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
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
- 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- Epidemiology, clinical aspects, outcomes and prognostic factors associated with Trichosporon fungaemia: results of an international multicentre study carried out at 23 medical centres(2021) JR, Joao Nobrega de Almeida; FRANCISCO, Elaine Cristina; RUIZ, Alexis Holguin; CUELLAR, Luis E.; AQUINO, Valerio Rodrigues; MENDES, Ana Verena; QUEIROZ-TELLES, Flavio; SANTOS, Daniel Wagner; GUIMARAES, Thais; CHAVES, Guilherme Maranhao; MIRANDA, Bianca Grassi de; MOTTA, Fabio Araujo; SCHWARZBOLD, Alexandre Vargas; OLIVEIRA, Marcio; RIERA, Fernando; PEROZIN, Jamile Sardi; NEVES, Rejane Pereira; SILVA, Ivan Leonardo A. Franca E.; SZTAJNBOK, Jaques; RAMOS, Jessica Fernandes; BOTURA, Monica Borges; CARLESSE, Fabianne; CASTRO, Paulo de Tarso de O. E.; NYIRENDA, Themba; COLOMBO, Arnaldo L.Background: Trichosporon fungaemia (TF) episodes have increased in recent years and mortality rates remain high despite the advances in the management of sepsis. New concepts about its clinical course, treatment and microbiology need to be investigated for the better management of this infection. Objectives: To describe the aetiology, natural history, clinical management and prognostic factors of TF. Methods: TF episodes documented between 2005 and 2018 in 23 South American centres were retrospectively investigated by using a standard clinical form. Molecular identification, antifungal susceptibility testing and biofilm production were also performed. Results: Eighty-eight TF episodes were studied. Patients had several underlying conditions, including haematological diseases (47.7%), post-operative status (34%), solid organ transplants (n = 7, 7.9%), among others. Seventy-three (82.9%) patients had a central venous catheter (CVC) at TF diagnosis. The 30 day mortality rate was 51.1%. Voriconazole-based therapy was given to 34 patients (38.6%), with a 30 day mortality rate of 38.2%. Multivariate predictors of 30 day mortality were age (OR 1.036), mechanical ventilation (OR 8.25) and persistent neutropenia (OR 9.299). CVC removal was associated with over 75% decreased risk of 30 day mortality (OR 0.241). Microbiological analyses revealed that 77.7% of the strains were identified as Trichosporon asahii, and voriconazole showed the strongest in vitro activity against Trichosporon spp. Most of the strains (63%) were considered medium or high biofilm producers. Conclusions: Older age, mechanical ventilation and persistent neutropenia were associated with poor prognosis. CVC may play a role in the pathogenicity of TF and its removal was associated with a better prognosis.
- 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.
conferenceObject Epidemiological and clinical characteristics of presumed ocular tuberculosis: a 12-year experience in a tertiary center in Brazil(2014) CONTIN, Inara; RAMOS, Jessica F.; LEITE, Olavo H.; HIRATA, Carlos E.; YAMAMOTO, Joyce H.- High mortality of bloodstream infection outbreak caused by carbapenem-resistant P. aeruginosa producing SPM-1 in a bone marrow transplant unit(2017) CHAVES, Lucas; TOMICH, Lisia Moura; SALOMAO, Matias; LEITE, Gleice Cristina; RAMOS, Jessica; MARTINS, Roberta Ruedas; RIZEK, Camila; NEVES, Patricia; BATISTA, Marjorie Vieira; AMIGO, Ulysses; GUIMARAES, Thais; LEVIN, Anna Sara; COSTA, Silvia FigueiredoPurpose. Carbapenem resistance in P. aeruginosa is increasing worldwide. In Brazil, SPM-1 is the main P. aeruginosa carbapenemase identified. Little is known about the virulence factor in SPM-1 clones. Methodolgy. We describe a carbapenem-resistant P. aeruginosa bloodstream infection (CRPa-BSI) outbreak in a bone marrow transplant Unit (BMT). Twenty-nine CRPa-BSI cases were compared to 58 controls. Microbiological characteristics of isolates, such as sensitivity, carbapenemase gene PCR for P. aeruginosa, and PFGE are described, as well as the whole-genome sequence (WGS) of three strains. Results/Key findings. The cultures from environmental and healthcare workers were negative. Some isolates harboured KPC and SPM. The WGS showed that the 03 strains belonged to ST277, presented the same mutations in outer membrane protein, efflux pump, and virulence genes such as those involved in adhesion, biofilm, quorum-sensing and the type III secretion system, but differ regarding the carbapenemase profile. A predominant clone-producing SPM harbouring Tn 4371 was identified and showed cross-transmission; no common source was found. Overall mortality rate among cases was 79 %. The first multivariate analysis model showed that neutropenia (P=0.018), GVHD prophylaxis (P=0.016) and prior use of carbapenems (P=0.0089) were associated with CRPa-BSI. However, when MASCC >= 21 points and platelets were added in the final multivariate analysis, only prior use of carbapenems remained as an independent risk factor for CRPa-BSI (P=0.043). Conclusions. The predominant clone belonging to ST277 showed high mortality. Carbapenem use was the only risk factor associated with CRPa-BSI. This finding is a wake-up call for the need to improve management in BMT units.
- Low Rates of Vancomycin Use in Febrile Neutropenia: A Multicenter Study(2019) PEREIRA, Andre Domingues; RAMOS, Jessica Fernandes; GUARANA, Mariana; NOUER, Simone A.; NUCCI, Marcio; ARRAIS-RODRIGUES, Celso
- 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.
bookPart Tuberculose óssea e articular(2013) LEITE, Olavo Henrique Munhoz; ATOMIYA, Angela Naomi; RAMOS, Jéssica Fernandes; HIGASHINO, Hermes Ryoiti