Ianick Martins - Academia.edu (original) (raw)

Papers by Ianick Martins

BMC Infectious Diseases, 2012

Background Infection with carbapenem-resistant Acinetobacter baumannii has been associated with h... more Background Infection with carbapenem-resistant Acinetobacter baumannii has been associated with high morbidity and mortality in solid organ transplant recipients. The main objective of this study was to assess the influence of carbapenem resistance and other potential risk factors on the outcome of A. baumannii infection after kidney and liver transplantation. Methods Retrospective study of a case series of A. baumannii infection among liver and renal transplant recipients. The primary outcome was death associated with A. baumannii infection. Multivariate logistic regression was used to assess the influence of carbapenem resistance and other covariates on the outcome. Results Forty-nine cases of A. baumannii infection affecting 24 kidney and 25 liver transplant recipients were studied. Eighteen cases (37%) were caused by carbapenem-resistant isolates. There were 17 (35%) deaths associated with A. baumannii infection. In unadjusted analysis, liver transplantation (p = 0.003), acquisi...

Memórias do Instituto Oswaldo Cruz

BACKGROUND Chikungunya virus (CHIKV) is an arbovirus that can cause chronic and debilitating mani... more BACKGROUND Chikungunya virus (CHIKV) is an arbovirus that can cause chronic and debilitating manifestations. The first autochthonous case in Rio de Janeiro state was diagnosed in 2015, and an outbreak was declared in 2016. OBJECTIVE The aim of this work was to evaluate CHIKV viral load in serum, plasma and urine in cancer patients to determine the best sample for diagnosis, as well as perform molecular characterisation and phylogenetic analysis of circulating strains. METHODS Paired serum, plasma and urine collected from 31 cancer patients were tested by real-time quantitative polymerase chain reaction (qPCR) and a segment of the CHIKV E1 gene was sequenced. FINDINGS We detected 11 CHIKV+ oncological patients. Paired samples analyses of nine patients showed a different pattern of detection. Also, a higher viral load in plasma (6.84 log 10) and serum (6.07 log 10) vs urine (3.76 log 10) was found. Phylogenetic analysis and molecular characterisation revealed East/Central/Southern Africa (ECSA) genotype circulation and three amino acids substitutions (E1-K211T, E1-M269V, E1-T288I) in positive patients. MAIN CONCLUSION The results indicate the bioequivalence of serum and plasma for CHIKV diagnosis, with urine being an important complement. ECSA genotype was circulating among patients in the period of the 2016 outbreak with K211T, M269V and T288I substitution.

Figure S1. Antimicrobial resistance encoding genes stratified by pathogens. blaTEM (n = 37), blaS... more Figure S1. Antimicrobial resistance encoding genes stratified by pathogens. blaTEM (n = 37), blaSHV (n = 42), blaOXA-1-like (n = 22), blaCTX-M-1(n = 22), blaCTX-M-2 (n = 1), blaCTX-M-9 (n = 4), blaGES (n = 1), blaOXA-48-like (n = 1),blaKPC (n = 5),blaVIM (n = 1), blaNDM (n = 1), blaOXA-23-like (n = 4). Others = Aeromonas hydrophila (blaSHV positive n = 1), Elizabethkingia meningoseptica (blaCTX-M-1 positive n = 1), Proteus mirabilis (blaTEM positive n = 1; blaOXA-23-liken = 3), Pseudomonas putida (blaVIM positive, n = 1), Sphingomonas paucimobilis (blaGES positive, n = 1). (n = 84). (PPTX 63 kb)

Table S3. Genetic profile of resistance among eighty-for isolates that were positive for ESBL and... more Table S3. Genetic profile of resistance among eighty-for isolates that were positive for ESBL and carbapenemases genes according PCR results. (a)-Acinetobacter baumannii, (ec)- Enterobacter cloacae, (e)- Escherichia coli, (kp)- Klebsiella pneumoniae, (pa)- Pseudomonas aeruginosa, (pm)-Proteus mirabilis, (em) Elizabethkingia meningoseptica, (pp) Pseudomonas putida, (sp) Sphingomomas paucimobilis, (ah) Aeromonas hydrophila. (DOCX 21 kb)

Table S2. Reference strains used as controls in polymerase chain reactions (PCR). (DOCX 14 kb)

Table S1. Primers and thermocycling conditions used in polymerase chain reactions (PCR). Primers ... more Table S1. Primers and thermocycling conditions used in polymerase chain reactions (PCR). Primers and thermocycling conditions used in polymerase chain reactions (PCR) (DOCX 21 kb)

