ANTONIO CARLOS NICODEMO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina - Docente
LIM/46 - Laboratório de Parasitologia Médica, Hospital das Clínicas, Faculdade de Medicina
LIM/46 - Laboratório de Parasitologia Médica, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
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- Antimicrobial susceptibility of Brazilian Clostridium difficile strains determined by agar dilution and disk diffusion(2016) FRAGA, Edmir Geraldo; NICODEMO, Antonio Carlos; SAMPAIO, Jorge Luiz MelloClostridium difficile is a leading cause of diarrhea in hospitalized patients worldwide. While metronidazole and vancomycin are the most prescribed antibiotics for the treatment of this infection, teicoplanin, tigecycline and nitazoxanide are alternatives drugs. Knowledge on the antibiotic susceptibility profiles is a basic step to differentiate recurrence from treatment failure due to antimicrobial resistance. Because C. difficile antimicrobial susceptibility is largely unknown in Brazil, we aimed to determine the profile of C. difficile strains cultivated from stool samples of inpatients with diarrhea and a positive toxin A/B test using both agar dilution and disk diffusion methods. All 50 strains tested were sensitive to metronidazole according to CLSI and EUCAST breakpoints with an MIC90 value of 21,1 mu g/mL. Nitazoxanide and tigecycline were highly active in vitro against these strains with an MIC90 value of 0.125 mu g/mL for both antimicrobials. The MIC90 were 4 mu g/mL and 2 mu g/mL for vancomycin and teicoplanin, respectively. A resistance rate of 8% was observed for moxifloxacin. Disk diffusion can be used as an alternative to screen for moxifloxacin resistance, nitazoxanide, tigecycline and metronidazole susceptibility, but it cannot be used for testing glycopeptides. Our results suggest that C. difficile strains from Sao Paulo city, Brazil, are susceptible to metronidazole and have low MIC90 values for most of the current therapeutic options available in Brazil. (C) 2016 Sociedade Brasileira de Infectologia.
- Facial Structure Alterations and Abnormalities of the Paranasal Sinuses on Multidetector Computed Tomography Scans of Patients with Treated Mucosal Leishmaniasis(2014) CAMARGO, Raphael Abegao de; NICODEMO, Antonio C.; SUMI, Daniel Vaccaro; GEBRIM, Eloisa Maria Mello Santiago; TUON, Felipe Francisco; CAMARGO, Lazaro Manoel de; IMAMURA, Rui; AMATO, Valdir SabbagaBackground/Objectives: Mucosal leishmaniasis (ML) is a progressive disease that affects cartilage and bone structures of the nose and other upper respiratory tract structures. Complications associated with ML have been described, but there is a lack of studies that evaluate the structural changes of the nose and paranasal sinuses in ML using radiological methods. In this study, we aimed to assess the opacification of the paranasal sinuses in patients with treated ML and any anatomical changes in the face associated with ML using multidetector computed tomography scans (MDCT) of the sinuses. We compared the findings with a control group. Methodology/Principal Findings: We evaluated 54 patients with treated ML who underwent CT scans of the sinuses and compared them with a control group of 40 patients who underwent orbital CT scans. The degree of sinus disease was assessed according to the Lund-Mackay criteria. Forty of the 54 patients with a history of ML (74.1%) had a tomographic score compatible with chronic sinusitis (Lund-Mackay >= 4). CT scans in the leishmaniasis and control groups demonstrated significant differences in terms of facial structure alterations. Patients from the ML group showed more severe levels of partial opacification and pansinus mucosal thickening (42.6%) and a greater severity of total opacification. Patients from the ML group with a Lund-Mackay score >= 4 presented longer durations of disease before treatment and more severe presentations of the disease at diagnosis. Conclusion/Significance: CT scans of the sinuses of patients with ML presented several structural alterations, revealing a prominent destructive feature of the disease. The higher prevalence in this study of chronic rhinosinusitis observed in CT scans of patients with treated ML than in those of the control group suggests that ML can be considered a risk factor for chronic rhinosinusitis in this population (p<0.05).
