JOSE OTTO REUSING JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Carbapenem-resistant Enterobacteriaceae among kidney transplant recipients - insights on the risk of acquisition and CRE infection(2021) FREIRE, Maristela P.; CARVALHO, Laina B.; REUSING JR., Jose Otto; SPADAO, Fernanda; LOPES, Max Igor B. F.; NAHAS, William C.; DAVID-NETO, Elias; PIERROTTI, Ligia C.Background Kidney transplant recipients are a risk group for carbapenem-resistant Enterobacteriaceae infection. Objectives This study aimed to identify risk factors for CRE acquisition and infection among kidney transplant recipients. Methods We conducted a case-control study; we defined the case as kidney transplant recipient with positive culture for carbapenem-resistant Enterobacteriaceae identified between January 2010 and February 2019. Controls were chosen among kidney transplant recipients hospitalized in the same period of cases (1:2). Surveillance culture for carbapenem-resistant Enterobacteriaceae was performed at admission and weekly during hospital stay. The risk factors analysis for carbapenem-resistant Enterobacteriaceae infection was performed among patients colonized by these bacteria. Results We identified 331 patients colonized with carbapenem-resistant Enterobacteriaceae; The median time from transplantation to first carbapenem-resistant Enterobacteriaceae positive culture was 42 days (range from 3 to 7399 days); 125(37.8%) patients developed infection; the most common site was urinary tract. Risk factors for carbapenem-resistant Enterobacteriaceae acquisition were recipient age >45-year, diabetes nephropathy, donor age >55-year, ureteral stent at kidney transplantation, delay of graft function, median lymphocytes count <800cells/mm(3), and acute cellular rejection. Risk factors for carbapenem-resistant Enterobacteriaceae infection were recipient age at CRE acquisition >50-year; median lymphocytes count <= 700 cells/mm(3), carbapenem use, and colonization by polymyxin-resistant strain. Patients colonized by polymyxin and carbapenem resistant Enterobacteriaceae strain who used carbapenem had a 93.8% probability of developing infection by this agent. Conclusion Carbapenem-resistant Enterobacteriaceae acquisition after kidney transplant is related to graft conditions, immunosuppression degree. Among carbapenem-resistant Enterobacteriaceae colonized patients, special attention is needed for those harbouring polymyxin-resistant strains.
- Chikungunya in kidney transplant recipients: A series of cases(2017) PIERROTTI, Ligia Camera; LOPES, Max Igor Banks Ferreira; NASCIMENTO, Ana Patricia do; CAIAFFA-FILHO, Helio; LEMOS, Francine Brambate Carvalhinho; REUSING JR., Jose Otto; SEJAS, Odeli Nicole Encinas; DAVID-NETO, Elias; AZEVEDO, Luiz SergioChikungunya (CHIK) is a mosquito-borne virus (CHIKV) infection that recently appeared in the Americas and thousands of confirmed cases have been reported in Brazil since the first autochthonous cases were reported in September 2014. We reported four cases of CHIK in kidney transplant recipients. The diagnosis was confirmed by positive CHIKV real-time polymerase chain reaction in two cases and positive CHIKV-IgM serology in two patients. The time between transplantation and CHIKV infection ranged from 2 to 11 years. All of them had arthralgia, and 3 of them had fever. Other symptoms were mild conjunctivitis, rash, and retro-orbital pain. Kidney function remained stable in all cases. In three patients prednisone doses were temporally increased and the symptoms disappeared concurrently with the increase of the dose. As for the fourth patient, the prednisone dose remained unchanged and yet she improved. Other immunosuppressive drugs were not changed for the four cases. As far as we know, there are only two previously reported cases of CHIK among solid organ transplant recipients besides the four cases reported here. Despite the small number of cases, we can speculate that the use of immunosuppression might have played a role in the paucity of symptoms and the gradual complete recovery with no complication. (C) 2017 The Authors.