Background. Infection with carbapenem-resistant Acinetobacter baumannii has been associated with ... more Background. Infection with carbapenem-resistant Acinetobacter baumannii has been associated with high morbidity and mortality in solid organ transplant recipients. The main objective of this study was to assess the influence of carbapenem resistance and other potential risk factors on the outcome of A. baumannii infection after kidney and liver transplantation. Methods. Retrospective study of a case series of A. baumannii infection among liver and renal transplant recipients. The primary outcome was death associated with A. baumannii infection. Multivariate Cox analysis was used to assess the influence of carbapenem resistance and other covariates on the outcome. Results. Forty-nine cases of A. baumannii infection affecting 24 kidney and 25 liver transplant recipients were retrospectively studied. Eighteen cases (37%) were caused by carbapenem-resistant isolates. There were 17 (35%), deaths associated with A. baumannii infection. In unadjusted Cox analysis, liver transplantation (p=...

Tropical Medicine & International Health

Over the past few decades, life expectancy in Brazil has increased from 48 years in 1950s to 76 y... more Over the past few decades, life expectancy in Brazil has increased from 48 years in 1950s to 76 years in 2017. The aim of this study was to investigate the impact of ageing on: (1) the frequency of hospitalisations due to bloodstream infection (BSI); (2) the incidence of hospital‐acquired BSI (H‐BSI); (3) the incidence of BSI caused by multidrug‐resistant (MDR) agents and (4) the mortality rate of BSI in a public hospital.

Journal of Medical Microbiology

Klebsiella pneumoniae causes a diversity of infections in both healthcare and community settings.... more Klebsiella pneumoniae causes a diversity of infections in both healthcare and community settings. This pathogen is showing an increased ability to accumulate antimicrobial resistance and virulence genes, making it a public health concern. Here we describe the whole-genome sequence characteristics of an ST15 colistin-resistant K. pneumoniae isolate obtained from a blood culture of a 79-year-old female patient admitted to a university hospital in Brazil. Kp14U04 was resistant to most clinically useful antimicrobial agents, remaining susceptible only to aminoglycosides and fosfomycin. The colistin resistance in this isolate was due to a ~1.3 kb deletion containing four genes, namely mgrB, yebO, yobH and the transcriptional regulator kdgR. The study isolate presented a variety of antimicrobial resistance genes, including the carbapenemase-encoding gene bla KPC-2, the extended-spectrum beta-lactamase (ESBL)-encoding gene bla SHV-28 and the beta-lactamase-encoding gene bla OXA-1. Addition...

Infection and Drug Resistance

The infections caused by ESCPM Enterobacterales (Enterobacter spp., Serratia spp., Citrobacter sp... more The infections caused by ESCPM Enterobacterales (Enterobacter spp., Serratia spp., Citrobacter spp., Providencia spp. and Morganella spp.) have limited therapeutic options. Patients with neoplastic diseases are particularly vulnerable to bloodstream infections (BSIs). Objective: To analyze determinant factors of death in patients with neoplasia complicated with BSI caused by ESCPM Enterobacterales. Patients and Methods: A cohort study of patients aged 18 years or older with neoplasia and BSI due to ESCPM group was conducted at the Cancer Hospital I of the National Cancer Institute, Brazil, from September 2012 to December 2017. The variables associated with death were analyzed using multivariate logistic regression. Results: Of the 103 patients included in the cohort, 67.0% were male, the median age was 63 years and 67.0% had solid tumors. Of the 107 BSI episodes evaluated, 70.1% were hospital-acquired infections, 54.2% were secondary to extravascular focus of infection, gastrointestinal tract (19.6%), mainly. Enterobacter spp. (n: 49, 45.4%) was the most frequent agent isolated followed by Serratia spp. (n: 34, 31.5%), Morganella morganii (n: 16, 14.9%), Citrobacter freundii. (n: 7, 6.5%) and Providencia spp. (n: 2, 1.8%). Ten (9.3%) BSI episodes were caused by multidrug-resistant ESCPM Enterobacterales (MDR-ESCPM). The 7-day and 30-day mortality were 9.3% and 21.5%, respectively. The BSIs caused by MDR-ESCPM were independently associated with 7-day death (OR = 21.62 95% CI: 1.81-258.51 P = 0.01). Monotherapy with piperacillin-tazobactam tended to be associated with 7-day death (OR = 10.46 95% CI: 0.97-112.91 P = 0.05) and 30-day death (OR = 2.73 95% CI: 0.96-7.70 P = 0.05). Conclusion: BSIs due to ESCPM group have high mortality and when caused by MDR-ESCPM are independently associated with 7-day death. The possible association of piperacillin-tazobactam monotherapy for BSI-ESCPM with death needs to be better studied.

