JOAO NOBREGA DE ALMEIDA JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- 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
- 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
- Emergence of colistin resistance in the largest university hospital complex of Sao Paulo, Brazil, over five years(2017) ROSSI, Flavia; GIRARDELLO, Raquel; CURY, Ana Paula; GIOIA, Thais Sabato Romano Di; ALMEIDA JR., Joao Nobrega de; DUARTE, Alberto Jose da SilvaColistin resistance involving Gram-negative bacilli infections is a challenge for health institutions around of the world. Carbapenem-resistance among these isolates makes colistin the last therapeutic option for this treatment. Colistin resistance among Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp. was evaluated between 2010 and 2014 years, at Hospital das Clinicas, Sao Paulo, Brazil. Over five years 1346 (4.0%) colistin resistant Gramnegative bacilli were evaluated. Enterobacteriaceae was the most frequent (86.1%) pathogen isolated, followed by Acinetobacter spp. (7.6%), and Pseudomonas spp. (6.3%). By temporal analysis there was a trend for an increase of colistin resistance among Enterobacteriaceae, but not among non-fermentative isolates. Among 1346 colistin resistant isolates, carbapenem susceptibility was observed in 21.5%. Colistin resistance in our hospital has been alarmingly increased among Klebsiella pneumoniae isolates in both KPC positive and negative, thus becoming a therapeutic problem. (C) 2016 Sociedade Brasileira de Infectologia.
- Candida haemulonii Complex Species, Brazil, January 2010-March 2015(2016) ALMEIDA JR., Joao Nobrega de; ASSY, Joao Guilherme Pontes Lima; LEVIN, Anna S.; NEGRO, Gilda M. B. Del; GIUDICE, Mauro C.; TRINGONI, Marcela Pullice; THOMAZ, Danilo Yamamoto; MOTTA, Adriana Lopes; ABDALA, Edson; PIERROTI, Ligia Camara; STRABELLI, Tania; MUNHOZ, Ana Lucia; ROSSI, Flavia; BENARD, Gil
- An Azole-Resistant Candida parapsilosis Outbreak: Clonal Persistence in the Intensive Care Unit of a Brazilian Teaching Hospital(2018) THOMAZ, Danilo Yamamoto; ALMEIDA JR., Joao Nobrega de; LIMA, Glaucia Moreira Espindola; NUNES, Maina de Oliveira; CAMARGO, Carlos Henrique; GRENFELL, Rafaella de Carvalho; BENARD, Gil; NEGRO, Gilda M. B. DelThe incidence of candidemia by the Candida parapsilosis complex has increased considerably in recent decades, frequently related to use of indwelling intravascular catheters. The ability of this pathogen to colonize healthcare workers (HCW)' hands, and to form biofilm on medical devices has been associated with the occurrence of nosocomial outbreaks and high mortality rates. Fluconazole has been the leading antifungal drug for the treatment of invasive candidiasis in developing countries. However, azole-resistant C. parapsilosis isolates are emerging worldwide, including in Brazil. Few studies have correlated outbreak infections due to C. parapsilosis with virulence factors, such as biofilm production. We thus conducted a microbiological investigation of C. parapsilosis complex isolates from a Brazilian teaching hospital. Additionally, we identified a previously unrecognized outbreak caused by a persistent azole-resistant C. parapsilosis (sensu stricto) clone in the intensive care unit (ICU), correlating it with the main clinical data from the patients with invasive candidiasis. The molecular identification of the isolates was carried out by PCR-RFLP assay; antifungal susceptibility and biofilm formation were also evaluated. The genotyping of all C. parapsilosis (sensu stricto) was performed by microsatellite analysis and the presence of ERG11 mutations was assessed in the azole non-susceptible isolates. Fourteen C. parapsilosis (sensu stricto) isolates were recovered from patients with invasive candidiasis, eight being fluconazole and voriconazole-resistant, and two intermediate only to fluconazole (FLC). All non-susceptible isolates showed a similar pattern of biofilm formation with low biomass and metabolic activity. The A395T mutation in ERG11 was detected exclusively among the azole-resistant isolates. According to the microsatellite analysis, all azole non-susceptible isolates from the adult ICU were clustered together indicating the occurrence of an outbreak. Regarding clinical data, all patients infected by the clonal non-susceptible isolates and none of the patients infected by the susceptible isolates had been previously exposed to corticosteroids (p=0.001), while the remaining characteristics showed no statistical significance. The current study revealed the persistence of an azole non-susceptible C. parapsilosis clone with low capacity to form biofilm over two years in the adult ICU. These results reinforce the need of epidemiological surveillance and monitoring antifungal susceptibility of C. parapsilosis isolates in hospital wards.
