Publications by authors named "Maura Salaroli 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.
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.
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.
Article 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.
Purpose: 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 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 PDFArticle Synopsis
- Surveillance strategies, including routine cultures, are crucial for detecting colonization and preventing infection in HSCT units, specifically targeting multidrug-resistant organisms (MDROs) like CRE, CRPa, and VRE.
- In a study with 1,323 samples from 200 patients over a year, 21.5% developed infections, many stemming from prior colonization, highlighting the link between colonization and increased infection risk.
- Rectal swabs yielded the highest positive rates, while the effectiveness of routine VRE surveillance for auto-HSCT patients is questionable due to costs and minimal impact on survival.
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.
Background: 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.
Article Synopsis
- A study evaluated the effectiveness of a rapid chromatographic immunoassay and ELISA for diagnosing COVID-19 among 122 individuals at two hospitals in Brazil, including both RT-PCR-positive and symptomatic RT-PCR-negative patients.
- The rapid test showed an overall sensitivity of 85.8%, which increased to 94.9% after 14 days of symptom onset, with a specificity of 100%.
- The common symptoms in patients included fever, cough, and dyspnea, and the main thoracic CT findings were ground glass changes, with a significant number of RT-PCR-negative patients also testing positive with the rapid test.
Article Synopsis
- Multidrug-resistant Gram-negative bacteria, including Enterobacterales, pose a global health threat as treatment options decrease, leading to this study focusing on 50 resistant isolates and their susceptibility to less-used antibiotics.
- The study examined various strains, revealing that many carried resistance genes, with a high prevalence of antimicrobial resistance and variable susceptibility to older drugs like tigecycline, minocycline, and ceftazidime/avibactam.
- Results indicated that while tigecycline exhibited promising effectiveness against most Gram-negative strains, other antibiotics like chloramphenicol showed poor performance, highlighting the need for continued research on alternative treatments.
Purpose: Antibiotic dosing is challenge in critically ill patients undergoing renal replacement therapy. Our aim was to evaluate the pharmacokinetic and pharmacodynamic (PK/PD) characteristics of meropenem and vancomycin in patients undergoing SLED.
Methods: Consecutive ICU patients undergoing SLED and receiving meropenem and/or vancomycin were prospectively evaluated.
The study investigated the effect of antibiotic combinations against 20 clinical isolates of A. baumannii (seven colistin-resistant and 13 colistin-susceptible) with different resistance mechanisms. Clinical data, treatment, and patient mortality were evaluated.
View Article and Find Full Text PDFColonization pressure as a risk factor for colonization by multiresistant Acinetobacter spp and carbapenem-resistant Pseudomonas aeruginosa in an intensive care unit.
Clinics (Sao Paulo)
May 2014
Objective: To determine factors associated with colonization by carbapenem-resistant Pseudomonas aeruginosa and multiresistant Acinetobacter spp.
Methods: Surveillance cultures were collected from patients admitted to the intensive care unit at admission, on the third day after admission and weekly until discharge. The outcome was colonization by these pathogens.