VIVIANE MAZO FAVERO GIMENES
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
14 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 14
- 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
- Antifungal susceptibility profile of Candida clinical isolates from 22 hospitals of Sao Paulo State, Brazil(2021) RODRIGUES, D. K. B.; BONFIETTI, L. X.; GARCIA, R. A.; ARAUJO, M. R.; RODRIGUES, J. S.; GIMENES, V. M. F.; MELHEM, M. S. C.This study aimed to evaluate the frequency of cryptic Candida species from candidemia cases in 22 public hospitals in Sao Paulo State, Brazil, and their antifungal susceptibility profiles. During 2017 and 2018, 144 isolates were molecularly identified as 14 species; C. parapsilosis (32.6%), C. albicans (27.7%), C. tropicalis (14.6%), C. glabrata (9.7%), C. krusei (2.8%), C. orthopsilosis (2.8%), C. haemulonii var. vulnera (2.1%), C. haemulonii (1.4%), C. metapsilosis (1.4%), C. dubliniensis (1.4%), C. guilliermondii (1.4%), C. duobushaemulonii (0.7%), C. kefyr (0.7%), and C. pelliculosa (0.7%). Poor susceptibility to fluconazole was identified in 6.4% of C. parapsilosis isolates (0.12 to >64 mu g/mL), 50% of C. guilliermondii (64 mu g/mL), 66.6% of C. haemulonii var. vulnera (16-32 mu g/mL), and C. duobushaemulonii strain (MIC 64 mu g/mL). Our results corroborated the emergence of C. glabrata in Brazilian cases of candidemia as previously reported. Importantly, we observed a large proportion of non-wild type C. glabrata isolates to voriconazole (28.6%; <0.015 to 4 mu g/mL) all of which were also resistant to fluconazole (28.6%). Of note, C. haemulonii, a multidrug resistant species, has emerged in the Southeast region of Brazil. Our findings suggested a possible epidemiologic change in the region with an increase in fluconazole-resistant species causing candidemia. We stress the relevance of routine accurate identification to properly manage therapy and monitor epidemiologic trends.
- Aspects related to biofilm production and antifungal susceptibility of clinically relevant yeasts of the genus Trichosporon(2023) LARA, Bruna Rossini; CAMARGO, Bruno Braidotti de; PAULA, Claudete Rodrigues; MONARI, Gabrielle Pires de Morais; GARCES, Hans Garcia; ARNONI, Mariana Volpe; SILVEIRA, Monica; GIMENES, Viviane Mazo Favero; LEITE JUNIOR, Diniz Pereira; BONFIETTI, Lucas Xavier; OLIVEIRA, Lidiane; MELHEM, Marcia de Souza Carvalho; AULER, Marcos; RAMOS, Regina Teixeira Barbieri; DIAS, Amanda Latercia Tranches; SILVA, Naiara Chaves; MOREIRA, Debora; RICHINI-PEREIRA, Virginia Bodelao; ANVERSA, Lais; RUIZ, Luciana da SilvaLay Summary This study investigated 59 isolates of the medically important yeast Trichosporon in relation to their ability to form biofilms and the susceptibility of biofilms to antifungal agents. All isolates were able to produce biofilms and biofilms showed lower antifungal susceptibility. Trichosporonosis corresponds to a systemic fungal disease that leads to high mortality rates and is frequently associated with medical devices. It affects immunosuppressed patients in particular and is strongly linked to acquired human immunodeficiency, organ and tissue transplants, and malignant hematologic diseases such as leukemia and lymphomas. Trichosporon infections have been increasingly reported worldwide; however, little information is available either about their characteristics or the causative microorganism. Thus, the aims of the present study were: to investigate 59 yeasts of the genus Trichosporon by verifying the biofilm formation capacity of isolates; to analyze the susceptibility patterns of planktonic cells against the antifungals fluconazole, itraconazole, amphotericin-B, voriconazole, and caspofungin by comparing European Committee for Antimicrobial Susceptibility Testing (EUCAST) broth microdilution technique with the commercial method Etest; and to assess the susceptibility patterns of biofilm cells (sessile) against the same antifungals through broth microdilution. The ability to form biofilm on the surface of polystyrene plates was noted for all isolates, and 54.3% of samples were considered strong producers. Comparison between the antifungal susceptibility techniques evidenced that Etest showed higher and discordant minimum inhibitory concentrations (MICs) from those obtained by the microdilution method, especially for fluconazole, itraconazole, and caspofungin. Considering the susceptibility of biofilms, most species had high MIC50 and MIC90 against the tested antifungals, showing 4-to-66-fold higher concentrations for amphotericin B and 2-to-33-fold greater concentrations for caspofungin. These results highlight the importance of further studies with Trichosporon spp. for comparison between laboratory findings and in vivo response, considering both the susceptibility tests and the behavior of biofilm cells against drugs.
