JESSICA FERNANDES RAMOS
Projetos de Pesquisa
Unidades Organizacionais
PAHC, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- Increased Risk of for Cytomegalovirus Reactivation after Allogeneic HSCT in T-Cell Depleted Patients(2020) MOLLA, Vinicius Campos; AZEVEDO, Roberta; RAMOS, Jessica Fernandes; PONCIANO, Danilo Belchior; MORAES, Pedro Henrique Arruda de; FONSECA, Ana Rita Da; SEIWALD, Maria Cristina Nunez; SERPA, Mariana; FERREIRA, Aliana Meneses; SZOR, Roberta Shcolnik; LEONEL, Rayana Bomfim; XAVIER, Erick Menezes; ROCHA, Vanderson; TUCUNDUVA, Luciana; NOVIS, Yana; NUCCI, Marcio; KALLAS, Esper; ARRAIS, Celso
conferenceObject Hepatitis B Virus Prophylaxis and Treatment among Hematopoietic Stem Cell Transplant Recipients: Impact on Engraftment and Outcomes(2020) BUZO, B.; RAMOS, J. Fernandes; ROSSETTI, R. Marques; SALLES, N.; MENDRONE-JUNIOR, A.; ROCHA, V.; NASTRI, A. de Seixas Santos- Clinical outcome from hematopoietic cell transplant patients with bloodstream infection caused by carbapenem-resistant P. aeruginosa and the impact of antimicrobial combination in vitro(2022) RAMOS, Jessica Fernandes; LEITE, Gleice; MARTINS, Roberta Cristina Ruedas; RIZEK, Camila; SANABANI, Sabri Saeed Al; ROSSI, Flavia; GUIMARAES, Thais; LEVIN, Anna Sara; ROCHA, Vanderson; COSTA, Silvia FigueiredoBloodstream infection (BSI) caused by carbapenem-resistant P. aeruginosa (CRPA) has high mortality in hematopoietic stem cell transplant (HSCT) recipients. We performed MIC, checkerboard, time-kill assay, PFGE, PCR, and whole genome sequence and described the clinical outcome through Epi Info comparing the antimicrobial combination in vitro. Mortality was higher in BSI caused by CRPA carrying the lasB virulence gene. The isolates were 97% resistant to meropenem displaying synergistic effect to 57% in combination with colistin. Seventy-three percent of the isolates harbored bla(SPM-1) and Tn4371 and belonged to ST277. The synergistic effect in vitro with meropenem with colistin appeared to be a better therapeutic option.
- Prevalence of latent Mycobacterium tuberculosis infection in hematopoietic stem cell transplantation comparing tuberculin skin test and interferon-gamma release assay(2023) CASTRO-LIMA, Victor A. C.; SANTOS, Ana Paula T.; MUSQUEIRA, Priscila T.; MALUF, Natalya Z.; RAMOS, Jessica F.; MARIANO, Livia; ROCHA, Vanderson; COSTA, Silvia F.The aim of this study was to evaluate the prevalence of latent Mycobacterium tuberculosis infection in hematopoietic stem cell transplantation candidates, using tuberculin skin test and QuantiFERON-TB Gold-Plus, in a high-burden tuberculosis country. Adult candidates for hematopoietic stem cell transplantation performed both tests before and those submitted to transplantation were followed up for 12 months. The prevalence of latent Mycobacterium tuberculosis infection was 17.1% and a moderate agreement between QuantiFERON-TB Gold-Plus and tuberculin skin test was observed in this population. Previous tuberculosis exposure was a risk factor for latent Mycobacterium tuberculosis infection. No cases of tuberculosis were diagnosed during follow-up period.
