Publications by authors named "Silviane Bezerra Pinheiro"

Cryptococcus neoformans is primarily responsible for cases of cryptococcal meningitis in individuals with HIV/AIDS. This study evaluated the susceptibility of C. neoformans obtained from individuals with cryptococcal meningitis associated with HIV/AIDS in Manaus, Amazonas, Brazil, against the action of the antifungals amphotericin B, flucytosine, fluconazole, itraconazole and posaconazole and analyzed it using Multilocus Sequence Typing (MLST) in order to identify the Sequence Types (STs).

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Objectives: In the state of Amazonas, northern Brazil, cryptococcosis is endemic, with a predominance of Cryptococcus neoformans in individuals with HIV/AIDS, and Cryptococcus gattii VGII in non-HIV individuals. This study analysed the clinical isolates and clinical-epidemiological characteristics of HIV/AIDS patients diagnosed with cryptococcosis in a tertiary healthcare facility in Manaus, Amazonas and investigated the presence of agents of cryptococcosis in environmental samples.

Methods: A survey was made of data from HIV/AIDS patients diagnosed with cryptococcosis between January 2017 and December 2019, and environmental samples were collected at the patients' and their neighbours' homes.

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Article Synopsis
  • - The study investigates heteroresistance in the C. neoformans/C. gattii complex, specifically looking at resistance to fluconazole in isolates from Amazonas, Brazil, revealing varying susceptibility levels in clinical and environmental samples.
  • - A total of 45 isolates were analyzed, showing that clinical C. gattii isolates had significantly higher minimal inhibitory concentrations (MICs) compared to environmental strains, with all isolates exhibiting some degree of heteroresistance.
  • - The results indicated that many isolates can adapt to higher fluconazole concentrations over time, suggesting that current antifungal susceptibility tests may need reevaluation to better understand their implications for treatment and patient outcomes in cryptococcosis cases.
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A common strategy in antifungal susceptibility testing is the utilization of the standardized protocol based on the microbroth dilution assay approach as described by the Clinical Laboratory Standards Institute (CLSI) (M27-A4). One major problem for laboratories in resource-limited countries with this protocol arises from the use of expensive culture media like RPMI-1640 and 3-N-morpholinopropanesulfonic acid (MOPS) buffer. One approach of circumventing this problem in cases of economic need is the evaluation of alternative culture media and buffers.

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Article Synopsis
  • - The study focuses on the prevalence and characteristics of pulmonary mycoses in patients who have smear-negative tuberculosis in the Brazilian Amazon.
  • - Conducted at two tuberculosis reference institutions, the study analyzed 213 patients using various diagnostic methods and found that 7% were diagnosed with pulmonary mycoses, particularly aspergillosis and paracoccidioidomycosis.
  • - A significant number of patients with pulmonary mycoses were former tuberculosis sufferers, with common symptoms including chronic cough and lung cavitation injuries.
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Cryptococcosis is a life-threatening fungal infection caused by the Cryptococcus neoformans/Cryptococcus gattii species complex. Most cases are recorded in patients suffering from HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome). However, this infection also occurs in non-HIV patients with a proportion of 10-30% of all cases.

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We present postmortem evidence of invasive pulmonary aspergillosis (IPA) in a patient with severe COVID-19. Autopsies of COVID-19 confirmed cases were performed. The patient died despite antimicrobials, mechanical ventilation, and vasopressor support.

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Background: Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. In the northern region of Brazil, this disease is caused by Cryptococcus neoformans genotype VNI and Cryptococcus gattii genotype VGII. However, few environmental studies have been conducted in this large tropical area.

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Cryptococcosis is considered endemic in Amazonas state, occurring more frequently in individuals with AIDS, who are predominantly infected by Cryptococcus neoformans molecular type VNI. Infections by Cryptococcus gattii VGII predominate in immunocompetent hosts from the American continent and are associated with outbreaks in North America, particularly the subtypes VGIIa and VGIIb, which are also present in the Brazilian Amazon region. Despite few environmental studies, several aspects of the molecular epidemiology of this disease in Amazonas remain unclear, including the limited use of multilocus sequence typing (MLST) to evaluate the genetic population structure of clinical isolates, mainly C.

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