- Comparing the phenotypic, genotypic, and proteomic identification of Trichosporon species: A globally emerging yeast of medical importance(2021) LARA, Bruna Rossini; CAMARGO, Bruno Braidotti de; PAULA, Claudete Rodrigues; LEITE JUNIOR, Diniz Pereira; GARCES, Hans Garcia; ARNONI, Mariana Volpe; SILVEIRA, Monica; GIMENES, Viviane Mazo Favero; SIQUEIRA, Lumena Pereira Machado; TAKAHASHI, Juliana Possatto Fernandes; MELHEM, Marcia de Souza Carvalho; RICHINI-PEREIRA, Virginia Bodelao; ANVERSA, Lais; RUIZ, Luciana da SilvaTrichosporon spp. are widely distributed in the nature, comprising species that inhabit different ecological niches and can be found in the water, soil, and body surface of animals and humans. Such microorganisms have been classically associated with superficial infections; however, in the last decades, they have also been related to disseminated infections in immunocompromised patients, behaving as opportunistic agents, which demands rapid and accurate species identification for efficient therapy. Concordance level between the traditional phenotypic method and the molecular technique (gold standard) in the identification of all 59 Trichosporon samples was 59.3%. Identification concordance between MALDI-TOF spectrometry and the molecular technique was 71.2%. No isolate of environmental origin was identifiable by MALDI-TOF mass spectrometry (MS), and 100% of such environmental isolates were discordant for IGS region sequencing and phenotypic characterization. Both comparisons evidenced greatest concordance in the identification of T. asahii. The species T. debeurmannianum, T. dermatis, T. venhuisii and T. insectorum were not properly identified by both MALDI-TOF MS and the phenotypic technique. MALDI-TOF MS, in particular, seems to be appropriate to investigate yeasts of the genus Trichosporon; however, database updates are still necessary, especially for species that are not common in the clinical routine. With the aim of helping understand the aspects involved in early and accurate diagnosis of infections caused by this opportunistic agent, the present study compared the phenotypic, molecular (IGS region) and mass-spectrometry (MALDI-TOF) identification of 59 yeasts of the genus Trichosporon which had clinical and environmental origin and were kept in a mycology collection.
- First report of tinea corporis caused by Arthroderma benhamiae in Brazil(2019) FREITAS, Roseli Santos de; FREITAS, Thais Helena Proenca de; SIQUEIRA, Lumena Pereira Machado; GIMENES, Viviane Mazo Favero; RENARD, GilArthroderma benhamiae is a zoophilic dermathophyte that can cause highly inflammatory tinea corporis and tinea capitis in humans. This is the first report of a patient with dermatophytosis caused by A. benhamiae in Brazil. The lesion was an erythematous, annular plaque on the lumbar region that appeared few weeks after playing with a street cat in a 19-month-old girl. Initial presumed diagnosis was tinea corporis caused by Microsporum canis. Topical treatments were ineffective and the patient required systemic treatment with griseofulvin. Mycological diagnosis was inconclusive: morphological differentiation between M. canis and Trichophyton benhamiae may be difficult, especially when the latter present yellow colonies. The etiological agent was identified only by ITS sequencing of the isolates aligned with reference strains to A. benhamiae. This report highlights the importance of ITS sequencing in the identification of isolates from some cases of dermatophytosis, because conventional morphological diagnosis may result in misdiagnosis of the agent and delay proper treatment.
- Whole-genome sequencing of Candida haemulonii species complex from Brazil and the United States: Genetic diversity and antifungal susceptibility(2023) RODRIGUES, Dality Keffelen de Barros; LOCKHART, Shawn R.; BERKOW, Elizabeth L.; GADE, Lalitha; BONFIETTI, Lucas Xavier; GIMENES, Viviane Mazo Favero; RUIZ, Luciana Silva; MACIONI, Milena Bronze; MELHEM, Marcia de Souza CarvalhoLay Summary Candida haemulonii complex species is worldwide distributed, and this study aimed to evaluate the resistance to antifungal drugs in cases from Brazil and the United States, and also compare their genetic relationships. A total of 50 strains were studied; most of them from Brazil were from cases of bloodstream infections, while the strains from the United States came from cases of wounds and may be associated with diabetic patients. The vast majority of strains were resistant to amphotericin B, one of the most effective drugs, and susceptible to fluconazole. In addition, 50% of C. pseudohaemulonii strains were resistant to echinocandins. The strains from Brazil and the United States had no genetic relationship and formed two distinct groups. In three Brazilian hospitals, strains were clonal, indicating an intra-hospital transmission. Our findings contribute to guiding therapy in bloodstream fungal infections caused by C. haemulonii species and alerting for nosocomial transmission of this yeast complex species. Candida haemulonii complex species can be multidrug-resistant and cause infections such as candidemia. This study determined the genetic relationship between isolates from Brazil and the United States through whole-genome sequencing and performed antifungal susceptibility testing to investigate drug resistance. Contrary to what is widely described, most isolates were susceptible to azoles. However, an atypical susceptibility profile was found in 50% of Candida pseudohaemulonii strains, including resistance to the three echinocandins. Isolates from both countries formed distinct clusters with wide genetic diversity. Isolates from three hospitals in Brazil were clonal and involved in candidemia cases, pointing to the importance of improving hospital infection control measures and molecular identification.