The Journal of Infection in Developing Countries

Infections due to multidrug resistant Gram-negative pathogens are of great concern worldwide, as ... more Infections due to multidrug resistant Gram-negative pathogens are of great concern worldwide, as they are frequently associated with high mortality and morbidity rates. The occurrence of Pseudomonas spp. producing Klebsiella pneumoniae carbapenemases (KPCs) imposes a great challenge through treatment course of bloodstream infections (BSIs). Pseudomonas putida has been recognized as an emerging pathogen of healthcare associated infections (HAIs). Therefore, we aimed to report a case of a non-fatal case of peripheral line associated BSI (PLA-BSI) in an immunocompromised host due to P. putida harboring blaKPC-2 gene in Brazil. A P. putida isolate was recovered from a blood culture of a 72-year-old man admitted at a University Hospital, identified by BD Phoenix™ 100 (Becton, Dickinson and Company), causing PLA-BSI. The species identification was confirmed by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) and resistance to carbapenems were con...

Medical Mycology

Bloodstream infections (BSI) caused by Candida species are the fourth cause of healthcare assoc... more Bloodstream infections (BSI) caused by Candida species are the fourth cause of healthcare associated infections worldwide. Non-albicans Candida species emerged in the last decades as agents of serious diseases. In this study, clinical and microbiological aspects of six patients with BSI due to the Meyerozyma (Candida) guilliermondii species complex from an oncology reference center in Brazil, were evaluated. To describe demographic and clinical characteristics, medical records of the patients were reviewed. Molecular identification of the isolates was performed by ITS1-5.8S-ITS2 region sequencing. Antifungal susceptibility was evaluated by the EUCAST method and the minimal inhibitory concentrations (MIC) assessed according to the epidemiological cutoff values. Virulence associated phenotypes of the isolates were also studied. Ten isolates from the six patients were evaluated. Five of them were identified as Meyerozyma guilliermondii and the others as Meyerozyma caribbica. One pati...

International Journal of Antimicrobial Agents

Klebsiella pneumoniae is an important human pathogen, able to accumulate and disseminate a variet... more Klebsiella pneumoniae is an important human pathogen, able to accumulate and disseminate a variety of antimicrobial resistance genes. Resistance to colistin, one of the last therapeutic options for MDR bacteria, has been increasingly reported. Colistin-resistant K. pneumoniae (ColRKp) emerged in two hospitals in Rio de Janeiro state, Brazil, in 2016. The aim of this study was to investigate if these ColRKp isolates were clonally related when compared between hospitals, to identify the molecular mechanisms of colistin resistance, and to describe other antimicrobial resistance genes carried by isolates. Twenty-three isolates were successively recovered, and 10 (each one of a PFGE type) had the whole-genome sequence analyzed. Although some PFGE clusters were found, no one included isolates from both hospitals. Half of the isolates were assigned to CC258, three to ST152 and two to ST15. One isolate was pandrug-resistant, one extensively drug-resistant, and the others multidrug-resistant. Colistin resistance was related to mutations in mgrB, pmrB, phoQ, and crrB. Eleven new mutations were found in these genes, including two nucleotide deletions in mgrB. All isolates were carbapenem resistant, seven of them associated with carbapenemase carriage, present in seven isolates (blaKPC-2 in 6, and blaOXA-370 in one). All isolates had a blaCTX-M, and two had a 16S ribosomal RNA methyltransferase encoding gene (armA and rmtB). ColRKp were composed of epidemic clones, but cross dissemination between hospitals was not detected. Colistin resistance emerged with several novel mutations amid highly resistant strains, further restricting the number of drugs available and leading to pandrug resistance.

Journal of Pain and Symptom Management

The Journal of hospital infection, Jan 16, 2018

Early onset prosthetic valve endocarditis (EO-PVE) is an infrequent complication of cardiac valve... more Early onset prosthetic valve endocarditis (EO-PVE) is an infrequent complication of cardiac valve surgery. It is considered a healthcare-associated infection due to contamination of the prosthesis during the implant or in the early postoperative period. To evaluate which factors may be related to the acquisition of EO-PVE. A nested case-control study was conducted from 2006 to 2016. Cases were patients who had definite prosthetic endocarditis by the modified Duke criteria up to 12 months of heart valve replacement. Cases and controls were matched by age, gender, date and type of surgery. There were 26 cases and 78 controls, in 2496 valve surgeries. The median incidence of EO-PVE was 1.1%. Risk factors identified during surgery were: use of ≥ two cryoprecipitate units (OR 5.95 95%, CI 1.31-27.0) and ≥ two plasma units (OR 2.73, 95% CI 1.0-7.5). In the postoperative period, associated factors were bloodstream infection (OR 14, CI 1.49-131.77), pneumonia (OR 4.38, CI 1.21-15.84), any i...

