JOAO NOBREGA DE ALMEIDA JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- 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.
- Bactec (TM) blood culture bottles allied to MALDI-TOF mass spectrometry: rapid etiologic diagnosis of bacterial endophthalmitis(2017) TANAKA, Tatiana; OLIVEIRA, Luiza Manhezi de Freitas; FERREIRA, Bruno Fortaleza de Aquino; KATO, Juliana Mika; ROSSI, Flavia; CORREA, Karoline de Lemes Giuntini; PIMENTEL, Sergio Luis Gianotti; YAMAMOTO, Joyce Hisae; ALMEIDA JUNIOR, Joao NobregaMatrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) has been used for direct identification of pathogens from blood-inoculated blood culture bottles (BCBs). We showed that MALDI-TOF MS is an useful technique for rapid identification of the causative agents of endophthalmitis from vitreous humor-inoculated BCBs with a simple protocol.
conferenceObject Epidemiology and prognostic factors of invasive trichosporonosis: alarming findings from a multicenter cohort study involving 12 tertiary care centers from Brazil(2017) DEALMEIDA JUNIOR, J. N.; TELLES FILHO, F. Q.; VAQUINO, V. R. Aquino; MENDES, A. V.; FRANCISCO, E. C.; ROSSI, F.; CHAVES, G. M.; GUIMARAES, T.; MOTTA, F. A.; MORALES, H. M. P.; PEROZIN, J. S.; CARLESSE, F.; OLIVEIRA, M. G. Lucca; COLOMBO, A. L.- Emerging multidrug-resistant Candida species(2017) COLOMBO, Arnaldo L.; ALMEIDA JUNIOR, Joao N. de; GUINEA, JesusPurpose of review To describe the epidemiology, strategies for early detection, and clinical management of infections caused by the most commonly found multidrug-resistant (MDR) Candida spp. Recent findings Increasing numbers of reports describing invasive infections by MDR Candida auris and Candida glabrata has been reported in medical centers worldwide. Summary We checked all papers published along the last 10 years describing epidemiological, diagnostic, and clinical aspects of infections by MDR Candida spp., with emphasis on C. auris and C. glabrata spp. C. auris has been reported in 15 countries and multidrug resistance rates is usually above 30%. Horizontal transmission is a great concern regarding C. auris. C. glabrata ranks the second most reported Candida spp. in deep-seated infections from United States and some European Centers, although multidrug resistance rates above 10% are restricted to some US centers. Candida haemulonii complex isolates with poor susceptibility to azoles and amphotericin B have been isolated in superficial and deep-seated infections, whereas Candida guilliiermondii complex isolates with poor susceptibility to azoles and echinocandins have been recovered from catheter-related bloodstream infections. Other potential MDR Candida species are Candida krusei, Candida lusitaniae, Candida kefyr, Yarrowia (Candida) lypolitica, and Candida rugosa.
