ANA RUBIA GUEDES VINHOLE
Projetos de Pesquisa
Unidades Organizacionais
PAHC, Hospital das Clínicas, Faculdade de Medicina
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- Understanding Sabia virus infections (Brazilian mammarenavirus)(2022) NASTRI, Ana Catharina; DUARTE-NETO, Amaro Nunes; CASADIO, Luciana Vilas Boas; SOUZA, William Marciel de; CLARO, Ingra M.; MANULI, Erika R.; SELEGATTO, Gloria; SALOMA, Matias C.; FIALKOVITZ, Gabriel; TABORDA, Mariane; ALMEIDA, Bianca Leal de; MAGRI, Marcello C.; GUEDES, Ana Rubia; NETO, Laura Vieira Perdigao; SATAKI, Fatima Mitie; GUIMARAES, Thais; MENDES-CORREA, Maria Cassia; TOZETTO-MENDOZA, Tania R.; FUMAGALLI, Marcilio Jorge; HO, Yeh-Li; SILVA, Camila ALves Maia da; COLETTI, Thais M.; JESUS, Jacqueline Goes de; ROMANO, Camila M.; HILL, Sarah C.; PYBUS, Oliver; PINHO, Joao Renato Rebello; LEDESMA, Felipe Lourenco; CASAL, Yuri R.; KANAMURA, Cristina; ARAUJO, Leonardo Jose Tadeu de; FERREIRA, Camila Santos da Silva; GUERRA, Juliana Mariotti; FIGUEIREDO, Luiz Tadeu Moraes; DOLHNIKOFF, Marisa; FARIA, Nuno R.; SABINO, Ester C.; AVANCINI, Venacio; ALVES, Ferreira; LEVIN, Anna S.Background: Only two naturally occurring human Sabi ' a virus (SABV) infections have been reported, and those occurred over 20 years ago. Methods: We diagnosed two new cases of SABV infection using metagenomics in patients thought to have severe yellow fever and described new features of histopathological findings. Results: We characterized clinical manifestations, histopathology and analyzed possible nosocomial transmission. Patients presented with hepatitis, bleeding, neurological alterations and died. We traced twenty-nine hospital contacts and evaluated them clinically and by RT-PCR and neutralizing antibodies. Autopsies uncovered unique features on electron microscopy, such as hepatocyte ""pinewood knot"" lesions. Although previous reports with similar New-World arenavirus had nosocomial transmission, our data did not find any case in contact tracing. Conclusions: Although an apparent by rare, Brazilian mammarenavirus infection is an etiology for acute hemorrhagic fever syndrome. The two fatal cases had peculiar histopathological findings not previously described. The virological diagnosis was possible only by contemporary techniques such as metagenomic assays. We found no subsequent infections when we used serological and molecular tests to evaluate close contacts.
bookPart Bacteremias e infecções de cateter venoso central(2022) VINHOLE, Ana Rubia Guedes; MENDES, Elisa Teixeira; GIRãO, Evelyne Santana; OLIVEIRA, Maura Salaroli de; LOBO, Renata Desordi- Impact of COVID-19 on healthcare-associated infections: Antimicrobial consumption does not follow antimicrobial resistance(2023) FREIRE, Maristela Pinheiro; ASSIS, Denise Brandao de; TAVARES, Bruno de Melo; BRITO, Valquiria O. C.; MARINHO, Igor; LAPCHIK, Milton; GUEDES, Ana Rubia; MADALOSSO, Geraldine; OLIVEIRA, Maura Salaroli; LIMA, Antonio Carlos Pedroso de; LEVIN, Anna S.Background: This study aimed to analyze the Healthcare-Associated Infections (HAI) rates and antimicrobial consumption in Intensive Care Units (ICU) in Sao Paulo city during the COVID-19 pandemic and compare them with the pre-pandemic period. Methods: This cohort included all hospitals that reported HAI rates (Central-Line-Associated Bloodstream Infection CLABSI and Ventilator-Associated Pneumonia - VAP), the proportion of microorganisms that caused CLABSI, the proportion of resistant microorganisms, and antimicrobial consumption from January 2017 - December 2020. Hospitals were stratified by the number of beds, Central Venous Catheter (CVC) utilization rate, Mechanical-Ventilation (MV) utilization rate, and type of funding. Statistical analyses were based on time-series plots and regression models. Results: 220 ICUs were included. The authors observed an abrupt increase in CLABSI rates after the pandemic onset. High CLABSI rates during the pandemic were associated with hospital size, funding (public and non-profit private), and low CVC use (<= 50%). An increase in VAP rates was associated with public hospitals, and high MV use (> 35%). The susceptibility profile of microorganisms did not differ from that of the pre-pandemic period. polymyxin, glycopeptides, and antifungal use increased, especially in COVID-19 ICUs. Conclusions: HAI increased during COVID-19. The microorganisms' susceptibility profile did not change with the pandemic, but the authors observed a disproportionate increase in large-spectrum antimicrobial drug use.
