MARISTELA PINHEIRO FREIRE

(Fonte: Lattes)
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21
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Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina

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Revista / Livro: American Journal of Transplantation ×

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  • article 6 Citação(ões) na Scopus
    Efficacy of ceftazidime-avibactam in solid organ transplant recipients with bloodstream infections caused by carbapenemase-producing Klebsiella pneumoniae
    (2023) PEREZ-NADALES, Elena; FERNANDEZ-RUIZ, Mario; NATERA, Alejandra M.; GUTIERREZ-GUTIERREZ, Belen; MULARONI, Alessandra; RUSSELLI, Giovanna; PIERROTTI, Ligia Camera; FREIRE, Maristela Pinheiro; FALCONE, Marco; TISEO, Giusy; TUMBARELLO, Mario; RAFFAELLI, Francesca; ABDALA, Edson; BODRO, Marta; GERVASI, Elena; FARINAS, Maria Carmen; SEMINARI, Elena M.; CASTON, Juan Jose; MARIN-SANZ, Juan Antonio; GALVEZ-SOTO, Victor; RANA, Meenakshi M.; LOECHES, Belen; MARTIN-DAVILA, Pilar; PASCUAL, Alvaro; RODRIGUEZ-BANO, Jesus; AGUADO, Jose Maria; MARTINEZ-MARTINEZ, Luis; TORRE-CISNEROS, Julian; REIPI INCREMENT-SOT Study Grp
    We aimed to compare the efficacy of ceftazidime-avibactam (CAZ-AVI) versus the best available therapy (BAT) in solid organ transplant (SOT) recipients with bloodstream infection caused by carbapenemase-producing Klebsiella pneumoniae (CPKP-BSI). A retrospective (2016-2021) observational cohort study was performed in 14 INCREMENT-SOT centers (ClinicalTrials.gov identifier: NCT02852902; Impact of Specific Antimicrobials and MIC Values on the Outcome of Bloodstream Infections Due to ESBL-or Carbapenemaseproducing Enterobacterales in Solid Organ Transplantation: an Observational Multinational Study). Outcomes were 14-day and 30-day clinical success (complete resolution of attributable manifestations, adequate source control, and negative follow-up blood cultures) and 30-day all-cause mortality. Multivariable logistic and Cox regression analyses adjusted for the propensity score to receive CAZ-AVI were constructed. Among 210 SOT recipients with CPKP-BSI, 149 received active primary therapy with CAZ-AVI (66/149) or BAT (83/ 149). Patients treated with CAZ-AVI had higher 14-day (80.7% vs 60.6%, P =.011) and 30 day (83.1% vs 60.6%, P = .004) clinical success and lower 30-day mortality (13.25% vs 27.3%, P =.053) than those receiving BAT. In the adjusted analysis, CAZ-AVI increased the probability of 14-day (adjusted odds ratio [aOR], 2.65; 95% confidence interval [CI], 1.036.84; P = .044) and 30-day clinical success (aOR, 3.14; 95% CI, 1.17-8.40; P = .023). In contrast, CAZ-AVI therapy was not independently associated with 30-day mortality. In the CAZ-AVI group, combination therapy was not associated with better outcomes. In conclusion, CAZ-AVI may be considered a first-line treatment in SOT recipients with CPKP-BSI.
  • article 21 Citação(ões) na Scopus
    Predictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales: The impact of cytomegalovirus disease and lymphopenia
