Publications by authors named "Maura S Oliveira"
Colonisation by multidrug-resistant organisms in health workers in primary care: narrow spectrum oral antimicrobials are a risk factor.
Eur J Clin Microbiol Infect Dis
December 2024
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.
Streptococcus equi subspecies zooepidemicus: an emergent cause of meningoencephalitis in Northeastern Brazil.
Rev Inst Med Trop Sao Paulo
August 2024
Article Synopsis
- * Epidemiological investigations and a literature review suggest that neurotropic strains of this bacteria had not been previously documented in Brazil prior to these instances.
- * The emergence of another meningoencephalitis case in 2023 indicates the ongoing presence of these harmful strains in the environment, emphasizing the importance of monitoring for such infections.
Backgrounds: Fortunately, much has been studied about COVID-19 in patients with inflammatory bowel diseases (IBD). Evidence suggests that these patients do not appear to be at increased risk of severe COVID-19. However, there are still some uncertainties regarding the clinical manifestations of COVID-19 in patients with immune-mediated diseases.
View Article and Find Full Text PDFThe II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia.
Crit Care Sci
December 2023
Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil.
Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform.
Background: Our aim in this retrospective cohort study was to assess the impact on mortality of the empirical use of polymyxin as therapy for carbapenem-resistant gram-negative bacteria (CR-GNB) in septic patients. The study was performed at a tertiary academic hospital in Brazil, from January 2018 to January 2020, the pre-coronavirus disease 2019 period.
Methods: We included 203 patients with suspected sepsis.
Article Synopsis
- - This study evaluated the rates of Healthcare-Associated Infections (HAIs) and antimicrobial consumption in ICUs in São Paulo during the COVID-19 pandemic, comparing data with the years before the pandemic.
- - Researchers analyzed data from 220 ICUs and found a significant rise in Central-Line-Associated Bloodstream Infections (CLABSI) following the pandemic, influenced by hospital size, type of funding, and catheter usage, while Ventilator-Associated Pneumonia (VAP) rates increased in public hospitals with higher mechanical ventilation use.
- - Despite a notable uptick in HAIs and increased use of broad-spectrum antibiotics during the pandemic, the susceptibility of the microorganisms remained unchanged compared to the pre-pandemic period.
Objective: COVID-19 has been associated with a significant burden to those who survive the acute phase. We aimed to describe the quality of life and symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) at 90 days after hospital discharge of COVID-19 patients.
Methods: Patients with COVID-19 admitted to a private hospital in the city of São Paulo, Brazil, between April of 2020 and April of 2021 were interviewed by telephone at 30 and 90 days after discharge to assess the quality of life and symptoms of depression, anxiety, and PTSD.
Background: Despite the advances in robotic surgery and its benefits for the patient and surgeon, there are difficulties and challenges in reprocessing surgical instruments, including with regard to patient safety, such as the risk of infection. The aim of this article is to evaluate the effectiveness of manual plus ultrasonic cleaning of EndoWrist devices used in robotic surgery using the adenosine triphosphate bioluminescence quantitative test.
Methods: A prospective cross-sectional study assessed the cleanliness of robotic instrumentals used in surgeries.
Case Report: Successful Treatment of Recurrent Urinary Tract Infection Due to Extensively Drug-Resistant Klebsiella Pneumoniae in a Kidney Transplant Recipient Using Chloramphenicol.
Transplant Proc
April 2023
Article Synopsis
- Effective treatments for multidrug-resistant (MDR) Gram-negative bacteria are becoming less available, particularly affecting solid-organ transplant patients.
- Kidney transplant recipients are particularly vulnerable to urinary tract infections, which can lead to serious complications and increased mortality post-transplant.
- A case study showed successful treatment of a complicated urinary tract infection in a kidney transplant patient with extensively drug-resistant (XDR) K. pneumoniae using chloramphenicol and ertapenem, suggesting that chloramphenicol could be a viable alternative for infections from MDR/XDR pathogens despite not being a first-line option.
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.
View Article and Find Full Text PDFArticle Synopsis
- The incidence of multidrug resistant organisms (MDROs), particularly carbapenem-resistant Gram-negative bacteria and vancomycin-resistant Enterococcus, is significantly high among solid organ transplant (SOT) patients in Brazil.
- This review highlights issues in antimicrobial use and resistance, focusing on the challenges and opportunities for establishing effective antimicrobial stewardship programs (ASPs) within Brazilian hospitals.
- Key barriers to implementing ASPs include lack of specific national guidelines for SOT patients, inadequate electronic medical records, limited rapid diagnostic testing, and insufficient time for healthcare personnel to devote to stewardship activities.
Evaluation of eleven immunochromatographic assays for SARS-CoV-2 detection: investigating the dengue cross-reaction.
Rev Inst Med Trop Sao Paulo
October 2022
COVID-19 disease is spread worldwide and diagnostic techniques have been studied in order to contain the pandemic. Immunochromatographic (IC) assays are feasible and a low-cost alternative especially in low and middle-income countries, which lack structure to perform certain diagnostic techniques. Here we evaluate the sensitivity and specificity of eleven different IC tests in 145 serum samples from confirmed cases of COVID-19 using RT-PCR and 100 negative serum samples from blood donors collected in February 2019.
View Article and Find Full Text PDFArticle Synopsis
- A study aims to improve COVID-19 patient management by creating a computational model that analyzes electronic medical records to find correlations between drug prescriptions and patient outcomes.
