ANGELA ESPOSITO
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PAINT-62, Hospital Universitário
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conferenceObject The Role of Respiratory Virus Infection in Suspected Pertussis: A Prospective Study(2019) VIEIRA, Sandra; FERRONATO, AngelabookPart Meningoencefalites(2022) FERRONATO, Angela Esposito; GILIO, Alfredo EliasbookPart Tuberculose(2022) FERRONATO, Angela Esposito; FERRER, Ana Paula Scoleze- Pediatric bacterial meningitis and meningococcal disease profile in a Brazilian General Hospital(2020) BLANCO, Bruna P.; BRANAS, Priscila C. A. A.; YOSHIOKA, Cristina R. M.; FERRONATO, Angela E.Objective: To evaluate the clinical and epidemiological profile of bacterial meningitis and meningococcal disease in pediatric patients admitted to a Brazilian Secondary Public Hospital. Methods: A descriptive observational study was conducted. Microbiologically proven bacterial meningitis or meningococcal disease diagnosed from 2008 to 2018 were included. Results: A total of 90 patients were diagnosed with proven bacterial meningitis. There were 64 confirmed cases of meningococcal disease. The prevalence was higher in boys (n=38), median age 30 months (1-185). The main clinical manifestations were: meningococcal meningitis (n = 27), meningococcemia without meningitis (n = 14), association of meningococcemia with meningitis (n=13), and fever without a known source in infants (n = 7). Admissions to intensive care unit were necessary for 45 patients. Three deaths were notified. Serogroup C was the most prevalent (n = 32) followed by serogroup B (n = 12). Pneumococcal meningitis was identified in 21 cases; out of the total, 10 were younger than two years. The identified serotypes were: 18C, 6B, 15A, 28, 7F, 12F, 15C, 19A and 14. Pneumococcal conjugate 10-valent vaccine covered four of the nine identified serotypes. Haemophilus influenzae meningitis serotype IIa was identified in three patients, median age 4 months (4-7). All of them needed intensive care. No deaths were notified. Conclusion: Morbidity and mortality rates from bacterial meningitis and meningococcal disease remain high, requiring hospitalization and leading to sequelae. Our study observed a reduced incidence of bacterial disease over the last decade, possibly reflecting the impact of vaccination. (C) 2020 Sociedade Brasileira de Infectologia.
bookPart Oxigenoterapia e ventilação mecânica no paciente pediátrico(2016) CARVALHO, Fabiane Alves de; ESPOSITO, AngelabookPart Coqueluche(2022) FERRONATO, Angela Esposito- The impact of varicella vaccination on varicella-related hospitalization rates: global data review(2016) HIROSE, Maki; GILIO, Alfredo Elias; FERRONATO, Angela Esposito; RAGAZZI, Selma Lopes BettaAbstract Objective: To describe the impact of varicella vaccination on varicella-related hospitalization rates in countries that implemented universal vaccination against the disease. Data source: We identified countries that implemented universal vaccination against varicella at the http://apps.who.int/immunization_monitoring/globalsummary/schedules site of the World Health Organization and selected articles in Pubmed describing the changes (pre/post-vaccination) in the varicella-related hospitalization rates in these countries, using the Keywords ""varicella"", ""vaccination/vaccine"" and ""children"" (or) ""hospitalization"". Publications in English published between January 1995 and May 2015 were included. Data synthesis: 24 countries with universal vaccination against varicella and 28 articles describing the impact of the vaccine on varicella-associated hospitalizations rates in seven countries were identified. The US had 81.4%–99.2% reduction in hospitalization rates in children younger than four years, 6–14 years after the onset of universal vaccination (1995), with vaccination coverage of 90%; Uruguay: 94% decrease (children aged 1–4 years) in six years, vaccination coverage of 90%; Canada: 93% decrease (age 1–4 years) in 10 years, coverage of 93%; Germany: 62.4% decrease (age 1–4 years) in 8 years, coverage of 78.2%; Australia: 76.8% decrease (age 1–4 years) in 5 years, coverage of 90%; Spain: 83.5% decrease (age <5 years) in four years, coverage of 77.2% and Italy 69.7%–73.8% decrease (general population), coverage of 60%–95%. Conclusions: The publications showed variations in the percentage of decrease in varicella-related hospitalization rates after universal vaccination in the assessed countries; the results probably depend on the time since the implementation of universal vaccination, differences in the studied age group, hospital admission criteria, vaccination coverage and strategy, which does not allow direct comparison between data.