- Epidemiology, risk factors and outcomes of multi-drug-resistant bloodstream infections in haematopoietic stem cell transplant recipients: importance of previous gut colonization(2018) FERREIRA, A. M.; MOREIRA, F.; GUIMARAES, T.; SPADAO, F.; RAMOS, J. F.; BATISTA, M. V.; FILHO, J. S.; COSTA, S. F.; ROCHA, V.Background: Bloodstream infections (BSI) are a major complication in the early phase of a haematopoietic stem cell transplant (HSCT). Aim: To describe the incidence and risk factors for BSI occurring in the pre-engraftment phase of HSCT, and its impact on mortality. Methods: Clinical variables of 232 HSCT patients were analysed retrospectively between 2014 and 2015. Univariate Cox regression analyses were performed to test the association between each covariate and the outcome. Covariates with P < 0.10 on univariate analysis were included in a multiple Cox regression analysis using a backward elimination method. Findings: The cumulative incidence of BSI was 25.4%, mainly caused by Gram-negative bacteria (GNB) (55.2%). Approximately 40.5% of the patients had gut colonization by multi-drug-resistant (MDR) bacteria (vancomycin-resistant enterococcus and carbapenem-resistant GNB). Among patients colonized by MDR GNB, 20% developed an overt BSI due to MDR bacteria with the same pattern of sensitivity. Of the 13 deaths related to infection, 10 were patients with BSI caused by MDR GNB. The independent risk factors for BSI were gut colonization by MDR bacteria including GNB (P < 0.001) and duration of neutropenia >10 days (P = 0.005), and those associated with BSI caused by MDR bacteria were age >62 years (P = 0.03), use of total parenteral nutrition (TPN) (P < 0.001) and previous gut colonization by MDR GNB (P = 0.002). Conclusions: Previous gut colonization by MDR was an independent risk factor for BSI, together with TPN and age, and had an impact on outcome. These findings suggest that gut decolonization may be a potential strategy to prevent BSI.
- Low Dose Ganciclovir for Cytomegalovirus Reactivation after Allogeneic HSCT Is a Feasible Option with Same Efficacy and Less Toxicity Than Regular Dose(2020) AZEVEDO, Roberta; MOLLA, Vinicius Campos; RAMOS, Jessica Fernandes; PONCIANO, Danilo Belchior; MORAES, Pedro Henrique Arruda De; FONSECA, Ana Rita Da; SEIWALD, Maria Cristina Nunez; SERPA, Mariana; FERREIRA, Aliana Meneses; SZOR, Roberta Shcolnik; LEONEL, Rayana Bomfim; XAVIER, Erick Menezes; TUCUNDUVA, Luciana; ROCHA, Vanderson; NOVIS, Yana; KALLAS, Esper; NUCCI, Marcio; ARRAIS-RODRIGUES, Celso
- A case-series of Toxoplasmosis in hematopoietic stem cell transplantation: still a concern for endemic countries(2018) PRESTES, Daniel P.; MENDES, Clara; BATISTA, Marjorie V.; RAMOS, Jessica F.; SCHIMIDT JUNIOR, Jayr; OKAY, Thelma Suely; CAIAFFA, Helio; ROCHA, Vanderson G.; COSTA, Silvia Figueiredo
- Hepatitis B virus among hematopoietic stem cell transplant recipients: Antiviral impact in seroconversion, engraftment, and mortality in a Latin American center(2020) BUZO, Bruno Fernando; RAMOS, Jessica Fernandes; ROSSETTI, Renata Ariza Marques; SALLES, Nanci; MEDRONE-JUNIOR, Alfredo; ROCHA, Vanderson; NASTRI, Ana Catharina de Seixas SantosBackground Hepatitis B virus (HBV) infection is a worldwide concern with a broad distribution. In immunosuppressed populations, such as solid organ and hematopoietic stem cell transplant (HSCT) recipients, it can reactivate leading to acute hepatic failure. Different risk factors are known for higher rates of reactivation, and entecavir, tenofovir, and lamivudine are often used for prophylaxis and treatment. However, data regarding the impact of antiviral drugs in neutrophil and platelet engraftment are still unknown and concern the management of viral hepatitis post-HSCT. Methods We performed a single-center, retrospective, observational study reviewing medical records of patients referred for hematopoietic stem cell transplant from 2010 to 2017, which were also HBV infected, aiming to describe outcomes related to antiviral treatment and also the impact on platelet and neutrophil recovery after transplant. A secondary goal consisted of analyzing the impact of HBV infection in early and late mortality post-HSCT. The study included patients with positive blood bank screening for hepatitis B infection (HBsAg, Anti-HBc or HBV-NAT), confirmed later on by a laboratory routine serology. Results