- The research involved data from 3,674 hospitalized patients, focusing on drug prescriptions and their relationship to whether patients were discharged alive or deceased, using advanced machine learning techniques for analysis.
- Results indicated that anticoagulants improved prognosis when given after the first week of symptoms, while commonly prescribed antibiotics did not significantly affect patient outcomes, signifying a potential reevaluation of treatment strategies.
Objectives: To describe the compliance to the practices of hand hygiene and hub disinfection before manipulation of the central venous catheter in two moments: before and after educational intervention. Adherence to hand hygiene was assessed with two methods: direct observation and video camera.
Methods: Before and after study conducted with the nursing team in an adult intensive care unit, in São Paulo, Brazil, including 180 observations using video cameras and direct observation.
Background: COVID-19 caused more than 622 thousand deaths in Brazil. The infection can be asymptomatic and cause mild symptoms, but it also can evolve into a severe disease and lead to death. It is difficult to predict which patients will develop severe disease.
View Article and Find Full Text PDFPurpose: The aim of this study was to describe the incidence and risk factors for hospital readmission and infection during the months after COVID-19 hospital admission.
Methods: This prospective study included adult patients who were hospitalized due to COVID-19 and had been discharged from April 2020 to August 2020. All patients had a medical evaluation with a structured questionnaire 6 to 11 months after hospital admission.
Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19: Joint guideline of Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia, Sociedade Brasileira de Reumatologia.
Rev Bras Ter Intensiva
June 2022
Objective: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil.
Methods: A group of 27 experts, including representatives of the Ministry of Health and methodologists, created this guideline.
Brazilian guidelines for the treatment of outpatients with suspected or confirmed COVID-19. A joint guideline of the Brazilian Association of Emergency Medicine (ABRAMEDE), Brazilian Medical Association (AMB), Brazilian Society of Angiology and Vascular Surgery (SBACV), Brazilian Society of Geriatrics and Gerontology (SBGG), Brazilian Society of Infectious Diseases (SBI), Brazilian Society of Family and Community Medicine (SBFMC), and Brazilian Thoracic Society (SBPT).
Braz J Infect Dis
May 2022
Background: Several therapies have been used or proposed for the treatment of COVID-19, although their effectiveness and safety have not been properly evaluated. The purpose of this document is to provide recommendations to support decisions about the drug treatment of outpatients with COVID-19 in Brazil.
Methods: A panel consisting of experts from different clinical fields, representatives of the Brazilian Ministry of Health, and methodologists (37 members in total) was responsible for preparing these guidelines.
Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study.
Clinics (Sao Paulo)
December 2021
Objective: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19.
View Article and Find Full Text PDFSurveillance strategies to detect colonization are an important tool to prevent and control the spread of microorganisms in hematopoietic stem cell transplant (HSCT) units. The aim of this study was to evaluate routine surveillance cultures for screening colonization and infection by carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPa), and vancomycin-resistant enterococci (VRE). Surveillance cultures were collected (1,323 samples) from 200 patients admitted to an HSCT unit over one year; swabs were taken on admission and then weekly.
View Article and Find Full Text PDFArticle Synopsis
- - The study evaluated the occurrence of COVID-19 among patients in hemodialysis facilities in São Paulo, finding 1,093 reported cases out of 20,984 patients surveyed.
- - Many facilities implemented preventive measures like dedicated COVID-19 areas and symptom screening, yet about 56% experienced at least one cluster of cases, with clustering suspected in only 7% of facilities.
- - The primary risk factor for clustering was linked to aerosol-generating procedures, suggesting the need for caution in such practices to reduce transmission and monitor outbreaks effectively.
Article Synopsis
- Antimicrobial stewardship programs (ASPs) in hospitals aim to coordinate interventions that enhance the appropriate use of antimicrobial medications, and this study focused on evaluating their implementation in São Paulo, Brazil.
- A survey conducted between March and July 2018 found that 85% of responding hospitals had formal ASPs, with guidelines for surgical prophylaxis and sepsis being widely adopted, but stricter measures like prior authorization were rare.
- Although most hospitals reported having active ASPs, there were discrepancies in understanding their objectives and evaluating their effectiveness, indicating a need for improved metrics and feedback systems in the future.
We evaluated the seroprevalence of SARS-CoV-2 and risk factors among 1,996 oligo/asymptomatic health care workers. The seroprevalence was 5.5% and risk factors associated with being infected with SARS-CoV-2 was professional category of cleaning (adj odds ratio 2.
View Article and Find Full Text PDFBackground: Acute post-cataract endophthalmitis (APE) is a rare complication potentially causing irreversible visual loss. A 10-year study of APE was conducted to determine its incidence, microbiological spectra and antibiotic resistance profile of APE-related pathogens at a major tertiary referral center in Brazil.
Methods: APE cases reported between January 2010 and December 2019 were included.
Nucleoprotein-based ELISA for detection of SARS-COV-2 IgG antibodies: Could an old assay be suitable for serodiagnosis of the new coronavirus?
J Virol Methods
April 2021
Objectives: We evaluated the performance of a nucleoprotein-based enzyme-linked immunosorbent assay (ELISA) for detection of IgG antibodies to SARS-CoV-2.
Methods: The ELISA was based on serum IgG reactivity to a 46-kDa protein derived from the recombinant SARS-CoV2 nucleoprotein. Assay sensitivity was assessed using serum samples from 134 COVID-19 confirmed cases obtained > 15 days after symptom onset.