- A neglected disease. Human sporotrichosis in a densely populated urban area in Sao Paulo, Brazil: clinical-epidemiological and therapeutic aspects(2022) BITTENCOURT, Amanda Azevedo; OYAFUSO, Luiza Keiko Matsuka; CAVALIN, Roberta Figueiredo; PALHARES, Renata Bacic; BENARD, Gil; GIMENES, Viviane Mazo Favero; NEGRO, Gilda Maria Barbaro Del; SIQUEIRA, Lumena Pereira Machado; XAVIER, Roseli Santos de Freitas; LOPES-BEZERRA, Leila M.; BUCCHERI, Renata; LINDOSO, Jose Angelo LaulettaHuman sporotrichosis is caused by different Sporothrix species; however, Sporothrix brasiliensis is the main species, usually related to cat transmission in urban areas. A retrospective descriptive study was conducted at the Institute of Infectology Emilio Ribas from 2010 to 2018. Demography, clinical, diagnostic, and therapeutic data were obtained from medical records. Polymerase chain reaction of the calmodulin gene was performed to identify Sporothrix species. In addition, to evaluate the spread of the disease across Sao Paulo metropolitan region, TerraView version 4.2.2 software was used for geocoding cases according to residence addresses. Kernell's maps using QGIS software version 2.16.3 were constructed to determine the concentration of cases. Results: 260 cases of sporotrichosis were diagnosed between 2010 and 2018. We observed a 700% increment in the number of human cases in the 2016-2018 triennium compared with the 2013-2015 triennium. Female adults with a median age of 46 years old were the predominant infected group associated with cats' exposition at home care, although the age range of all patients was 01 to 86 years old. The main epidemiological risk of acquiring sporotrichosis was contact with cats, reported by 96.5% of the patients. Molecular identification showed that most of the tested isolates were Sporothrix brasiliensis. Lymphocutaneous form was observed in 59.2% and fixed cutaneous form in 37.5% of the patients. Regarding treatment, itraconazole was the main drug used (94.2%) with a cure rate of 98.8%. We observed an important spread of human sporotrichosis involving cat transmission caused by Sporothrix brasiliensis in a densely populated area of Sao Paulo state. These results are important to alert clinicians and dermatologists about the occurrence and progression of a neglected tropical disease in an urban area and the urgent necessity to include sporotrichosis as a differential diagnosis in the clinical investigation routine.
- Evaluating VITEK MS for the identification of clinically relevant Aspergillus species(2020) AMERICO, Fernanda M.; SIQUEIRA, Lumena P. Machado; NEGRO, Gilda Maria B. Del; GIMENES, Viviane M. Favero; TRINDADE, Mario Roberto S.; MOTTA, Adriana L.; FREITAS, Roseli Santos de; ROSSI, Flavia; COLOMBO, Arnaldo L.; BENARD, Gil; ALMEIDA JUNIOR, Joao N. deAspergillus spp. identification has become more relevant in clinical practice since azole-resistant cryptic species have been related to invasive fungal infections. Conventional morphologic identification is not able to discriminate Aspergillus species, and DNA sequencing is not feasible for clinical laboratories. MALDI-TOF mass spectrometry is an emergent technology that has been explored to provide fast and accurate identification of microorganisms, including clinically relevant moulds. However, only a few studies have explored the platform VITEK MS for the identification of Aspergillus species. Hence, we provided additional data regarding the performance of the VITEK MS system for the identification of Aspergillus species, including azole-resistant ones. We also improved the RUO system by adding additional spectral profiles from well-identified Aspergillus strains belonging to different noncryptic and cryptic species. The IVD library correctly identified 91.6% of the organisms at genus and section level, and 84.7% at species level, including the azole-resistant Aspergillus lentulus and Aspergillus calidoustus. The organisms belonging to Aspergillus cryptic species had only 31.2% of correct species identification. The RUO library plus our in-house SuperSpectra correctly identified 100% of the organisms at genus and section level and 91.6% at species level. Among organisms belonging to Aspergillus cryptic species, 68.7% had correct species identification. Some closely related Aspergillus cryptic species showed similar spectral profiles and were difficult to be differentiated.
- 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.
- 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.