Browsing by Author "Pelerito, Ana"
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- Adaptation of Brucella melitensis Antimicrobial Susceptibility Testing to the ISO 20776 Standard and Validation of the MethodPublication . Tscherne, A.; Mantel, E.; Boskani, T.; Budniak, S.; Elschner, M.; Fasanella, A.; Feruglio, S.L.; Galante, D.; Giske, C.G.; Grunow, Roland; Henczko, Judit; Hinz, Christin; Iwaniak, Wojciech; Jacob, Daniela; Kedrak-Jablonska, Agnieszka; Jensen, Veronica K.; Johansen, Tone B.; Kahlmeter, Gunnar; Manzulli, Viviana; Matuschek, Erika; Melzer, Falk; Nuncio, Maria S.; Papaparaskevas, Joseph; Pelerito, Ana; Solheim, Margrete; Thomann, Susanne; Tsakris, Athanasios; Wahab, Tara; Weiner, Marcin; Zoeller, Lothar; Zange, Sabine; EMERGE AST Working GroupBrucellosis, mainly caused by Brucella (B.) melitensis, is associated with a risk of chronification and relapses. Antimicrobial susceptibility testing (AST) standards for B. melitensis are not available, and the agent is not yet listed in the EUCAST breakpoint tables. CLSI recommendations for B. melitensis exist, but they do not fulfill the requirements of the ISO 20776 standard regarding the culture medium and the incubation conditions. Under the third EU Health Programme, laboratories specializing in the diagnostics of highly pathogenic bacteria in their respective countries formed a working group within a Joint Action aiming to develop a suitable method for the AST of B. melitensis. Under the supervision of EUCAST representatives, this working group adapted the CLSI M45 document to the ISO 20776 standard after testing and validation. These adaptations included the comparison of various culture media, culture conditions and AST methods. A Standard Operation Procedure was derived and an interlaboratory validation was performed in order to evaluate the method. The results showed pros and cons for both of the two methods but also indicate that it is not necessary to abandon Mueller–Hinton without additives for the AST of B. melitensis.
- An Overview of Monkeypox Virus Detection in Different Clinical Samples and Analysis of Temporal Viral Load DynamicsPublication . Cordeiro, Rita; Pelerito, Ana; de Carvalho, Isabel Lopes; Lopo, Sílvia; Neves, Raquel; Rocha, Raquel; Palminha, Paula; Verdasca, Nuno; Palhinhas, Cláudia; Borrego, Maria José; Manita, Carla; Ferreira, Idalina; Bettencourt, Célia; Vieira, Patrícia; Silva, Sónia; Água-Doce, Ivone; Roque, Carla; Cordeiro, Dora; Brondani, Greice; Santos, João Almeida; Martins, Susana; Rodrigues, Irene; Ribeiro, Carlos; Núncio, Maria Sofia; Gomes, João Paulo; Batista, Fernando da ConceiçãoMpox is a zoonotic disease caused by the Monkeypox virus (MPXV), and since May 2022, tens of thousands of cases have been reported in non-endemic countries. We aimed to evaluate the suitability of different sample types for mpox diagnostic and assess the temporal dynamics of viral load. We evaluated 1914 samples from 953 laboratory-confirmed cases. The positivity rate was higher for lesion (91.3%) and rectal swabs (86.1%) when compared with oropharyngeal swabs (69.5%) and urines (41.2%), indicating higher viral loads for the former. Supporting this, lesion and rectal swabs showed lower median PCR C values (C = 23 and C = 24), compared to oropharyngeal swabs and urines (C = 31). Stable MPXV loads were observed in swabs from lesions up to 30 days after symptoms onset, contrasting with a considerable decrease in viral load in rectal and oropharyngeal swabs. Overall, these results point to lesion swabs as the most suitable samples for detecting MPXV in the 2022-2023 multicountry outbreak and show comparable accuracy to rectal swabs up to 8 days after symptoms onset. These findings, together with the observation that about 5% of patients were diagnosed through oropharyngeal swabs while having negative lesions, suggest that multisite testing should be performed to increase diagnostic sensitivity.