- Reinfection rate in a cohort of healthcare workers over 2 years of the COVID-19 pandemic(2023) GUEDES, Ana Rubia; OLIVEIRA, Maura S. S.; TAVARES, Bruno M. M.; LUNA-MUSCHI, Alessandra; LAZARI, Carolina dos Santos; MONTAL, Amanda C. C.; FARIA, Elizabeth de; MAIA, Fernando Liebhart; BARBOZA, Antonio dos Santos; LEME, Mariana Deckers; TOMAZINI, Francis M. M.; COSTA, Silvia Figueiredo; LEVIN, Anna S. S.In this large cohort of healthcare workers, we aimed to estimate the rate of reinfections by SARS-CoV-2 over 2 years of the COVID-19 pandemic. We investigated the proportion of reinfections among all the cases of SARS-CoV-2 infection from March 10, 2020 until March 10, 2022. Reinfection was defined as the appearance of new symptoms that on medical evaluation were suggestive of COVID-19 and confirmed by a positive RT-PCR. Symptoms had to occur more than 90 days after the previous infection. These 2 years were divided into time periods based on the different variants of concern (VOC) in the city of Sao Paulo. There were 37,729 medical consultations due to COVID-19 at the hospital's Health Workers Services; and 25,750 RT-PCR assays were performed, of which 23% (n = 5865) were positive. Reinfection by SARS-CoV-2 was identified in 5% (n = 284) of symptomatic cases. Most cases of reinfection occurred during the Omicron period (n = 251; 88%), representing a significant increase on the SARS-CoV-2 reinfection rate before and during the Omicron variant period (0.8% vs. 4.3%; p < 0.001). The mean interval between SARS-CoV-2 infections was 429 days (ranged from 122 to 674). The Omicron variant spread faster than Gamma and Delta variant. All SARS-CoV-2 reinfections were mild cases.
- Nationwide surveillance system to evaluate hospital-acquired COVID-19 in Brazilian hospitals(2022) COSTA, M. Machado de Miranda; GUEDES, A. R.; NOGUEIRA, M. D. S. P.; OLIVEIRA, L. S. C.; BARROS, L. de Souza; GONCALVES, M. R. S.; CARVALHO, A. A.; MOURA, H. L. C. Amaral de; LEVIN, A. S.; OLIVEIRA, M. S.Background: Although the risk of SARS-CoV-2 transmission within hospitals has been well recognized, there is a paucity of data on its occurrence. Our aim was to report the incidence of hospital-acquired (HA) COVID-19 at Brazilian hospitals. Methods: We investigated the incidence of HA COVID-19 in Brazilian hospitals using data from a national surveillance system, from August 2020 through September 2021. Definitions of HA COVID-19 were: (1) symptom onset >14 days after hospital admission plus a positive SARS-CoV-2 RNA or antigen test; (2) symptom onset on days 8-14 after admission, plus a positive SARS-CoV-2 RNA or antigen test positive, plus documented high-risk exposure. We performed descriptive analyses and reported HA COVID-19 rates using pooled mean and percentile distribution. Results: A total of 48,634 cases of HA COVID-19 were reported from 1428 hospitals. Incidence ranged from 0.16/1000 patient-days at neonatal intensive care units (ICUs) to 5.8/1000 patient-days at adult ICUs. The highest incidence of HA COVID-19 was during the months March to July 2021, similar to that which was observed for community-acquired COVID-19. Conclusions: This report provides a national view of the burden of HA COVID-19. The highest incidence of HA COVID-19 similar that which was observed for community-acquired COVID-19. We believe that this reflects the difficulty of implementing preventive measures. Further studies evaluating risk factors for the hospital transmission of SARS-Cov-2 should clarify strategies to minimize the risk of HA COVID-19 and may be applicable to other respiratory diseases. Furthermore, the implementation of a national system to evaluate HA COVID-19 has the potential to shine a light on this problem and lead to interventions in each hospital.