- Cytomegalovirus prophylaxis in seropositive renal transplant recipients receiving thymoglobulin induction therapy: Outcome and risk factors for late CMV disease(2018) JR, Jose O. Reusing; FEITOSA, Emanoela B.; AGENA, Fabiana; PIERROTTI, Ligia C.; AZEVEDO, Luiz S. F.; KOTTON, Camille N.; DAVID-NETO, EliasBackgroundAnti-thymocyte globulin (ATG) therapy is a risk factor for cytomegalovirus (CMV) disease in renal transplant (RTx) recipients and therefore antiviral prophylaxis is commonly used. We evaluated the outcome of our current policy of 90days of CMV prophylaxis in seropositive recipients given ATG and the risk factors for the occurrence of CMV disease after prophylaxis. MethodsWe studied a retrospective cohort of 423 RTx (2010-2014) CMV-seropositive adults given ATG induction therapy. Results54 (13%) patients developed CMV disease at a median of 163days after transplant, of which 29 (54%) had viral syndrome and 25 (46%) had invasive disease. Median prophylaxis time (94days) and immunosuppressive drugs were similar between groups (CMV vs no-CMV). Those with CMV disease had more deceased donors and higher donor age, lower lymphocyte count, and lower median eGFR at day 90. Multivariable logistic regression analysis at day 90 and 180 found that eGFR 40ml/min/1.73m(2) (but not acute rejection) was associated with late CMV disease. In a separate validation cohort of 124 patients with 8% late CMV disease, eGFR 45 and lymphocyte count 800cells/mm(3) at the end of prophylaxis remained predictive of late CMV disease occurrence. ConclusionsThese data indicate that antiviral prophylaxis adequately prevented CMV in seropositive recipients given ATG, but late disease still occurred. Low eGFR and low lymphocyte count at the end of prophylaxis may help identify patients at higher risk of CMV disease.
- Critical points and potential pitfalls of outbreak of IMP-1-producing carbapenem-resistant Pseudomonas aeruginosa among kidney transplant recipients: a case-control study(2021) FREIRE, M. P.; CAMARGO, C. H.; YAMADA, A. Y.; NAGAMORI, F. O.; JUNIOR, J. O. Reusing; SPADAO, F.; CURY, A. P.; ROSSI, F.; NAHAS, W. C.; DAVID-NETO, E.; PIERROTTI, L. C.Background: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection after kidney transplantation (KT) is associated with high mortality. Aim: To analyse an outbreak of infection/colonization with IMP-1-producing CRPA on a KT ward. Methods: A case-control study was conducted. Cases were identified through routine surveillance culture and real-time polymerase chain reaction for carbapenemase performed directly from rectal swab samples. Controls were randomly selected from patients hospitalized on the same ward during the same period, at a ratio of 3:1. Strain clonality was analysed through pulsed-field gel electrophoresis (PFGE), and whole-genome sequencing was performed for additional strain characterization. Findings: CRPA was identified in 37 patients, in 51.4% through surveillance cultures and in 49.6% through clinical cultures. The median persistence of culture positivity was 42.5 days. Thirteen patients (35.1%) presented a total of 15 infections, of which seven (46.7%) were in the urinary tract; among those, 30-day mortality rate was 46.2%. PFGE analysis showed that all of the strains shared the same pulsotype. Multilocus sequence typing analysis identified the sequence type as ST446. Risk factors for CRPA acquisition were hospital stay >10 days, retransplantation, urological surgical reintervention after KT, use of carbapenem or ciprofloxacin in the last three months and low median lymphocyte count in the last three months.