Infection control and hospital epidemiology, May 16, 2017

Central-line bloodstream infection (CLABSI) increases hospital mortality. A cohort study was cond... more Central-line bloodstream infection (CLABSI) increases hospital mortality. A cohort study was conducted in a Brazilian hospital to estimate the disability-adjusted life year (DALY) of CLABSI using modified World Health Organization (WHO) methodology. CLABSI DALY was 20.44 per 1,000 inpatients, most were the result of premature death (20.42 per 1,000 inpatients). DALY can be useful to guide and measure the impact of healthcare infection prevention. Infect Control Hosp Epidemiol 2017;1-4.

Current microbiology, Jan 26, 2016

The objective of this work was to assess the genetic characteristics of uropathogenic Escherichia... more The objective of this work was to assess the genetic characteristics of uropathogenic Escherichia coli, ciprofloxacin resistance or susceptibility, obtained from patients with gynecological cancer and urinary tract infection (UTI). Seventy-seven E. coli ciprofloxacin-resistant isolates and 38 ciprofloxacin-susceptible were analyzed by polymerase chain reaction (PCR) to determine the phylogenetic groups, virulence factors as iucC, fyuA, hlyC, cnf1 genes, and pks pathogenicity island. The presence of genes related to ciprofloxacin resistance such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, and qepA, and the sequencing of DNA gyrase genes and topoisomerase IV were determined. The genetic profile of the isolates was determined by pulsed-field gel electrophoresis (PFGE). Statistical analysis was performed using Fisher's exact test and Chi-square test. Phylogenetic group B2 was the most prevalent although a great genetic diversity was observed by PFGE. Only genes associated to siderophore...

Microbial Drug Resistance, 2013

The main objective of this study was to assess the frequency and possible sources of colonization... more The main objective of this study was to assess the frequency and possible sources of colonization and infection by Acinetobacter in the intensive care unit (ICU) of a university hospital in Rio de Janeiro, Brazil, and characterize the isolates for relatedness to internationally and locally disseminated lineages. Patients consecutively admitted to the ICU from April 2007 to April 2008 were screened for colonization and infection. Species were identified by rpoB sequencing. The presence of acquired and intrinsic carbapenemase genes was assessed by polymerase chain reaction (PCR). Strains were typed by random amplification of polymorphic DNA (RAPD)-PCR, pulsed-field gel electrophoresis, and multilocus sequence typing (MLST) using the schemes hosted at the University of Oxford (UO) and Institut Pasteur (IP). Of 234 patients, 98 (42%) had at least one specimen positive for the Acinetobacter isolate, and 24 (10%) had infection. A total of 22 (92%) infections were caused by Acinetobacter baumannii and one each (4%) by Acinetobacter nosocomialis and Acinetobacter berezinae. A. baumannii isolates from 60 patients belonged to RAPD types that corresponded to MLST clonal complexes (CCs) 109/1 (UO/IP scheme, known as International Clone I), CC 110/110 (UO/IP), CC 113/79 (UO/IP), and CC 104/15 (UO/IP). Most CCs were carbapenem resistant and carried the bla(OXA-23)-like gene. Strains were introduced by patients transferred from other wards of the same hospital (11 patients, 18%) or acquired from cross-transmission within the ICU (49 patients, 82%). A. nosocomialis lineage sequence type 260 colonized 10% of the whole study population. A. baumannii have become established in this hospital as a part of a global epidemic of successful clones. Once introduced into the hospital, such clones have become entrenched among patients in the ICU.

Memórias do Instituto Oswaldo Cruz, 2013

The epidemiology of urinary tract infections (UTI) by Staphylococcus saprophyticus has not been f... more The epidemiology of urinary tract infections (UTI) by Staphylococcus saprophyticus has not been fully characterised and strain typing methods have not been validated for this agent. To evaluate whether epidemiological relationships exist between clusters of pulsed field gel-electrophoresis (PFGE) genotypes of S. saprophyticus from community-acquired UTI, a cross-sectional surveillance study was conducted in the city of Rio de Janeiro, Brazil. In total, 32 (16%) female patients attending two walk-in clinics were culture-positive for S. saprophyticus. Five PFGE clusters were defined and evaluated against epidemiological data. The PFGE clusters were grouped in time, suggesting the existence of community point sources of S. saprophyticus. From these point sources, S. saprophyticus strains may spread among individuals.