GABRIELA TAKESHIGUE LEMOS

Índice h a partir de 2011
1
Projetos de Pesquisa
Unidades Organizacionais
FMUSP, Hospital das Clínicas, Faculdade de Medicina
P ICHC, Hospital das Clínicas, Faculdade de Medicina - Médico

Filtros

Limpar filtros

Configurações

Resultados de Busca

Agora exibindo 1 - 3 de 3
  • article 0 Citação(ões) na Scopus
    Pre-transplant multidrug-resistant infections in liver transplant recipients-epidemiology and impact on transplantation outcome
    (2024) LEMOS, Gabriela T.; TERRABUIO, Debora R. B.; NUNES, Nathalia N.; SONG, Alice T. W.; OSHIRO, Isabel C. V.; D'ALBUQUERQUE, Luiz Augusto C.; LEVIN, Anna S.; ABDALA, Edson; FREIRE, Maristela P.
    Background Cirrhotic patients are highly exposed to healthcare services and antibiotics. Although pre-liver transplantation (LT) infections are directly related to the worsening of liver function, the impact of these infections on LT outcomes is still unclear. This study aimed to identify the effect of multidrug-resistant microorganism (MDRO) infections before LT on survival after LT.Methods Retrospective study that included patients who underwent LT between 2010 and 2019. Variables analyzed were related to patients' comorbidities, underlying diseases, time on the waiting list, antibiotic use, LT surgery, and occurrences post-LT. Multivariate analyses were performed using logistic regression, and Cox regression for survival analysis.Results A total of 865 patients were included; 351 infections were identified in 259 (30%) patients, of whom 75 (29%) had >= 1 pre-LT MDRO infection. The most common infection was spontaneous bacterial peritonitis (34%). The agent was identified in 249(71%), 53(15%) were polymicrobial. The most common microorganism was Klebsiella pneumoniae (18%); the most common MDRO was ESBL-producing Enterobacterales (16%), and carbapenem-resistant (CR) Enterobacterales (10%). Factors associated with MDRO infections before LT were previous use of therapeutic cephalosporin (p = .001) and fluoroquinolone (p = .001), SBP prophylaxis (p = .03), ACLF before LT (p = .03), and days of hospital stay pre-LT (p < .001); HCC diagnosis was protective (p = .01). Factors associated with 90-day mortality after LT were higher MELD on inclusion to the waiting list (p = .02), pre-LT MDRO infection (p = .04), dialysis after LT (p < .001), prolonged duration of LT surgery (p < .001), post-LT CR-Gram-negative bacteria infection (p < .001), and early retransplantation (p = .004).Conclusion MDRO infections before LT have an important impact on survival after LT.
  • article 4 Citação(ões) na Scopus
    Prediction models for carbapenem-resistant Enterobacterales carriage at liver transplantation: A multicenter retrospective study
    (2022) FREIRE, Maristela Pinheiro; RINALDI, Matteo; TERRABUIO, Debora Raquel Benedita; FURTADO, Mariane; PASQUINI, Zeno; BARTOLETTI, Michele; OLIVEIRA, Tiago Almeida de; NUNES, Nathalia Neves; LEMOS, Gabriela Takeshigue; MACCARO, Angelo; SINISCALCHI, Antonio; LAICI, Cristiana; CESCON, Matteo; DT'ALBUQUERQUE, Luiz Augusto Carneiro; MORELLI, Maria Cristina; SONG, Alice T. W.; ABDALA, Edson; VIALE, Pierluigi; CHIAVEGATTO FILHO, Alexandre Dias Porto; GIANNELLA, Maddalena
    Background: Carbapenem-resistant Enterobacterales (CRE) colonisation at liver transplantation (LT) increases the risk of CRE infection after LT, which impacts on recipients' survival. Colonization status usually becomes evident only near LT. Thus, predictive models can be useful to guide antibiotic prophylaxis in endemic centres. Aims: This study aimed to identify risk factors for CRE colonisation at LT in order to build a predictive model. Methods: Retrospective multicentre study including consecutive adult patients who underwent LT, from 2010 to 2019, at two large teaching hospitals. We excluded patients who had CRE infections within 90 days before LT. CRE screening was performed in all patients on the day of LT. Exposure variables were considered within 90 days before LT and included cirrhosis complications, underlying disease, time on the waiting list, MELD and CLIF-SOFA scores, antibiotic use, intensive care unit and hospital stay, and infections. A machine learning model was trained to detect the probability of a patient being colonized with CRE at LT. Results: A total of 1544 patients were analyzed, 116 (7.5%) patients were colonized by CRE at LT. The median time from CRE isolation to LT was 5 days. Use of antibiotics, hepato-renal syndrome, worst CLIF sofa score, and use of beta-lactam/beta-lactamase inhibitor increased the probability of a patient having pre-LT CRE. The proposed algorithm had a sensitivity of 66% and a specificity of 83% with a negative predictive value of 97%. Conclusions: We created a model able to predict CRE colonization at LT based on easyto-obtain features that could guide antibiotic prophylaxis
  • article 0 Citação(ões) na Scopus
    Neisseria gonorrhoeae arthritis in a patient with systemic lupus: resistance and virulence profiles
    (2023) TONACIO, Adriana Coracini; MARCHI, Ana Paula; BAZZO, Maria Luiza; LEMOS, Gabriela Takeshigue; BAMPI, Jose Victor Bortolotto; ESPINOZA, Evelyn Patricia Sanchez; DUARTE, Edson Luiz Tarsia; MARTINS, Roberta Cristina Ruedas; COSTA-LOURENCO, Ana Paula Ramalho da; OLIVEIRA, Vitor Falcao de; CORTES, Marina Farrel; SANTOS, Sania Alves dos; NETO, Lauro Vieira Perdigao; BONELLI, Raquel Regina; ELMORE, Maria Rita; ROSSI, Flavia; HUGHES, Gwenda; COSTA, Silvia Figueiredo
    In this study, we describe a case report of gonococcal arthritis in a Systemic Lupus Erythematosus patient. Although several mechanisms favor disseminated gonococcal infection (DGI) in patients immunosup-pressed by SLE, this association is rarely reported in literature. We performed whole genome sequencing (WGS) of the etiologic agent involved and molecular analysis using a global collection of Neisseria gonorrhoeae strains. Ours is the only sample derived from synovial fluid identified in this collection, the others being from the usual anatomical sites. Antimicrobial susceptibility was determined by disk diffusion and Etest, and WGS was conducted to determine multilocus sequence typing profiles, group isolates based on core genome single nucleotide polymorphisms (SNP), and identify virulence genes and antimicrobial resistance determinants. The N. gonorrhoeae samples in the global collection were highly heterogeneous. The SNP tree had a total 19,532 SNPs in 320 samples. Our sample displayed resistance to ciprofloxacin (MIC = 2 mg/mL) and tetracycline (zone diameter = 0 mm) belonged to ST 1588 and was not closely related to any isolate in the global collection of N. gonorrhoeae strains. The isolate had genetic features related to beta-lactam, tetracycline and quinolone resistance. Seventy-one virulence genes were identified in our sample, belonging to the following classes: adherence, efflux pump, immune modulator, invasion, iron uptake, protease and stress adaptation. Moreover, no virulence genes for immune evasion and toxin were identified.(c) 2022 Institut Pasteur.