, and the predominant cluster was related to the New York/Japanese clone. A new spa t14789, and ST1510 never reported in Brazil were identified.
- Candida parapsilosis candidaemia in a neonatal unit over 7 years: a case series study(2012) MIRANDA, Lourdes das Neves; RODRIGUES, Eliete C. A.; COSTA, Silvia F.; HEIJDEN, Inneke Marie van der; DANTAS, Katia C.; LOBO, Renata D.; BASSO, Mariusa; VARKULJA, Glaucia F.; KREBS, Vera Lucia Jornada; GIBELLI, Maria Augusta Bento Cicaroni; CRIADO, Paulo R.; LEVIN, Anna SaraObjective: To evaluate Candida parapsilosis candidaemia in a neonatal unit over 7 years. Design: Case series study. Setting: A 2000-bed tertiary-care university hospital at Sao Paulo, Brazil. Participants: Neonates hospitalised in a 63-bed neonatal unit. Primary and secondary outcome measures: We evaluated the incidence of C parapsilosis fungemia in a neonatal unit from 2002 through 2008 and the main microbiological, clinical and epidemiological aspects of this disease in neonates. During the study period an outbreak occurred, an infection control programme was implemented, and isolates from blood and hand healthcare workers (HCWs) were submitted to molecular typing. Results: During 7 years, there were 36 cases of C parapsilosis fungaemia and annual incidence varied from 0 to 19.7 per 1000 admissions. Evaluating 31 neonates with fungemia, the mean age at diagnosis was 19 days. All children except for one were premature; all had received total parenteral nutrition and all but one had used central venous catheter. Three neonates had received antifungal treatment previously to the diagnosis. Thirty-day mortality was 45%. Only lower birthweight was associated with mortality. C parapsilosis species complex was isolated from hand cultures in eight (11%) of the HCWs (one isolate was identified as C orthopsilosis). By molecular typing no HCW isolate was similar to any of the blood isolates. Conclusions: The incidence of C parapsilosis fungemia in a neonatal unit varied widely over 7 years. We observed in our series a higher death rate than that reported in European countries and the USA.
article 8 Citação(ões) na Scopus Outbreak of vancomycin-resistant Enterococcus in a renal transplant unit(2011) TUON, Felipe Francisco; PENTEADO-FILHO, Sergio Ricardo; CAMILOTTI, Janaina; HEIJDEN, Inneke Marie van der; COSTA, Silvia Figueiredo- In vitro activity of potential old and new drugs against multidrug-resistant gram-negatives(2015) RIZEK, Camila; FERRAZ, Juliana Rosa; HEIJDEN, Inneke Marie van der; GIUDICE, Mauro; MOSTACHIO, Anna Karina; PAEZ, Jorge; CARRILHO, Claudia; LEVIN, Anna Sara; COSTA, Silvia F.Background: The aim of this study was to evaluate the in vitro susceptibility of MDR gram-negatives bacteria to old drugs such as polymyxin B, minocycline and fosfomycin and new drugs such as tigecycline. Methods: One hundred and fifty-three isolates from 4 Brazilian hospitals were evaluated. Forty-seven Acinetobacter baumannii resistant to carbapenens harboring adeB, bla(OxA23), bla(OxA51), bla(OxA143) 23, and bla(IMP) genes, 48 Stenotrophomonas maltophilia including isolates resistant to levofloxacin and/or trimethoprim-sulfamethoxazole harboring sul-1, sul-2 and qnr(MR) and 8 Serratia marcescens and 50 Klebsiella pneumoniae resistant to carbapenens harboring bla(KPC-2) were tested to determine their minimum inhibitory concentrations (MICs) by microdilution to the following drugs: minocycline, ampicillin-sulbactam, tigecycline, and polymyxin B and by agar dilution to fosfomycin according with breakpoint criteria of CLSI and EUCAST (fosfomycin). In addition, EUCAST fosfomycin breakpoint for Pseudomonas spp. was applied for Acinetobacter spp and S. maltophilia, the FDA criteria for tigecycline was used for Acinetobacter spp and S. maltophilia and the Pseudomonas spp polymyxin B CLSI criterion was used for S. maltophilia. Results: Tigecycline showed the best in vitro activity against the MDR gram-negative evaluated, followed by polymyxin B and fosfomycin. Polymyxin B resistance among K. pneumoniae was detected in 6 isolates, using the breakpoint of MIC > 8 ug/mL. Two of these isolates were resistant to tigecycline. Minocycline was tested only against S. maltophilia and A. baumannii and showed excellent activity against both. Conclusions: Fosfomycin seems to not be an option to treat infections due to the A. baumannii and S. maltophilia isolates according with EUCAST breakpoint, on the other hand, showed excellent activity against S. marcescens and K. pneumoniae. (C) 2014, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.
bookPart Estafilococcias(2016) PERDIGãO NETO, Lauro Vieira; OLIVEIRA, Maura Salaroli de; HEIJDEN, Inneke Marie van der; MENDES, Elisa Donalisio Teixeira; LEVIN, Anna Sara S.; COSTA, Silvia Figueiredo- Virulence and resistance profiles of MRSA isolates in pre- and post-liver transplantation patients using microarray(2016) HEIJDEN, Inneke Marie van der; OLIVEIRA, Larissa Marques de; BRITO, Glauber Costa; ABDALA, Edson; FREIRE, Maristela Pinheiro; ROSSI, Flavia; D'ALBUQUERQUE, Luiz Augusto Carneiro; LEVIN, Anna Sara Shafferman; COSTA, Silvia FigueiredoMethicillin-resistant Staphylococcus aureus (MRSA) screening plays a great role in preventing infections in surgical patients. This study aims to evaluate clonality, virulence and resistance of MRSA in pre- and post-liver transplantation (LT) patients. Nasal and groin swabs of 190 patients were collected. PCR for virulence genes and staphylococcal cassette chromosome mec (SCCmec) types, microarray, PFGE, multilocus sequence typing and MIC were performed. MRSA carriers were detected in 20.5% (39/190) of the patients. However, only three colonized patients developed infections post-LT. Sixty-nine MRSA isolates were identified, and the most frequent SCCmec type was type II (29/69; 42.0 %). Most isolates (57/69; 82.6 %) were susceptible to trimethoprim-sulfamethoxazole (TMP/SMX) and harboured the lukD, lukE, clf and fnbA genes as determined by PCR. Five sequence types (ST) were identified among nine clones; 36.2% (25/69) isolates belonged to a predominant clone (ST105 and SCCmec type II) that was susceptible to TMP/SMX, mupirocin and chlorhexidine, which had 87.9% similarity with the New York/Japan clone. The array showed virulence difference in isolates of the same clone and patients and that colonized isolates (pre-LT patients) were less virulent than those post-LT and those infected. Therefore, despite the high frequency of MRSA colonization, infection due to MRSA was uncommon in our LT unit. MRSA isolates presented great diversity. Isolates of the same clone expressed different virulence factors by array. Colonizing isolates pre-LT expressed less virulent factors than post-LT and infecting isolates.