Browsing by Author "Almeida, Francisco"
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- Botulism disguised as parotitisPublication . Caldas, João Paulo; Filipe, Rita; Queirós, Rita; Grilo Novais, António; Almeida, Francisco; Malheiro, Luís; Teixeira Lopes, Teresa; Saraiva, Margarida; Tavares, Margarida; Sarmento, AntónioBotulism is an acute toxin-mediated neuroparalytic syndrome caused by some Clostridium species. It typically presents itself as an acute symmetric descending paralysis of cranial and peripheral nerves, which can potentially evolve to respiratory failure and death. We report a case of botulism diagnosed in a patient presenting with a parotitis probably due to xerostomia, even though he had already sought medical assistance for blurred vision and dysphagia. The neurological symptoms resolved without administration of antitoxin and botulism diagnosis was confirmed with identification of both toxins B and F in patient's serum. We aim to illustrate the need for a high clinical suspicion for the diagnosis of botulism and to report an atypical case of botulism with the production of toxins B and F, the latter being of rare occurrence.
- Commentary: Human Liver FlukesPublication . Botelho, Monica Catarina; Almeida, Francisco; Richter, Joachim; Sarmento, AntónioWe read with interest the paper by Harrington et al. on “human liver flukes,” recently published in the Lancet Gastroenterology and Hepatology. They report that the prevalence of Fasciola hepatica in the inner Porto area of Portugal is 3.2%. These authors also state that this is a notably high prevalence. Fascioliasis, as a neglected tropical disease, commonly affects poor people from developing countries and occurs sporadically in Europe. In 1996, Dias et al. reported a case of chronic fascioliasis in a patient with a 6-year history of intermittent biliary colic after having ingested uncooked wild watercress. Our group has performed a search in the database of Centro Hospitalar de S. João (CHSJ), from 1997 to 2017. CHSJ is the biggest hospital in the North of Portugal. This hospital is located in the city of Porto and serves a population of 1,700,000 inhabitants distributed by an approximate area of 2,040 km2. The results we have obtained diverge from the figures reported by Harrington et al.: during the last 20 years only four cases of fascioliasis have been recorded: one case in 1998, one case in 2003, and two cases in 2014.
- Emergence of community-acquired methicillin-resistant Staphylococcus aureus EMRSA-15 clone as the predominant cause of diabetic foot ulcer infections in PortugalPublication . Silva, Vanessa; Almeida, Francisco; Carvalho, José António; Castro, Ana Paula; Ferreira, Eugénia; Manageiro, Vera; Tejedor-Junco, María Teresa; Caniça, Manuela; Igrejas, Gilberto; Poeta, PatríciaMethicillin-resistant Staphylococcus aureus (MRSA) are often found in infected diabetic foot ulcers, in which the prevalence may reach 40%. These complications are one of the main causes of morbidity in diabetic patients. The objectives of this study were to investigate the prevalence and antimicrobial resistance of MRSA strains in infected diabetic foot ulcers and to characterize their genetic lineages. Samples collected from 42 type 2 diabetic patients, presenting infected foot ulcers, were seeded onto ORSAB plates with 2 mg/L of oxacillin for MRSA isolation. Susceptibility to 14 antimicrobial agents was tested by the Kirby-Bauer disk diffusion method. The presence of resistance genes, virulence factors, and the immune evasion cluster system was studied by PCR. All isolates were characterized by MLST, accessory gene regulator (agr), spa, and staphylococcal chromosomal cassette mec (SCCmec) typing. Twenty-five MRSA strains were isolated. All isolates showed resistance to penicillin and cefoxitin. Sixteen isolates showed phenotypic resistance to erythromycin being 7 co-resistant to clindamycin. Resistance to trimethoprim-sulfamethoxazole was found in 2 isolates harboring the dfrA and dfrG genes. The IEC genes were detected in 80% of isolates, 16 of which were ascribed to IEC-type B. Isolates were assigned to 12 different spa types. The MLST analysis grouped the isolates into 7 sequence types being the majority (68%) ascribed to SCCmec type IV. In this study, there was a high prevalence of the EMRSA-15 clone presenting multiple resistances in diabetic foot ulcers making these infections complicated to treat leading to a higher morbidity and mortality in diabetic patients.
- First report of linezolid-resistant cfr-positive methicillin-resistant Staphylococcus aureus in humans in PortugalPublication . Silva, Vanessa; Almeida, Francisco; Silva, Adriana; Correia, Susana; Carvalho, José António; Castro, Ana Paula; Ferreira, Eugénia; Manageiro, Vera; Caniça, Manuela; Igrejas, Gilberto; Poeta, PatríciaLinezolid and vancomycin are the most reliable therapeutic agents to treat complicated soft tissue infections caused by multidrug-resistant methicillin-resistant Staphylococcus aureus (MRSA) strains. However, despite the fact that the prevalence of linezolid-resistant MRSA strains (LR-MRSA) remains overall low, in the past few years resistance to linezolid has been reported among human patients worldwide, imposing a public-health concern, in particular when associated with a mobile gene such as cfr [1]. The aim of this study was to identify LR-MRSA isolates recovered from infected diabetic foot ulcers and to characterise their antimicrobial resistance profiles and genetic lineage. (...)