JOAO NOBREGA DE ALMEIDA JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- 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, GilMoulds 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.
conferenceObject The Trichosporosis Collaborative Project(2016) GRAEFF, L. A. Duran; SEIDEL, D.; CORNELY, O. A.; VEHRESCHILD, M. J.; WISPLINGHOFF, H.; LASS-FLOERL, C.; ALMEIDA JUNIOR, J. Nobrega de; HENNEQUIN, C.- 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
- Invasive Trichosporon Infection: a Systematic Review on a Re-emerging Fungal Pathogen(2016) ALMEIDA JUNIOR, Joao N. de; HENNEQUIN, ChristopheObjectives: This review aimed to better depict the clinical features and address the issue of therapeutic management of Trichosporon deep-seated infections. Methods: We comprehensively reviewed the cases of invasive Trichosporon infection reported in the literature from 1994 (date of taxonomic modification) to 2015. Data from antifungal susceptibility testing (AST) studies were also analyzed. Results: Two hundred and three cases were retained and split into four groups: homeopathy (n = 79), other immunodeficiency conditions (n = 41), miscellaneous (n = 58) and newborns (n = 25). Trichosporon asahii was the main causative species (46.7%) and may exhibit cross-resistance to different antifungal classes. The unfavorable outcome rate was at 44.3%. By multivariate analysis, breakthrough infection (OR 2.45) was associated with unfavorable outcome, whilst the use of an azole-based therapy improved the prognosis (OR 0.16). Voriconazole-based treatment was associated with favorable outcome in hematological patients (73.6 vs. 41.8%; p = 0.016). Compiled data from AST demonstrated that (i) T asahii exhibits the highest MICs to amphotericin B and (ii) voriconazole has the best in vitro efficacy against clinical isolates of Trichosporon spp. Conclusions: Trichosporon infection is not only restricted to hematological patients. Analysis of compiled data from AST and clinical outcome support the use of voriconazole as first line therapy.
- Rhizopus arrhizus and Fusarium solani Concomitant Infection in an Immunocompromised Host(2016) ALMEIDA JUNIOR, Joao N. de; IBRAHIM, Karim Y.; NEGRO, Gilda M. B. Del; BEZERRA, Evandro D.; DUARTE NETO, Amaro N.; BATISTA, Marjorie V.; SICILIANO, Rinaldo F.; GIUDICE, Mauro C.; MOTTA, Adriana L.; ROSSI, Flavia; PIERROTTI, Ligia C.; FREIRE, Maristela P.; BELLESSO, Marcelo; PEREIRA, Juliana; ABDALA, Edson; BENARD, GilNeutropenic patients are at risk of the development of hyalohyphomycosis and mucormycosis. Correct identification is essential for the initiation of the specific treatment, but concomitant mold infections are rarely reported. We report one unprecedented case of concomitant mucormycosis and fusariosis in a neutropenic patient with acute myeloid leukemia. The patient developed rhino-orbital infection by Rhizopus arrhizus and disseminated infection by Fusarium solani. The first culture from a sinus biopsy grew Rhizopus, which was consistent with the histopathology report of mucormycosis. A second sinus biopsy collected later during the patient's clinical deterioration was reported as hyalohyphomycosis, and the culture yielded F. solani. Due to the discordant reports, the second biopsy was reviewed and two hyphae types suggestive of both hyalohyphomycetes and mucormycetes were found. The dual mold infection was confirmed by PCR assays from paraffinized tissue sections. Increased awareness of the existence of dual mold infections in at-risk patients is necessary. PCR methods in tissue sections may increase the diagnosis of dual mold infections. In case of sequential biopsies showing discrepant results, mixed infections have to be suspected.