- Gordonia terrae kidney graft abscess in a renal transplant patient(2014) NICODEMO, A. C.; ODONGO, F. C. A.; DOI, A. M.; SAMPAIO, J. L. M.We present the first report, to our knowledge, of a renal abscess cause by an infection from Gordonia terrae in a kidney transplant patient. The patient simultaneously had pulmonary tuberculosis and a perirenal allograft abscess caused by G.terrae. After treatment with imipenem, in addition to anti-tuberculous drugs, the patient was cured.
- Frequency of Plasmid-Mediated AmpC beta-Lactamases in Escherichia coli Isolates from Urine Samples in Sao Paulo, Brazil(2016) ROCHA, Darlan Augusto Costa; CAMPOS, Juliana Coutinho; PASSADORE, Lilian Ferri; SAMPAIO, Suely Carlos Ferreira; NICODEMO, Antonio Carlos; SAMPAIO, Jorge Luiz MelloPlasmid-mediated AmpC beta-lactamases (PMACBLs) in Enterobacteriaceae encode resistance to third-generation cephalosporins, and these can mediate carbapenem resistance when associated with porin loss. However, no standardized phenotypic method is available for detecting these enzymes in the clinical microbiology laboratory. Limited data are available concerning the frequency of PMACBLs in Enterobacteriaceae in Brazil. This study was conducted in response to an increased cefoxitin (CFO) resistance rate of 3.7% in Escherichia coli isolates from urine samples from patients with suspected urinary tract infections during 2010. We collected 2,266 E. coli isolates prospectively during January 2012. A total of 109 (4.8%) isolates were nonsusceptible to CFO. These strains were further examined using multiplex PCR for the presence of genes encoding PMACBLs and using inhibitor assays with CFO and ceftazidime (CAZ) disks with and without phenylboronic acid. Pulsed-field gel electrophoresis was used to evaluate clonal dissemination. Genes encoding PMACBLs were detected in 1.8% of the isolates from inpatients and 0.46% of isolates from outpatients. The most prevalent gene was bla(CMY-2) and bla(CMY-4) was also detected. The phenotypic analysis showed 100% sensitivity and specificity for CMY-2 and CMY-4 when CFO-resistant isolates with a minimum zone diameter difference of 5mm for CAZ or CAZ and CFO were considered positive. Although most of the isolates were nonclonal, one clonal group with two isolates was observed. Thus, the most frequent PMACBL in E. coli from Sao Paulo, Brazil is CMY-2, and both clonal and plasmid-mediated dissemination occur.
- Mucosal leishmaniasis mimicking T-cell lymphoma in a patient receiving monoclonal antibody against TNF alpha(2017) NICODEMO, Antonio Carlos; DUAILIBI, Daniel Fernandes; FERIANI, Diego; DUARTE, Maria Irma Seixas; AMATO, Valdir Sabbaga
- Visceral leishmaniasis reactivation diagnosed by molecular technique in blood sample(2012) BRAZ, L.; NICODEMO, A.; SOUZA, R.; SANTOS, N.; GODOY, N.; OKAY, T.; AMATO, V.Background: It is possible to perform the serological diagnosis of visceral leishmaniasis through k39 immunochromatographic test. However, usually in the co-infection visceral leishmaniasis with HIV k39 strip results are not conclusive. Then, investigation by microscopic examination of smear, culture medium NNN/BHI and PCR can be performed in bone marrow aspirates (gold standard) or blood sample. In this case report PCR in blood sample proved to be useful for monitoring reactivation of visceral leishmaniasis in a patient with HIV. Methods: In four different periods of a patient hospitalization with visceral leishmaniasis, samples of bone marrow aspirates and peripheral blood were examined. They were evaluated by microscopic examination of smear stained by Panóptico, culture medium NNN/BHI and PCR targeting the kDNA. Results: In four different periods of patient hospitalization the samples from bone marrow aspirates and blood sample presented amastigotes after smear microscopic examination. By PCR (kDNA) the samples from bone marrow aspirates and blood sample showed a 120-bp band on the electrophoresis gel. And promastigotes were found in the culture medium NNN/BHI from aspirated bone marrow only in the last hospitalization. Conclusion: Aspiration of bone marrow, the gold-standard diagnostic laboratory of visceral leishmaniasis, is known to be invasive and painful. However, it is possible to diagnose the disease through k39 immunochromatographic test. But usually in patients coinfected with HIV the k39 results are not conclusive. And the microscopic examination of smear is subjective and extremely time consuming. Our results of positive PCR (120 bp) in both bone marrow aspirates and in the blood sample demonstrated the importance of PCR in detection of visceral leishmaniasis reactivation. PCR results in blood samples suggest the possibility of replacing the PCR and even the smear examination in bone marrow aspirates to detect reactivation.