    (2020) PEREZ-NADALES, Elena; GUTIERREZ-GUTIERREZ, Belen; NATERA, Alejandra M.; ABDALA, Edson; MAGALHAES, Maira Reina; MULARONI, Alessandra; MONACO, Francesco; PIERROTTI, Ligia Camera; FREIRE, Maristela Pinheiro; IYER, Ranganathan N.; STEINKE, Seema Mehta; CALVI, Elisa Grazia; TUMBARELLO, Mario; FALCONE, Marco; FERNANDEZ-RUIZ, Mario; COSTA-MATEO, Jose Maria; RANA, Meenakshi M.; STRABELLI, Tania Mara Varejao; PAUL, Mical; FARINAS, Maria Carmen; CLEMENTE, Wanessa Trindade; ROILIDES, Emmanuel; MUNOZ, Patricia; DEWISPELAERE, Laurent; LOECHES, Belen; LOWMAN, Warren; TAN, Ban Hock; ESCUDERO-SANCHEZ, Rosa; BODRO, Marta; GROSSI, Paolo Antonio; SOLDANI, Fabio; GUNSEREN, Filiz; NESTOROVA, Nina; PASCUAL, Alvaro; MARTINEZ-MARTINEZ, Luis; AGUADO, Jose Maria; RODRIGUEZ-BANO, Jesus; TORRE-CISNEROS, Julian; SONG, A. T. Wan; ANDRAUS, W.; D'ALBUQUERQUE, L. A. Carneiro; DAVID-NETO, E.; PAULA, F. Jota de; ROSSI, F.; OSTRANDER, D.; AVERY, R.; RIZZI, M.; LOSITO, A. R.; RAFFAELLI, F.; GIACOMO, P. Del; TISEO, G.; LORA-TAMAYO, J.; SAN-JUAN, R.; GRACIA-AHUFINGER, I; CASTON, J.; RUIZ, Y. A.; ALTMAN, D. R.; V, S. Campos; BAR-SINAI, N.; KOPPEL, F.; ALMAJANO, F. Arnaiz de las Revillas; RICO, C. Gonzalez; MARTINEZ, M. Fernandez; MOURAO, P. H. O.; NEVES, F. A.; FERREIRA, J.; PYRPASOPOULOU, A.; IOSIFIDIS, E.; ROMIOPOULOS, I; V, M. Minero; SANCHEZ-CARRILLO, C.; LARDO, S.; COUSSEMENT, J.; DODEMONT, M.; JIAYUN, K.; MARTIN-DAVILA, P.; FORTUN, J.; ALMELA, M.; MORENO, A.; LINARES, L.; GASPERINA, D. D.; BALSAMO, M. L.; ROVELLI, C.; CONCIA, E.; CHIESI, S.; SALERNO, D. N.; OGUNC, D.; PILMIS, B.; SEMINARI, E. M.; CARRATALA, J.; DOMINGUEZ, A.; CORDERO, E.; LEPE, J. A.; MONTEJO, M.; LUCAS, E. Merino de; ERIKSSON, B. M.; DELDEN, C. van; MANUEL, O.; ARSLAN, H.; TUFAN, Z. Kocak; KAZAK, E.; DAVID, M.; LEASE, E.; CORNAGLIA, G.; AKOVA, M.
    Treatment of carbapenemase-producing Enterobacterales bloodstream infections in solid organ transplant recipients is challenging. The objective of this study was to develop a specific score to predict mortality in solid organ transplant recipients with carbapenemase-producing Enterobacterales bloodstream infections. A multinational, retrospective (2004-2016) cohort study (INCREMENT-SOT, ClinicalTrials.gov NCT02852902) was performed. The main outcome variable was 30-day all-cause mortality. The INCREMENT-SOT-CPE score was developed using logistic regression. The global cohort included 216 patients. The final logistic regression model included the following variables: INCREMENT-CPE mortality score >= 8 (8 points), no source control (3 points), inappropriate empirical therapy (2 points), cytomegalovirus disease (7 points), lymphopenia (4 points), and the interaction between INCREMENT-CPE score >= 8 and CMV disease (minus 7 points). This score showed an area under the receiver operating characteristic curve of 0.82 (95% confidence interval [CI] 0.76-0.88) and classified patients into 3 strata: 0-7 (low mortality), 8-11 (high mortality), and 12-17 (very-high mortality). We performed a stratified analysis of the effect of monotherapy vs combination therapy among 165 patients who received appropriate therapy. Monotherapy was associated with higher mortality only in the very-high (adjusted hazard ratio [HR] 2.82, 95% CI 1.13-7.06, P = .03) and high (HR 9.93, 95% CI 2.08-47.40, P = .004) mortality risk strata. A score-based algorithm is provided for therapy guidance.
  • conferenceObject
    Prior Infection or Colonization with Carbapenem-Resistant Enterobacteriaceae Is Not an Absolute Contraindication for Solid Organ Transplantation
    (2016) HUPRIKAR, S.; CASNER, L.; POUCH, S.; FREIRE, M. Pinheiro; MADAN, R.; KWAK, E.; SATLIN, M.; HARTMAN, P.; PISNEY, L.; MOURAO, P. Henrique; HOZ, R. La; PATEL, G.