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Projetos de Pesquisa
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LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 73
  • article 88 Citação(ões) na Scopus
    Global guideline for the diagnosis and management of rare yeast infections: an initiative of the ECMM in cooperation with ISHAM and ASM
    (2021) CHEN, Sharon C-A; PERFECT, John; COLOMBO, Arnaldo L.; CORNELY, Oliver A.; GROLL, Andreas H.; SEIDEL, Danila; ALBUS, Kerstin; ALMEDIA JR., Joao Nobrega de; GARCIA-EFFRON, Guillermo; GILROY, Nicole; LASS-FLOERL, Cornelia; OSTROSKY-ZEICHNER, Luis; PAGANO, Livio; PAPP, Tamas; RAUTEMAA-RICHARDSON, Riina; SALMANTON-GARCIA, Jon; SPEC, Andrej; STEINMANN, Joerg; ARIKAN-AKDAGLI, Sevtap; ARENZ, Dorothee E.; SPRUTE, Rosanne; DURAN-GRAEFF, Luisa; FREIBERGER, Tomas; GIRMENIA, Corrado; HARRIS, Michelle; KANJ, Souha S.; ROUDBARY, Maryam; LORTHOLARY, Olivier; MELETIADIS, Joseph; SEGAL, Esther; TUON, Felipe Francisco; WIEDERHOLD, Nathan; BICANIC, Tihana; CHANDER, Jagdish; CHEN, Yee-Chun; HSUEH, Po-Ren; IP, Margaret; MUNOZ, Patricia; SPRIET, Isabel; TEMFACK, Elvis; THOMPSON, Luis; TORTORANO, Anna Maria; VELEGRAKI, Aristea; GOVENDER, Nelesh P.
    Uncommon, or rare, yeast infections are on the rise given increasing numbers of patients who are immunocompromised or seriously ill. The major pathogens include those of the genera Geotrichum, Saprochaete, Magnusiomyces, and Trichosporon (ie, basidiomycetes) and Kodamaea, Malassezia, Pseudozyma (ie, now Moesziomyces or Dirkmeia), Rhodotorula, Saccharomyces, and Sporobolomyces (ie, ascomycetes). A considered approach to the complex, multidisciplinary management of infections that are caused by these pathogens is essential to optimising patient outcomes; however, management guidelines are either region-specific or require updating. In alignment with the One World-One Guideline initiative to incorporate regional differences, experts from diverse geographical regions analysed publications describing the epidemiology and management of the previously mentioned rare yeasts. This guideline summarises the consensus recommendations with regards to the diagnostic and therapeutic options for patients with these rare yeast infections, with the intent of providing practical assistance in clinical decision making. Because there is less clinical experience of patients with rare yeast infections and studies on these patients were not randomised, nor were groups compared, most recommendations are not robust in their validation but represent insights by use of expert opinions and in-vitro susceptibility results. In this Review, we report the key features of the epidemiology, diagnosis, antifungal susceptibility, and treatment outcomes of patients with Geotrichum, Saprochaete, Magnusiomyces, and Trichosporon spp infections.
  • article 12 Citação(ões) na Scopus
    Candida blankii: an emergent opportunistic yeast with reduced susceptibility to antifungals
    (2018) ALMEIDA JR., Joao Nobrega de; CAMPOS, Silvia V.; THOMAZ, Danilo Y.; THOMAZ, Luciana; ALMEIDA, Renato K. G. de; NEGRO, Gilda M. B. del; GIMENES, Viviane F.; GRENFELL, Rafaella C.; MOTTA, Adriana L.; ROSSI, Flavia; BENARD, Gil
  • article 32 Citação(ões) na Scopus
    Rapid identification of moulds and arthroconidial yeasts from positive blood cultures by MALDI-TOF mass spectrometry
    (2016) ALMEIDA JR., Joao N. de; SZTAJNBOK, Jaques; SILVA JUNIOR, Afonso Rafael da; VIEIRA, Vinicius Adriano; GALASTRI, Anne Layze; BISSOLI, Leandro; LITVINOV, Nadia; NEGRO, Gilda Maria Barbaro Del; MOTTA, Adriana Lopes; ROSSI, Flavia; BENARD, Gil
    Moulds and arthroconidial yeasts are potential life-threatening agents of fungemia in immunocompromised patients. Fast and accurate identification (ID) of these pathogens hastens initiation of targeted antifungal therapy, thereby improving the patients' prognosis. We describe a new strategy that enabled the identification of moulds and arthroconidial yeasts directly from positive blood cultures by MALDI-TOFmass spectrometry (MS). Positive blood cultures (BCs) with Gram staining showing hyphae and/or arthroconidia were prospectively selected and submitted to an in-house protein extraction protocol. Mass spectra were obtained by Vitek MS (TM) system, and identifications were carried out with in the research use only (RUO) mode with an extended database (SARAMIS (TM) [v.4.12] plus in-house database). Fusarium solani, Fusarium verticillioides, Exophiala dermatitidis, Saprochaete clavata, and Trichosporon asahii had correct species ID by MALDI-TOF MS analysis of positive BCs. All cases were related to critically ill patients with high mortality fungemia and direct ID from positive BCs was helpful for rapid administration of targeted antifungal therapy.
