Publications by authors named "Marina Farrel Cortes"

Background: Limited information exists on carriage of multidrug-resistant organisms (MDRO) by health workers (HWs) in primary care settings. This study aims to determine the prevalence of MDRO carriage among HWs in primary care and to identify associated risk factors.

Methods: A cross-sectional study was conducted across all 12 primary care units in São Caetano do Sul-SP, Brazil, from October to December 2023.

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We aimed to characterise vaccine-induced protection against COVID-19 during five waves caused by Variants of Concern (VOCs). This is a nested case-control study of 3,972 HCW primarily vaccinated with CoronaVac (98%) that evaluated symptomatic SARS-CoV-2 breakthrough infections (BI) in almost two-years follow-up until the 3rd Omicron wave. Predictors of protection against SARS-CoV-2 BI were analysed using conditional logistic regression models.

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Background: Assessing the risk of multidrug-resistant colonization and infections is pivotal for optimizing empirical therapy in hematopoietic stem cell transplants (HSCTs). Limited data exist on extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) colonization in this population. This study aimed to assess whether ESBL-E colonization constitutes a risk factor for ESBL-E bloodstream infection (BSI) and to evaluate ESBL-E colonization in HSCT recipients.

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Hematopoietic stem cell transplant (HSCT) recipients are at -increased risk for severe COVID-19. The aim of this study was to evaluate the burden of COVID-19 in a cohort of HSCT recipients. This retrospective study evaluated a cohort of adult hospitalized HSCT recipients diagnosed with COVID-19 in two large hospitals in São Paulo, Brazil post-HSCT, from January 2020 to June 2022.

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  • The study discusses the immune responses of an HIV-infected patient suffering from mucosal leishmaniasis, a condition not well understood in terms of immune reactions.
  • The patient had a notably low CD4 count of 85 cells/mm3 and experienced significant nasal damage over 2 years due to the disease.
  • Immune evaluations indicated a mixed Th1/Th2 response alongside both activated and exhausted T cells, enhancing our understanding of HIV's impact on responses to mucosal leishmaniasis.
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Dogs often carry methicillin-resistant Staphylococci asymptomatically. These bacteria are frequently linked to conditions such as canine pyoderma and otitis. Close interaction between dogs and humans can facilitate the exchange of resistant strains, particularly Methicillin-resistant Staphylococcus pseudintermedius (MRSP).

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  • This study investigates the susceptibility of various bacterial isolates (32 Gram-negative and 6 Gram-positive) to chlorhexidine gluconate (CHG) using different concentration measures in both planktonic cells and biofilms.
  • Results indicate that Gram-negative isolates require higher minimal concentrations of CHG compared to Gram-positive, and that biofilm-forming bacteria are more tolerant to CHG than planktonic cells.
  • The study also highlights the occurrence of the Eagle effect in 60.5% of isolates, which leads to elevated minimum concentrations of CHG needed for effectiveness, suggesting a need for cautious interpretation of susceptibility results in clinical settings.
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Background: Chikungunya-fever (CHIKF) remains a public health major issue. It is clinically divided into three phases: acute, post-acute and chronic. Chronic cases correspond to 25-40% individuals and, though most of them are characterized by long-lasting arthralgia alone, many of them exhibit persistent or recurrent inflammatory signs that define post-Chikungunya chronic inflammatory joint disease (pCHIKV-CIJD).

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  • - This study explores the relationship between multidrug-resistant bacteria and their virulence traits using zebrafish as a model, analyzing 46 strains from Brazilian hospitals that were resistant to colistin and contained specific resistance genes (bla).
  • - Ten different sequence types (STs) were identified, with the majority falling under CC258, and certain virulence factors like fimbriae and efflux-pumps were frequently present; however, only ST16 strains showed a significant increase in mortality in zebrafish embryos (52% vs. 29%).
  • - The findings suggest that while several virulence factors exist, ST16 is uniquely linked to heightened virulence in the zebrafish model, indicating the need for additional studies to better
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  • A study of 30 vaccinated healthcare workers with mild Omicron infections evaluated viral tests (viral culture, RAT, and RT-PCR) over two weeks.
  • Viral culture positivity was 46% on day 5 and 20% on day 7, indicating some level of transmissibility.
  • RAT and RT-PCR had a high negative predictive value, which suggests they could be effective in determining when individuals may no longer need to isolate.
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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 immunosuppressed 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.

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Infections caused by multidrug-resistant are a worldwide health concern with high mortality rates. Rapid identification of this infectious agent is critical as it can easily spread with difficult or no options for treatment. In this context, the development of reliable and economically viable detection and therapeutic methodologies are still challenging.