A total of 1132 hematopoietic stem cell recipients were assessed between 2010 and 2017. Eighty-six patients were confirmed to have HBV infection, of which six were HBsAg-positive, 20 were isolated anti-HBc-positive, and 60 had resolved infection (anti-HBc-positive and anti-HBs-positive). With regard to prophylaxis, 19 patients underwent HSCT on HBV antiviral therapy or prophylaxis: two were HBeAg-positive, three were HBeAg-negative and HBV-DNA was only detectable in three of them. Moreover, one patient had an occult HBV infection. Regarding therapy, 9 patients were on entecavir, 6 patients on lamivudine, two on tenofovir, and two of them on a combination of tenofovir + lamivudine due to HIV co-infection. Reverse seroconversion was not identified in any patients receiving antiviral therapy or prophylaxis, but it was detected in one patient with occult hepatitis B and another with resolved infection. No severe side effects led to therapy discontinuation in the treated group, which also did not have any significant delay in neutrophil or platelet engraftment when compared to patients without antiviral therapy. In addition, the only factors associated with increased mortality were transplant onset after 50 years, allogeneic transplant and myeloablative conditioning regimens. Interestingly, the presence of HBsAg or detectable HBV-DNA was not related to worse outcomes, neither the use of rituximab. In multivariate analysis, the use of antiviral therapy, the occurrence of graft-versus-host disease or CMV reactivation also was not linked to increased mortality. Conclusions To sum up, HBV serology, ALT, and HBV-DNA monitoring are essential to detect hepatic flares earlier, even in populations with chronic inactive hepatitis, due to the possibility of later seroconversion. HBV infection was not related to increased 2-year mortality post-transplant. Antiviral prophylaxis did not cause any important clinical or laboratory side effects that could demand discontinuation, and its use was not associated with later neutrophil and platelet engraftments.
- Carbapenem-resistant Pseudomonas aeruginosa carrying bla(VIM-36) assigned to ST308: Indicated non-virulence in a Galleria mellonella model(2019) NEVES, Patricia R.; PERDIGAO NETO, Lauro Vieira; MARTINS, Roberta Cristina Ruedas; RAMOS, Jessica F.; LEITE, Gleice; ROSSI, Flavia; SANABANI, Sabri Saeed; ROCHA, Vanderson; BATISTA, Marjorie Vieira; GUIMARAES, Thais; LEVIN, Anna S.; COSTA, Silvia F.Objectives: Based on pulsed-field gel electrophoresis (PFGE) profile, whole-genome sequencing (WGS) of eight carbapenem-resistant Pseudomonas aeruginosa isolates from a bone marrow transplant unit in Sao Paulo, Brazil, was performed to investigate the presence of resistance and virulence genes as well as to determine the sequence type (ST) by multilocus sequence typing (MLST). Methods: The initial phenotypic susceptibility pattern of the isolates was determined by VITEK (R) 2. Minimum inhibitory concentrations (MICs) were determined by the broth microdilution method for amikacin, meropenem and colistin. WGS was performed using an Illumina MiSeq system. A Galleria mellonella infection model was used to evaluate the virulence of the strains. Results: WGS demonstrated that mutations in genes encoding outer membrane proteins and efflux pumps in an isolate harbouring bla(VIM-36) (ST308) differed from those in isolates harbouring bla(SPM)(ST277). The mexTgene harboured a mutation resulting in a frameshift in all isolates; in addition, the oprD gene of the bla(VIM-36)-carrying isolate had an insertion leading to a frameshift. Virulence genes did not differ between ST277 and ST308 strains. Moreover, only two isolates harbouring bla(SPM) showed virulence in the G. mellonella model, killing 100% of larvae after 18-24 h. Conclusions: P. aeruginosa carrying bla(VIM-36) belonging to ST308 was identified for the first time in our hospital. Although the virulence gene profiles were similar in isolates carrying bla(SPM )and the isolate carrying bla(VIM-36), only two isolates harbouring bla(SPM )showed virulence in the G. mellonella model.
- Disseminated Skin Lesions After Allogeneic Hematopietic Stem Cell Transplantation(2018) NEFFA, Pedro Pereira; SCHMIDT FILHO, Jayr; RAMOS, Jessica Fernandes; OKAY, Thelma Suely; CASTELLI, Jussara Bianchi; ROCHA, Vanderson; COSTA, Silvia Fiqueiredo; BATISTA, Marjorie Vieira