- Clinical features of COVID-19 by SARS-CoV-2 Gamma variant: A prospective cohort study of vaccinated and unvaccinated healthcare workers(2022) LUNA-MUSCHI, Alessandra; BORGES, Igor C.; FARIA, Elizabeth de; BARBOZA, Antonio S.; MAIA, Fernando L.; LEME, Mariana D.; GUEDES, Ana Rubia; MENDES-CORREA, Maria Cassia; KALLAS, Esper G.; SEGURADO, Aluisio C.; DUARTE, Alberto J. S.; LAZARI, Carolina S.; ANDRADE, Pamela S.; SALES, Flavia C. S.; CLARO, Ingra M.; SABINO, Ester C.; LEVIN, Anna S.; COSTA, Silvia F.
- Disinfection of 3D-printed protective face shield during COVID-19 pandemic(2021) NOGUERA, Saidy Vasconez; ESPINOZA, Evelyn Patricia Sanchez; CORTES, Marina Farrel; OSHIRO, Izabel Cristina Vilela; SPADAO, Fernanda de Sousa; BRANDAO, Laura Maria Brasileiro; BARROS, Ana Natiele da Silva; COSTA, Sibeli; ALMEIDA, Bianca Leal de; SORIANO, Paula Gemignani; SALLES, Alessandra Grassi; ESCORCIO, Mirian Elizabete Marques; BARRETTI, Cristina Madeira; BAPTISTA, Fernanda Spadotto; ALVARENGA, Glaura Souza; MARINHO, Igor; LETAIF, Leila Suemi Harima; LI, Ho Ye; BACCHI, Pedro; SANTOS, Ana Rubia Guedes dos; REGADAS, Lucas Borges; BRAGA, Carlos Eduardo Lima; ZSIGMOND, Fabio; SEGURADO, Aluisio Cotrim; GUIMARAES, Thais; LEVIN, Anna Sara; BERTOLDI, Cristiane Aun; CATALANI, Luiz Henrique; ZANCUL, Eduardo de Senzi; COSTA, Silvia FigueiredoThis study assessed the disinfection using 70% ethanol; H2O2-quaternary ammonium salt mixture; 0.1% sodium hypochlorite and autoclaving of four 3D-printed face shields with different designs, visor materials; and visor thickness (0.5-0.75 mm). We also investigated their clinical suitability by applying a questionnaire to health workers (HW) who used them. Each type of disinfection was done 40 times on each type of mask without physical damage. In contrast, autoclaving led to appreciable damage.
- Increased Risk for Carbapenem-Resistant Enterobacteriaceae Colonization in Intensive Care Units after Hospitalization in Emergency Department(2020) SALOMAO, Matias Chiarastelli; FREIRE, Maristela Pinheiro; BOSZCZOWSKI, Icaro; RAYMUNDO, Sueli F.; GUEDES, Ana Rubia; LEVIN, Anna S.Carbapenem-resistant Enterobacteriaceae (CRE) colonization is common in hospital patients admitted to intensive care units (ICU) from the emergency department. We evaluated the effect of previous hospitalization in the emergency department on CRE colonization at ICU admission. Our case-control study included 103 cases and 201 controls; cases were patients colonized by CRE at admission to ICU and controls were patients admitted to ICU and not colonized. Risk factors were emergency department stay, use of carbapenem. Simplified Acute Physiology Score, upper digestive endoscopy, and transfer from another hospital. We found that ED stay before ICU admission was associated with CRE colonization at admission to the ICU. Our findings indicate that addressing infection control problems in EDs will help to control carbapenem resistance in ICUs.