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Background: Resistance to linezolid has become a worldwide concern since it is one of the last-resort antibiotics to treat multidrug-resistant staphylococcal and enterococcal infections.

Objectives: We investigated staphylococcal infections caused by 16 cfr-positive linezolid-resistant Staphylococcus epidermidis and Staphylococcus aureus isolates in a French university hospital from 2015 to 2018.

Methods: Antimicrobial susceptibility of isolates was tested by broth microdilution and gradient strips.

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Background: Bloodstream infections (BSI) by multidrug-resistant (MDR) organisms are responsible for significant mortality in critically ill trauma patients. Our objective is to identify the risk factors for BSI by MDR agents and their resistance mechanisms in a trauma reference hospital.

Methods: During 18 months, all patients admitted in our Intensive Care Unit (ICU) were enrolled in this prospective cohort.

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  • Vancomycin-resistant Enterococcus faecium (VREfm) poses significant risks for hospital infections, with specific resistance patterns linked to the vanA and vanD genes that require further exploration.
  • The study found that VRE isolates with a VanD-vanA phenotype showed a mix of susceptibility to teicoplanin and high resistance to vancomycin, while not sharing a common genetic lineage among samples.
  • Key genetic features revealed variations in important resistance genes and insertion elements, indicating the complexity of genetic mechanisms at play, emphasizing the need for deeper research into these patterns.
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  • * A retrospective study reviewed cases of colonization and infection, analyzing 42 isolates, including environmental samples, for carbapenemase genes and genetic mutations, revealing key resistance mechanisms and virulence factors.
  • * The findings suggested that a history of polymyxin use significantly increased the risk for infection and indicated that cross-transmission might be a factor in the spread of these resistant strains, emphasizing the importance of monitoring and controlling this pathogen.
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Carbapenem-resistant (CRK) infections are a growing concern in immunocompromised patients. The aim of the present study was to evaluate the impact of CRK colonization and infection in overall mortality for haematopoietic stem-cell transplant (HSCT) patients. We also aimed to investigate resistance and virulence profiles of CRK isolates and assess their epidemiological and genetic relatedness.

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  • * A cross-sectional study in a COVID-19 ICU included an educational campaign on virus transmission and proper MP disinfection, and involved swabbing 51 MPs for SARS-CoV-2 testing.
  • * Results indicated that while most HCWs practiced better hand hygiene and disinfected their MPs during the pandemic, SARS-CoV-2 RNA was detected on 4% of MPs, highlighting the need for improved infection control guidelines for electronic devices in healthcare settings.
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Background: The impact of COVID-19 on healthcare- associated infections (HCAI) caused by multidrug-resistant (MDR) bacteria that contribute to higher mortality is a growing area of study METHODS: This retrospective observational study compares the incidence density (ID) of HCAI caused by MDR bacteria (CRE, CRAB, CRP, MRSA and VRE) pre-COVID (2017-2019) and during the COVID-19 pandemic (2020) in overall hospitalized patients and in intensive care (ICU) units.

Results: We identified 8,869 HCAI, of which 2,641 (29.7%) were caused by bacterial MDR, and 1,257 (14.

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Ventilator associated pneumonia(VAP) is a severe complication that can lead to high mortality when not early identified or when therapy is delayed. The aim of this study was to evaluate procalcitonin(PCT) as a biomarker for VAP development. In total, 73 hospitalized patients with COVID-19 were analyzed.

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  • A new LAMP assay called HiberGene's CD was tested on 82 unformed stool samples from patients thought to have C. difficile infection (CDI).
  • When compared to the GDH toxins A/B test, HiberGene's LAMP showed perfect sensitivity (100%) and high specificity (95.8%).
  • Compared to the FilmArray™ GI panel test, it exhibited a sensitivity of 81.2% and perfect specificity (100%), with 96.38% agreement between the tests.
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  • * A study in São Paulo, Brazil, found seven unique E. coli strains with the mcr-1 gene, collected between 2016-2018 from both community and hospital settings.
  • * These E. coli strains exhibited different resistance profiles, and five of them were able to transfer the mcr-1 gene through conjugation, highlighting the potential for wider dissemination of colistin resistance in the region.
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Methicillin-resistant (MRSA) of the ST1-SCCIV lineage has been associated with community-acquired (CA) infections in North America and Australia. In Brazil, multi-drug resistant ST1-SCCIV MRSA has emerged in hospital-associated (HA) diseases in Rio de Janeiro. To understand these epidemiological differences, genomic and phylogenetic analyses were performed.

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