conferenceObject Fast Decrease of Humoral Response Against SARS-CoV-2 in A Kidney Transplant Cohort(2022) COSTA, Gisela Serra Rodrigues; MIRANDA, Lara Judith Cabral; BRINGEL, Eric Arcanjo; OTTO, Jose Junior; CENEVIVA, Carina; CORA, Aline Pivetta; SILVA, Luciane Carvalho Sarahyba; DIAS, Claudia Maria Meira; UDILOFF, Patricia Alves Santos; DAVID-NETO, Elias; PIERROTTI, Ligia Camera- COVID-19 among kidney-transplant recipients requiring hospitalization: preliminary data and outcomes from a single-center in Brazil(2020) PIERROTTI, Ligia Camera; REUSING JUNIOR, Jose Otto; FREIRE, Maristela Pinheiro; MACHADO, David J. Barros; MOREIRA, Raquel Megale; VENTURA, Carlucci G.; LITVOC, Marcelo Nobrega; NAHAS, William C.; DAVID-NETO, Elias
- A Brazilian university hospital position regarding transplantation criteria for HIV-positive patients according to the current literature(2019) PIERROTTI, Lígia Camera; LITVINOV, Nadia; COSTA, Silvia Figueiredo; AZEVEDO, Luiz Sérgio Fonseca de; STRABELLI, Tânia Mara Varejão; CAMPOS, Silvia Vidal; ODONGO, Fatuma Catherine Atieno; REUSING-JUNIOR, Jose Otto; SONG, Alice Tung Wan; LOPES, Max Igor Banks Ferreira; BATISTA, Marjorie Vieira; LOPES, Marta Heloisa; MALUF, Natalya Zaidan; CAIAFFA-FILHO, Hélio Helh; DE OLIVEIRA, Maura Salarolli; SOUSA MARQUES, Heloisa Helena de; ABDALA, EdsonHuman immunodeficiency virus (HIV) infection was considered a contraindication for solid organ transplantation (SOT) in the past. However, HIV management has improved since highly active antiretroviral therapy (HAART) became available in 1996, and the long-term survival of patients living with HIV has led many transplant programs to reevaluate their policies regarding the exclusion of patients with HIV infection. Based on the available data in the medical literature and the cumulative experience of transplantation in HIV-positive patients at our hospital, the aim of the present article is to outline the criteria for transplantation in HIV-positive patients as recommended by the Immunocompromised Host Committee of the Hospital das Clínicas of the University of São Paulo.
- Renal transplantation in human immunodeficiency virus-infected recipients: a case-control study from the Brazilian experience(2016) VICARI, A. R.; SPULDARO, F.; SANDES-FREITAS, T. V.; CRISTELLI, M. P.; REQUIAO-MOURA, L. R.; REUSING, J. O.; PIERROTTI, L. C.; OLIVEIRA, M. L.; GIRAO, C. M.; GADONSKI, G.; KROTH, L. V.; DEBONI, L. M.; FERREIRA, G. F.; TEDESCO-SILVA, H.; ESMERALDO, R.; DAVID-NETO, E.; SAITOVITCH, D.; KEITEL, E.; GARCIA, V. D.; PACHECO-SILVA, A.; MEDINA-PESTANA, J. O.; MANFRO, R. C.BackgroundHighly active antiretroviral therapy has turned human immunodeficiency virus (HIV)-infected patients with end-stage renal disease into suitable candidates for renal transplantation. We present the Brazilian experience with kidney transplantation in HIV-infected recipients observed in a multicenter study. MethodsHIV-infected kidney transplant recipients and matched controls were evaluated for the incidence of delayed graft function (DGF), acute rejection (AR), infections, graft function, and survival of patients and renal grafts. ResultsFifty-three HIV-infected recipients and 106 controls were enrolled. Baseline characteristics were similar, but a higher frequency of pre-transplant positivity for hepatitis C virus and cytomegalovirus infections was found in the HIV group. Immunosuppressive regimens did not differ, but a trend was observed toward lower use of anti-thymocyte globulin in the group of HIV-infected recipients (P = 0.079). The HIV-positive recipient group presented a higher incidence of treated AR (P = 0.036) and DGF (P = 0.044). Chronic Kidney Disease Epidemiology Collaboration estimated that glomerular filtration rate was similar at 6 months (P = 0.374) and at 12 months (P = 0.957). The median number of infections per patient was higher in the HIV-infected group (P = 0.018). The 1-year patient survival (P < 0.001) and graft survival (P = 0.004) were lower, but acceptable, in the group of HIV-infected patients. ConclusionsIn the Brazilian experience, despite somewhat inferior outcomes, kidney transplantation is an adequate therapy for selected HIV-infected recipients.
conferenceObject Omicron COVID-19 in Kidney Transplant Recipients(2022) COSTA, Gisela Serra Rodrigues; REUSING, Jose Otto; FREIRE, Maristela Pinheiro; MOREIRA, Raquel Megale; LITVOC, Marcelo Nobrega; VENTURA, Carlucci; MACHADO, David; DAVID-NETO, Elias; PIERROTTI, Ligia CameraconferenceObject Prediction Model With Quantiferon-CMV for Clinically Significant Cytomegalovirus Event in Seropositive Kidney Transplant Recipients(2022) REUSING JUNIOR, Jose Otto; AGENA, Fabiana; CAMPANA, Gustavo A.; PIERROTTI, Ligia C.; DAVID-NETO, Elias