  • article 22 Citação(ões) na Scopus
    First report of a clinical isolate of Candida haemulonii in Brazil
    (2012) ALMEIDA JR., Joao Nobrega de; MOTTA, Adriana Lopes; ROSSI, Flavia; ABDALA, Edson; PIERROTTI, Ligia Camera; KONO, Adriana Satie Goncalves; DIZ, Maria Del Pilar Estevez; BENARD, Gil; NEGRO, Gilda Maria Barbaro Del
  • article 12 Citação(ões) na Scopus
    Multidrug-resistant Trichosporon species: underestimated fungal pathogens posing imminent threats in clinical settings
    (2021) ARASTEHFAR, Amir; ALMEIDA JUNIOR, Joao N. de; PERLIN, David S.; ILKIT, Macit; BOEKHOUT, Teun; COLOMBO, Arnaldo Lopes
    Species of Trichosporon and related genera are widely used in biotechnology and, hence, many species have their genome sequenced. Importantly, yeasts of the genus Trichosporon have been increasingly identified as a cause of life-threatening invasive trichosporonosis (IT) in humans and are associated with an exceptionally high mortality rate. Trichosporon spp. are intrinsically resistant to frontline antifungal agents, which accounts for numerous reports of therapeutic failure when echinocandins are used to treat IT. Moreover, these fungi have low sensitivity to polyenes and azoles and, therefore, are potentially regarded as multidrug-resistant pathogens. However, despite the clinical importance of Trichosporon spp., our understanding of their antifungal resistance mechanisms is quite limited. Furthermore, antifungal susceptibility testing is not standardized, and there is a lack of interpretive epidemiological cut-off values for minimal inhibitory concentrations to distinguish non-wild type Trichosporon isolates. The route of infection remains obscure and detailed clinical and environmental studies are required to determine whether the Trichosporon infections are endogenous or exogenous in nature. Although our knowledge on effective IT treatments is rather limited and future randomized clinical trials are required to identify the best antifungal agent, the current paradigm advocates the use of voriconazole, removal of central venous catheters and recovery from neutropenia.
  • conferenceObject
    The Trichosporosis Collaborative Project
  • article 8 Citação(ões) na Scopus
    Lomentospora prolificans fungemia in hematopoietic stem cell transplant patients: First report in South America and literature review
    (2018) PENTEADO, Fernando D.; LITVINOV, Nadia; SZTAJNBOK, Jaques; THOMAZ, Danilo Y.; SANTOS, Antonio M. dos; VASCONCELOS, Dewton M.; MOTTA, Adriana L.; ROSSI, Flavia; FERNANDES, Juliana F.; MARQUES, Heloisa Helena S.; BENARD, Gil; ALMEIDA JR., Joao N. de
    Lomentospora prolificans is a filamentous fungus and an emerging pathogen in immunocompromised patients. It is encountered most commonly in Australia, Spain, and USA. We described the first case of Lomentospora prolificans fungemia in South America. The patient was a hematopoietic stem cell transplantation (HSCT) recipient who developed the infection 37days after stem cells infusion. In addition, we performed a literature review of invasive lomentosporiosis in HSCT patients.
  • article 5 Citação(ões) na Scopus
    Trichosporon inkin as an Emergent Pathogen in Patients With Severe Pemphigus
    (2015) ALMEIDA JUNIOR, Joao Nobrega de; OLIVEIRA, Renata Buccheri de; DUARTE, Amaro; MOTTA, Adriana Lopes; ROSSI, Flavia; FIGUEIREDO, Dulce Sachiko Yamamoto de; NEGRO, Gilda Maria Barbaro Del; AOKI, Valeria; MARUTA, Celina Wakisaka; SANTI, Claudia Giuli; BENARD, Gil
    IMPORTANCE To our knowledge, these are the first reports of bloodstream infections by Trichosporon inkin in patients with pemphigus. OBSERVATIONS Trichosporon inkin, a novel organism causing bloodstream infection, was detected in 2 patients with pemphigus. An elderly man with pemphigus foliaceus died despite treatment with liposomal amphotericin B, 3mg/kg/d, and a young girl with pemphigus vulgaris responded to treatment with voriconazole, 8mg/kg/d, for 24 days. One of the T inkin isolates had a minimal inhibitory concentration of 2mg/L against amphotericin B, suggesting resistance to the drug. CONCLUSIONS AND RELEVANCE Delayed suspicion of invasive infection by T inkin may result in a poor outcome in patients with severe forms of pemphigus. This opportunistic infection is highly refractory to conventional potent antifungal treatment.
  • article 30 Citação(ões) na Scopus
    Usefulness of matrix-assisted laser desorption ionisation-time-of-flight mass spectrometry for identifying clinical Trichosporon isolates
    Trichosporon spp. have recently emerged as significant human pathogens. Identification of these species is important, both for epidemiological purposes and for therapeutic management, but conventional identification based on biochemical traits is hindered by the lack of updates to the species databases provided by the different commercial systems. In this study, 93 strains, or isolates, belonging to 16 Trichosporon species were subjected to both molecular identification using IGS1 gene sequencing and matrix-assisted laser desorption ionisation-time-of-flight (MALDI-TOF) analysis. Our results confirmed the limits of biochemical systems for identifying Trichosporon species, because only 27 (36%) of the isolates were correctly identified using them. Different protein extraction procedures were evaluated, revealing that incubation for 30 min with 70% formic acid yields the spectra with the highest scores. Among the six different reference spectra databases that were tested, a specific one composed of 18 reference strains plus seven clinical isolates allowed the correct identification of 67 of the 68 clinical isolates (98.5%). Although until recently it has been less widely applied to the basidiomycetous fungi, MALDI-TOF appears to be a valuable tool for identifying clinical Trichosporon isolates at the species level.
  • conferenceObject
    The Influence of Antifungal Prophylaxis in Invasive Fungal Infections in Liver Transplantation
    (2015) SONG, Alice T. W.; ALMEIDA JUNIOR, Joao N.; MAU, Luciana B.; FREIRE, Maristela; PROENCA, Adriana; HADDAD, Luciana; D'ALBUQUERQUE, Luiz A. C.; ABDALA, Edson