- Avaliação Externa da Qualidade (AEQ) em Segurança LaboratorialPublication . Cardoso, Ana; Rodrigues, Vitória; Pelerito, Ana; Lopes Carvalho, Isabel; Faria, Ana Paula1. Avaliação Externa da Qualidade (AEQ) em Segurança Laboratorial 2. Apresentações: A Importância da Higiene, Segurança e promoção da Saúde no Laboratório; Identificação e avaliação dos principais fatores de risco no Laboratório; Estratégia da prevenção; Instruções gerais de Segurança no laboratório; Medidas de proteção coletiva e individual; Principais acidentes no laboratório; Gestão de Resíduos; Gestão e Organização da Emergência; Procedimentos em caso de acidente; Avaliação e Gestão de risco; 3. Discussão
- Brucelose humana: análise retrospetiva de casos clínicos suspeitos de infeção entre 2002 e 2013Publication . Pelerito, Ana; Cordeiro, Rita; Matos, Rita; Santos, Maria Augusta; Soeiro, Sofia; Núncio, Sofia
- Burkholderia pseudomallei: first case of melioidosis in PortugalPublication . Pelerito, Ana; Nunes, Alexandra; Coelho, Susana; Piedade, Cátia; Paixão, Paulo; Cordeiro, Rita; Sampaio, Daniel A.; Vieira, Luís; Gomes, João Paulo; Núncio, M. SofiaBurkholderia pseudomallei is a Gram-negative bacillus and the causative agent of melioidosis, a serious infection associated with high mortality rate in humans. It can be naturally found as an environmental saprophyte in soil or stagnant water, and rice paddies that predominate in regions of endemicity such as Northeast Thailand. B. pseudomallei is a Biosafety Level 3 organism due to risks of aerosolization and severe disease and is now included in formal emergency preparedness plans and guidelines issued by various authorities in the United States and Europe. Here, we report the first case of imported melioidosis in Portugal. B. pseudomallei was isolated from the patient’s blood as well as from a left gluteal abscess pus. The isolate strain showed the unusual resistance profile to first-line eradication therapy trimethroprim/sulfamethoxazole. Whole genome sequencing revealed its similarity with isolates from Southeast Asia, suggesting the Thai origin of this Portuguese isolate, which is in agreement with a recent patient’s travel to Thailand.
- Burkholderia pseudomallei: primeiro caso de melioidose em PortugalPublication . Pelerito, Ana; Nunes, Alexandra; Coelho, Susana; Piedade, Cátia; Paixão, Paulo; Cordeiro, Rita; Sampaio, Daniel A.; Vieira, Luís; Gomes, João Paulo; Núncio, SofiaObjetivo: Este estudo apresenta o primeiro caso de melioidose em Portugal, revelando o importante papel da metodologia de Sequenciação Total do Genoma para a correta identificação e caracterização da estirpe isolada.
- Carbúnculo: uma doença rara em Portugal?Publication . Cordeiro, Rita; Pelerito, Ana; Núncio, Sofia
- Comparative complete scheme and booster effectiveness of COVID‐19 vaccines in preventing SARS‐CoV‐2 infections with SARS‐CoV‐2 Omicron (BA.1) and Delta (B.1.617.2) variants: A case–case study based on electronic health recordsPublication . Kislaya, Irina; Peralta‐Santos, André; Borges, Vítor; Vieira, Luís; Sousa, Carlos; Ferreira, Bibiana; Pelerito, Ana; Gomes, João Paulo; Leite, Pedro Pinto; Nunes, Baltazar; on behalf of PT COVID-19 groupBackground: Information on vaccine effectiveness in a context of novel variants of concern (VOC) emergence is of key importance to inform public health policies. This study aimed to estimate a measure of comparative vaccine effectiveness between Omicron (BA.1) and Delta (B.1.617.2 and sub-lineages) VOC according to vaccination exposure (primary or booster). Methods: We developed a case-case study using data on RT-PCR SARS-CoV-2-positive cases notified in Portugal during Weeks 49-51, 2021. To obtain measure of comparative vaccine effectiveness, we compared the odds of vaccination in Omicron cases versus Delta using logistic regression adjusted for age group, sex, region, week of diagnosis, and laboratory of origin. Results: Higher odds of vaccination were observed in cases infected by Omicron VOC compared with Delta VOC cases for both complete primary vaccination (odds ratio [OR] = 2.1; 95% confidence interval [CI]: 1.8 to 2.4) and booster dose (OR = 5.2; 95% CI: 3.1 to 8.8), equivalent to reduction of vaccine effectiveness from 44.7% and 92.8%, observed against infection with Delta, to -6.0% (95% CI: 29.2% to 12.7%) and 62.7% (95% CI: 35.7% to 77.9%), observed against infection with Omicron, for complete primary vaccination and booster dose, respectively. Conclusion: Consistent reduction in vaccine-induced protection against infection with Omicron was observed. Complete primary vaccination may not be protective against SARS-CoV-2 infection in regions where Omicron variant is dominant.