conferenceObject Bactec (TM) blood culture bottles allied to MALDI-TOF mass spectrometry: Rapid etiologic diagnosis of bacterial endophthalmitis(2017) TANAKA, Tatiana; OLIVEIRA, Luiza Manhezi de Freitas; FERREIRA, Bruno Fortaleza de Aquino; KATO, Juliana Mika; ROSSI, Flavia; CORREA, Karoline de Lemes Giuntini; PIMENTEL, Sergio Luis Gianotti; YAMAMOTO, Joyce H.; ALMEIDA JUNIOR, Joao Nobrega de- Evaluating and Improving Vitek MS for Identification of Clinically Relevant Species of Trichosporon and the Closely Related Genera Cutaneotrichosporon and Apiotrichum(2017) ALMEIDA JR., Joao N. de; GIMENES, Viviane M. Favero; FRANCISCO, Elaine C.; SIQUEIRA, Lumena P. Machado; ALMEIDA, Renato K. Goncalves de; GUITARD, Juliette; HENNEQUIN, Christophe; COLOMBO, Arnaldo L.; BENARD, Gil; ROSSI, FlaviaTrichosporon species are relevant etiologic agents of hospital-acquired infections. High mortality rates are attributed to Trichosporon deep-seated infections in immuno-compromised individuals, making fast and accurate species identification relevant for hastening the discovery of best-targeted therapy. Recently, Trichosporon taxonomy has been reassessed, and three genera have been proposed for the pathogenic species: Trichosporon, Cutaneotrichosporon, and Apiotrichum. Matrix-assisted laser desorption ionization- time of flight mass spectrometry (MALDI-TOF MS) has replaced old phenotypic methods for microorganism identification in clinical laboratories, but spectral profile databases have to be evaluated and improved for optimal species identification performance. Vitek MS (bioMerieux) is one of the commercially available MALDI-TOF MS platforms for pathogen identification, and its spectral profile databases remain poorly evaluated for Trichosporon, Cutaneotrichosporon, and Apiotrichum species identification. We herein evaluated and improved Vitek MS for the identification of the main clinical relevant species of Trichosporon, Cutaneotrichosporon, and Apiotrichum using a large set of strains and isolates belonging to different yeast collections in Brazil and France.
- Candida and invasive mould diseases in non-neutropenic critically ill patients and patients with haematological cancer(2017) COLOMBO, A. L.; ALMEIDA JUNIOR, J. N. de; SLAVIN, Monica A.; CHEN, Sharon C-A; SORRELL, Tania C.Critically ill patients and patients with haematological cancer are HIV-negative populations at high risk of invasive fungal infections. In intensive-care units, candidaemia and intra-abdominal candidiasis predominate, but aspergillosis has emerged as a lethal, under-recognised cause of pneumonia. In patients with haematological malignancies or who have undergone stem-cell transplantations, pulmonary disease due to aspergillus and other mould diseases predominate. In this Series paper, we provide an update on risk assessment, new diagnostic strategies, and therapeutic approaches. New concepts have emerged for use of risk prediction rules and an evidence base now exists for inclusion of biomarkers (eg, galactomannan, 1,3-beta-D-glucan, and PCR assays for Aspergillus spp) into early diagnostic and therapeutic strategies. Imaging techniques remain helpful for early diagnosis of pulmonary mould diseases, with PET techniques offering potential improvements in diagnostic specificity and evaluation of clinical response. Echinocandins and triazoles have been validated extensively for prophylaxis, empirical therapy, and targeted therapy, but an increase in intrinsically resistant fungi and emergence of secondary resistance as a result of drug-induced selection pressure are of major concern. Echinocandins remain a major component of treatment of invasive candidiasis and new triazoles are the best alternative for prophylaxis and therapy of invasive aspergillosis.
- Emergence of Trichosporon mycotoxinivorans (Apiotrichum mycotoxinivorans) invasive infections in Latin America(2017) ALMEIDA JR., Joao Nobrega de; FRANCISCO, Elaine Cristina; BARBERINO, Maria Goreth M. de Andrade; SILVA FILHO, Luiz Vicente Ribeiro F. da; BRANDAO, Oriana M.; COLOMBO, Arnaldo Lopes; PADOVAN, Ana Carolina BarbosaWe report the first two cases of Trichosporon mycotoxinivorans infections in Latin America. We also conducted a literature review and a microbiological investigation, including that of clinical and environmental isolates. A 30-year-old man with chronic renal failure had disseminated infection after dialysis and a 15-year-old boy with cystic fibrosis (CF) had pulmonary exacerbations with positive respiratory samples. A review of the relevant literature revealed that deep-seated infections were related to immunosuppression or invasive devices, while most of the CF patients showed a decline in lung function after positive cultures. Phylogenetic analyses revealed three distinct circulating genotypes. MALDI-TOF mass spectrometry analysis showed similar spectral profiles and correctly identified all strains/isolates. Biofilm production was documented in a bloodstream isolate and biofilm-producing cells showed high minimum inhibitory concentrations against antifungals.