- The role of respiratory virus infection in suspected pertussis: A prospective study(2021) FERRONATO, Angela Esposito; LEITE, Daniela; VIEIRA, Sandra ElisabeteBackground: Infections caused by Bordetella pertussis are frequent and responsible for cases of huge severity in unvaccinated young infants. However, clinical manifestations vary and mimic other respiratory diseases as respiratory viruses. Methods: A prospective cohort study was performed with infants under 1 old, hospitalized with suspected pertussis. All infants were submitted to etiological research to identify Bordetella pertussis (nasopharynx swab for culture and/or PCR) and respiratory viruses (nasopharyngeal aspirate for indirect immunofluorescence). Clinical and demographic data were collected. Results: Among 59 infants, an etiological agent was identified in 37 (62.8%). Respiratory virus was identified in 19 (32%) and Bordetella pertussis in 14 (23.7%) as sole agent. Codetection was found in 4 (7%). Younger age, absence of fever, lack of BP immunization, leukocytosis > 20,000/mm3, lymphocytosis >10,000/mm3 were associated to a greater chance of pertussis. Wheezing and living with siblings were associated with viral infection. After adjustment for confounders, the most important predictors were presence of wheezing for respiratory virus and leukocytosis for pertussis. The severity of infections by RV and BP were similar. Conclusion: Respiratory virus infections are frequent in cases of clinical suspicion of pertussis and may actually exceed the prevalence of BP. Clinical/laboratory characteristics may suggest the etiology, but they are not pathognomonic, which stresses the need for respiratory virus and Bordetella pertussis research in this clinical situation.
- Infections Caused by HRSV A ON1 Are Predominant among Hospitalized Infants with Bronchiolitis in S(a)over-tildeo Paulo City(2017) VIEIRA, Sandra E.; THOMAZELLI, Luciano M.; PAULIS, Milena de; FERRONATO, Angela E.; OLIVEIRA, Daniele B.; MARTINEZ, Marina Baquerizo; DURIGON, Edison L.Human respiratory syncytial virus is the main cause of respiratory infections in infants. Several HRSV genotypes have been described. Goals. To describe the main genotypes that caused infections in S (a) over tildeo Paulo (2013-2015) and to analyze their clinical/epidemiological features. Methods. 94 infants (0-6 months) with bronchiolitis were studied. Clinical/epidemiological information was collected; a search for 16 viruses in nasopharyngeal secretion (PCR-real-time and conventional, sequencing, and phylogenetic analyses) was performed. Results. The mean age was 2.4 m; 48% were male. The mean length of hospital stay was 4.4 d (14% in the Intensive Care Unit). The positive rate of respiratory virus was 98.9%; 73 cases (77.6%) were HRSV (76,7% HRSVA). HRSVA formed three clusters: ON1 (n = 34), NA1 (n = 1), and NA2 (n = 4). All HRSVB were found to cluster in the BA genotype (BA9-n = 10; BA10-n = 3). Clinical analyses showed no significant differences between the genotype AON1 and other genotypes. Conclusion. This study showed a high rate of HRSV detection in bronchiolitis. HRSVA ON1, which has recently been described in other countries and has not been identified in previous studies in the southeast region of Brazil, was predominant. The clinical characteristics of the infants that were infected with AON1 were similar to infants with infections by other genotypes.
bookPart Doença de Kawasaki(2022) FERRONATO, Angela Esposito; GILIO, Alfredo Elias