- Rothia aeria endocarditis in a patient with a bicuspid aortic valve: case report(2014) NICODEMO, Antonio Carlos; GONCALVES, Luiz Guilherme; ODONGO, Fatuma Catherine Atieno; MARTINO, Marines Dalla Valle; SAMPAIO, Jorge Luiz MelloRothia aerie is an uncommon pathogen mainly associated with endocarditis in case reports. In previous reports, endocarditis by R. aerie was complicated by central nervous system embolization. In the case we report herein, endocarditis by R. aerie was diagnosed after acute self-limited diarrhea. In addition to the common translocation of R. aerie from the oral cavity, we hypothesize the possibility of intestinal translocation. Matrix-assisted laser desorption ionization-time of flight mass spectrometry and genetic sequencing are important tools that can contribute to early and more accurate etiologic diagnosis of severe infections caused by Gram-positive rods.
- Strong correlation by ultrasonography of hepatomegaly and the presence of co-infection in HIV/HCV cirrhotic patients(2013) VEZOZZO, Denise Cerqueira Paranagua; MENDES-CORREA, Maria Cassia; CUNHA-SILVA, Marlone; ALVARADO-MORA, Monica Viviana; FRANCA, Joao Italo Dias; SEBBA, Jose Luiz; NICODEMO, Antonio Carlos; OLIVEIRA, Claudia P. M. S.; CARRILHO, Flair JoseObjectives: Progression of hepatic fibrosis is accelerated in patients co-infected with human immunodeficiency virus and hepatitis C virus compared to hepatitis C virus mono-infected patients. This study aimed to compare ultrasound features and selected clinical and biochemical variables between patients with human immunodeficiency virus/hepatitis C virus co-infection (n = 16) versus hepatitis C virus mono-infection (n = 16). Methods: Each patient underwent abdominal ultrasound, and a specific evaluation was performed in order to detect findings consistent with chronic liver disease. Characterization of spleen size, liver structural pattern, diameter of the portal, spleen, and mesenteric veins was based on classical ultrasound parameters. Propensity score was used for control of selection bias and performed using binary logistic regression to generate a score for each patient. The Fisher and Mann-Whitney tests were used to evaluate categorical variables and continuous variables, respectively. Results: On univariate analysis right hepatic lobe size was larger in human immunodeficiency virus/hepatitis C virus patients (157.06 +/- 17.56 mm) compared to hepatitis C virus mono-infected patients (134.94 +/- 16.95 mm) (p = 0.0011). The left hepatic lobe was also significantly larger in human immunodeficiency virus/hepatitis C virus patients (115.88 +/- 22.69 mm) versus hepatitis C virus mono-infected patients (95.06 +/- 24.18 mm) (p = 0.0177). Also, there was a strong correlation between hepatomegaly and co-infection (p = 0.005). Conclusion: Human immunodeficiency virus infection was the primary variable influencing liver enlargement in this population. Hepatomegaly on ultrasound was more common among cirrhotic human immunodeficiency virus/hepatitis C virus co-infected patients than among cirrhotic hepatitis C virus mono-infected patients. This aspect is very important in the management of human immunodeficiency virus/hepatitis C virus co-infected patients, because screening for hepatocellular carcinoma is necessary in this population.