conferenceObject TRISCHOSPORON INFECTION IN A PATIENT WITH CYSTIC FIBROSIS - DOES IT WORSEN THE CLINICAL STATUS?(2016) VENTURA, Jessica; DANIEL, Marcelo Bernasconi; ALMEIDA JUNIOR, Joao Nobrega de; SILVA FILHO, Luiz Vicente Ribeiro F. da- Identification of Candida haemulonii Complex Species: Use of ClinProTools (TM) to Overcome Limitations of the Bruker Biotyper (TM), VITEK MS (TM) IVD, and VITEK MS (TM) RUO Databases(2016) GRENFELL, Rafaella C.; SILVA JUNIOR, Afonso R. da; NEGRO, Gilda M. B. Del; MUNHOZ, Regina B.; GIMENES, Viviane M. F.; ASSIS, Diego M.; ROCKSTROH, Anna C.; MOTTA, Adriana L.; ROSSI, Flavia; JULIANO, Luiz; BENARD, Gil; ALMEIDA JUNIOR, Joao N. deCandida haemulonli is now considered a complex of two species and one variety: C. haemulonii sensu strict, Candida duobushaemulonii and the variety C. haemulonii var. vulnera. Identification (ID) of these species is relevant for epidemiological purposes and for therapeutic management, but the different phenotypic commercial systems are unable to provide correct species ID for these emergent pathogens. Hence, we evaluated the MALDI-TOF MS performance for the ID of C. haemulonli species, analyzing isolates/strains of C. haemulonli complex species, Candida pseudohaemulonii and Candida auris by two commercial platforms, their databases and softwares. To differentiate C. haemulonli sensu sctricto from the variety vulnera, we used the ClinProTools (TM) models and a single-peak analysis with the software FlexAnalysis (TM). The Biotyper (TM) database gave 100% correct species ID for C. haemulonii sensu strict, C. pseudohaemulonii and C. auris, with 69% of correct species ID for C. duobushaemulonii. Vitek MS (TM) IVD database gave 100% correct species ID for C. haemulonii sensu stricto, misidentifying all C. duobushaemulonii and C. pseudohaemulonii as C. haemulonii, being unable to identify C. auris. The Vitek MS (TM) RUO database needed to be upgraded with in-house SuperSpectra to discriminate C. haemulonii sensu stricto, C. duobushaemulonii, C. pseudohaemulonii, and C. auris strains/isolates. The generic algorithm model from ClinProTools (TM) software showed recognition capability of 100% and cross validation of 98.02% for the discrimination of C. haemulonli sensu stricto from the variety vulnera. Single-peak analysis showed that the peaks 5670, 6878, or 13750 m/z can distinguish C. haemulonli sensu stricto from the variety vulnera.
conferenceObject Trichosporon Infection in Lung Transplant Patients: An Emerging Fungal Infection?(2016) CAMPOS, S. V.; ALMEIDA JR., J. N.; SAMANO, M. N.; CARRARO, R. M.; COSTA, A. N.; TEIXEIRA, R. O.; AFONSO- JR., J.; CAMARGO, P. L.; ABDALLA, L.; FERNANDES, L. M.; PEGO-FERNANDES, P. M.bookPart Introdução(2016) ANTONANGELO, Leila; SALES, Maria Mirtes; KULIKOWSKI, Leslie Domenici; JúNIOR, João Nóbrega Almeida; DUARTE, Nilo José Coêlho; CAIAFFA FILHO, Hélio Hehl; DUARTE, Alberto José da Silva- Does the Capsule Interfere with Performance of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry for Identification of Cryptococcus neoformans and Cryptococcus gattii?(2016) THOMAZ, Danilo Y.; GRENFELL, Rafaella C.; VIDAL, Monica S. M.; GIUDICE, Mauro C.; NEGRO, Gilda M. B. Del; JULIANO, Luiz; BENARD, Gil; ALMEIDA JUNIOR, Joao N. deWe described the impact of the capsule size for Cryptococcus neoformans and Cryptococcus gattii identification at the species level by Bruker matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). After experimental capsule size modulation, we observed that reducing the capsule size resulted in improved identification by Bruker MALDI-TOF MS across all of the reference strains analyzed.