- Chronic Meningitis and Hydrocephalus due to Sporothrix brasiliensis in Immunocompetent Adults: A Challenging Entity (vol 5, ofy081, 2018)(2018) MIALSKI, Rafael; ALMEIDA JR., Joao Nobrega de; SILVA, Larissa Honorato da; KONO, Adriana; PINHEIRO, Rosangela Lameira; TEIXEIRA, Manoel Jacobsen; GOMES, Renata Rodrigues; QUEIROZ-TELLES, Flavio de; PINTO, Fernando Gomes; BENARD, Gil
- Axillary Digital Thermometers uplifted a multidrug-susceptible Candida auris outbreak among COVID-19 patients in Brazil(2021) ALMEIDA JR., Joao Nobrega de; BRANDAO, Igor B.; FRANCISCO, Elaine C.; ALMEIDA, Silvio Luis R. de; DIAS, Patricia de Oliveira; PEREIRA, Felicidade M.; FERREIRA, Fabio Santos; ANDRADE, Thaisse Souza de; COSTA, Magda M. de Miranda; JORDAO, Regiane T. de Souza; MEIS, Jacques F.; COLOMBO, Arnaldo L.Objectives To describe the first outbreak of Candida auris in Brazil, including epidemiological, clinical and microbiological data. Methods After the first Candida auris-colonised patient was diagnosed in a COVID-19 ICU at a hospital in Salvador, Brazil, a multidisciplinary team conducted a local C. auris prevalence investigation. Screening cultures for C. auris were collected from patients, healthcare workers and inanimate surfaces. Risk factors for C. auris colonisation were evaluated, and the fungemia episodes that occurred after the investigation were also analysed and described. Antifungal susceptibility of the C. auris isolates was determined, and they were genotyped with microsatellite analysis. Results Among body swabs collected from 47 patients, eight (n = 8/47, 17%) samples from the axillae were positive for C. auris. Among samples collected from inanimate surfaces, digital thermometers had the highest rate of positive cultures (n = 8/47, 17%). Antifungal susceptibility testing showed MICs of 0.5 to 1 mg/L for AMB, 0.03 to 0.06 mg/L for voriconazole, 2 to 4 mg/L for fluconazole and 0.03 to 0.06 mg/L for anidulafungin. Microsatellite analysis revealed that all C. auris isolates belong to the South Asian clade (Clade I) and had different genotypes. In multivariate analysis, having a colonised digital thermometer was the only independent risk factor associated with C. auris colonisation. Three episodes of C. auris fungemia occurred after the investigation, with 30-day attributable mortality of 33.3%. Conclusions Emergence of C. auris in Salvador, Brazil, may be related to local C. auris clade I closely related genotypes. Contaminated axillary monitoring thermometers may facilitate the dissemination of C. auris reinforcing the concept that these reusable devices should be carefully cleaned with an effective disinfectant or replaced by other temperature monitoring methods.
- Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry for Differentiation of the Dimorphic Fungal Species Paracoccidioides brasiliensis and Paracoccidioides lutzii(2015) ALMEIDA JR., Joao Nobrega de; NEGRO, Gilda M. B. Del; GRENFELL, Rafaella C.; VIDAL, Monica S. M.; THOMAZ, Danilo Y.; FIGUEIREDO, Dulce S. Y. De; BAGAGLI, Eduardo; JULIANO, Luiz; BENARD, GilIsolates of Paracoccidioides brasiliensis and Paracoccidioides lutzii, previously characterized by molecular techniques, were identified for the first time by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). All isolates were correctly identified, with log score values of >2.0. Thus, MALDI-TOF MS is a new tool for differentiating species of the genus Paracoccidioides.
article 23 Citação(ões) na Scopus Carbapenem stewardship - positive impact on hospital ecology(2011) LIMA, Ana Lucia Lei Munhoz; OLIVEIRA, Priscila Rosalba Domingos de; PAULA, Adriana Pereira de; DAL-PAZ, Karine; ALMEIDA JR., Joao Nobrega de; FELIX, Cassia da Silva; ROSSI, FlaviaIntroduction: Excessive group 2 carbapenem use may result in decreased bacterial susceptibility. Objective: We evaluated the impact of a carbapenem stewardship program, restricting imipenem and meropenem use. Methods: Ertapenem was mandated for ESBL-producing Enterobacteriaceae infections in the absence of non-fermenting Gram-negative bacilli (GNB) from April 2006 to March 2008. Group 2 carbapenems were restricted for use against GNB infections susceptible only to carbapenems and suspected GNB infections in unstable patients. Cumulative susceptibility tests were done for nosocomial pathogens before and after restriction using Clinical and Laboratory Standards Institute (CLSI) guidelines. Vitek System or conventional identification methods were performed and susceptibility testing done by disk diffusion according to CLSI. Antibiotic consumption (t-test) and susceptibilities (McNemar's test) were determined. Results: The defined daily doses (DDD) of group 2 carbapenems declined from 61.1 to 48.7 DDD/1,000 patient-days two years after ertapenem introduction (p = 0.027). Mean ertapenem consumption after restriction was 31.5 DDD/1,000 patient-days. Following ertapenem introduction no significant susceptibility changes were noticed among Gram-positive cocci. The most prevalent GNB were P. aeruginosa, Klebsiella pneumoniae, and Acinetobacter spp. There was no change in P. aeruginosa susceptibility to carbapenems. Significantly improved P. aeruginosa and K. pneumoniae ciprofloxacin susceptibilities were observed, perhaps due to decreased group 2 carbapenem use. K. pneumoniae susceptibility to trimethoprim-sulfamethoxazole improved. Conclusion: Preferential use of ertapenem resulted in reduced group 2 carbapenem use, with a positive impact on P. aeruginosa and K. pneumoniae susceptibility.- Polymyxins susceptibility tests: we need talk about a solution(2019) GIRARDELLO, Raquel; CURY, Ana Paula; FRANCO, Maria Renata Gomes; GIOIA, Thais Romano Di; ALMEIDA JR., Joao Nobrega de; ARAUJO, Maria Rita Elmor de; DUARTE, Alberto Jose da Silva; ROSSI, Flavia