- Demographic and Clinical Characteristics of Mpox Patients Attending an STD Clinic in LisbonPublication . Cid Brito, Margarida; Nuncio, M.S.; Lopes de Carvalho, Isabel; Cordeiro, Rita; Pelerito, AnaMpox is a viral disease caused by the monkeypox virus, which marked the year of 2022 with a global outbreak. While previously considered to be a zoonosis of almost exclusive animal-to-human transmission, the current outbreak has been attributed to human-to-human transmission, particularly sexual transmission. As a new sexually transmissible disease, we studied the epidemiological and clinical features, as well as the concomitant occurrence of other sexually transmissible diseases, treatment approach, and outcome of our 291 patients, in the current outbreak. We found a total of 169 concomitant sexually transmissible infections of bacterial and viral origins, corresponding to 107 patients. Neisseria gonorrhoeae was the most common agent, particularly in the anal location. With this work, we emphasize the need for a thorough epidemiological and medical history, as well as a concomitant complete laboratorial screening for other STIs in patients with confirmed or suspected mpox.
- Detecting Biothreat Agents: the Portuguese National Reference Laboratory ResponsePublication . Pelerito, Ana; Cordeiro, Rita; Núncio, SofiaAt present, the threat of a biological terrorist event with a dangerous pathogen and its insidious impact are among the most, yet least understood, threats to civil society today. The use of manufactured weapon, such as bomb, will produce consequences limited in time hence the most of the damage occurs immediately. By contrast, the use of a biological weapon is an extended process whose scope and timing cannot be precisely controlled. Many biological agents could be used as biological weapons. The CDC bioterrorism list includes 45 biological agents that have been targeted as most likely to be used in bioterrorism attack. Of these, six have been designated as ‘‘high priority’’ agents: Bacillus anthracis, Yersinia pestis, Francisella tularensis, Brucella spp., botulinum toxin produced by Clostridium botulinum and Variola major virus. Beside the pathogenic impact, the use of these agents will likely produce widespread panic, which will quickly overwhelm local law enforcement, as well as providers of health care. Since the majority of these agents require an incubation period before disease becomes noticed, the terrorists often escape without notice. The Portuguese National Institute of Health (PNIH) is prepared to recognize and respond to a biological event, including bioterrorism, having responsibilities in the determination of the etiological agent’s and its susceptibility to antibiotics. In order to ensure quick and reliable results, a laboratory algorithm was developed, taking in account the human and technical resources available. This algorithm was tested within a framework of an external quality control scheme and the results obtained demonstrated that the performance of our lab is at the same level of other European reference labs, even if the human, technical and financial resources are quite different. The PNIH also have the responsibility to inform other health and criminal authorities whenever an unusual biological agent is detected. Therefore, the role of PNIH is essential, promoting a rapid laboratory response and contributing to risk communication between the several authorities with responsibilities in the establishment of preparedness plans and measures that will contribute to control and mitigate the effects of bioterrorism attack on public health.
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