- Statewide evaluation of infection control measures for preventing coronavirus disease 2019 in hemodia-lysis facilities(2021) GUEDES, Ana Rubia; TAVARES, Bruno de Melo; ASSIS, Denise Brandao de; FREIRE, Maristela Pinheiro; MADALOSSO, Geraldine; LEVIN, Anna S.; PERDIGAO NETO, Lauro Vieira; OLIVEIRA, Maura Salaroli deOBJECTIVE: This study aimed to evaluate the occurrence of coronavirus disease 2019 (COVID-19) in hemodialysis facilities and the occurrence of and risk factors for clustering of COVID-19 cases. METHODS: We conducted a cross-sectional online survey between March and July 2020, in all dialysis facilities in Sao Paulo state, using Google Forms. The online questionnaire contained questions addressing specific components of infection prevention and control practices and the number of cases during the COVID-19 pandemic. RESULTS: A total of 1,093 (5%) COVID-19 cases were reported among 20,984 patients; approximately 56% of the facilities had X1 cluster. Most facilities implemented various measures (such as allocation of dedicated COVID-19 areas/shifts, symptom screening, environmental disinfection, and maintenance of adequate ventilation) to prevent the transmission of severe acute respiratory syndrome coronavirus 2. Clustering of COVID-19 cases was suspected in only 7% of dialysis facilities. The only variable associated with this event was the performance of aerosol-generating procedures (odds ratio: 4.74; 95% confidence interval: 1.75-12.86). CONCLUSION: Attention should be paid to avoiding the performance of aerosol-generating procedures in dialysis facilities and monitoring the clustering of cases.
- Decontamination and re-use of surgical masks and respirators during the COVID-19 pandemic(2021) CORTES, Marina Farrel; ESPINOZA, Evelyn Patricia Sanchez; NOGUERA, Saidy Liceth Vasconez; SILVA, Aline Alves; MEDEIROS, Marion Elke Sielfeld Araya de; BOAS, Lucy Santos Villas; FERREIRA, Noely Evangelista; TOZETTO-MENDOZA, Tania Regina; MORAIS, Fernando Goncalves; QUEIROZ, Rayana Santiago de; PROENCA, Adriana Coracini Tonacio de; GUIMARAES, Thais; GUEDES, Ana Rubia; LETAIF, Leila Suemi Harima; MONTAL, Amanda Cardoso; MENDES-CORREA, Maria Cassia; JOHN, Vanderley M.; LEVIN, Anna S.; COSTA, Silvia FigueiredoObjectives: The coronavirus disease 2019 pandemic increased global demand for personal protective equipment (PPE) and resulted in shortages. The study evaluated the re-use of surgical masks and respirators by analysing their performance and safety before and after reprocessing using the following methods: oven, thermal drying, autoclave, and hydrogen peroxide plasma vapour. Methods: In total, 45 surgical masks and 69 respirators were decontaminated. Visual integrity, air permeability, burst resistance, pressure differential and particulate filtration efficiency of new and decontaminated surgical masks and respirators were evaluated. In addition, 14 used respirators were analysed after work shifts before and after decontamination using reverse transcription polymerase chain reaction (RT-PCR) and viral culturing. Finally, reprocessed respirators were evaluated by users in terms of functionality and comfort. Results: Oven decontamination (75 degrees C for 45 min) was found to be the simplest decontamination method. Physical and filtration assays indicated that all reprocessing methods were safe after one cycle. Oven decontamination maintained the characteristics of surgical masks and respirators for at least five reprocessing cycles. Viral RNA was detected by RT-PCR in two of the 14 used respirators. Four respirators submitted to viral culture were PCR-negative and culture-negative. Reprocessed respirators used in work shifts were evaluated positively by users, even after three decontamination cycles. Conclusion: Oven decontamination is a safe method for reprocessing surgical masks and respirators for at least five cycles, and is feasible in the hospital setting. (C) 2020 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.