Percorrer por autor "Rodrigues, Paulo"
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- Aspergillus fumigatus - úlcera cutânea e osteomielite crónica em doente imunocompetentePublication . Tavares, Raquel; Silva, Ana Rita; Oliveira, Isménia; Calha, Jaime; Pereira, Patrícia; Galvão, Isabel; Sabino, Raquel; Veríssimo, Cristina; Rodrigues, PauloOs casos de osteomielite por Aspergillus são pouco frequentes e quando ocorrem, podem dever-se a contiguidade, disseminação hematogénea, traumatismo ou procedimentos cirúrgicos Os autores reportam um caso de ulceração cutânea extensa com dois anos de evolução e consequente atingimento ósseo, secundária a A. fumigatus, de difícil diagnóstico e tratamento, num homem imunocompetente, natural de São Tomé e Príncipe, previamente saudável (à excepção de hepatite B crónica), sem história de traumatismo grave ou intervenção cirúrgica. A identificação do agente foi efetuada por detecção molecular de DNA fúngico na biópsia óssea.
- Draft Genome Sequence of the First NDM-1-ProducingProvidencia stuartiiStrain Isolated in PortugalPublication . Manageiro, Vera; Sampaio, Daniel A.; Pereira, Patrícia; Rodrigues, Paulo; Vieira, Luís; Palos, Carlos; Caniça, ManuelaWe report here the draft genome sequence of the first NDM-1-producing Providencia stuartii strain isolated in Portugal. Sequence analyses revealed the presence of an incompatibility group A/C2 (IncA/C2) plasmid and of diverse acquired genes conferring resistance to β-lactams, aminoglycosides, tetracycline, macrolides, chloramphenicol, and sulfonamides. This sequence contributes to the evaluation of the spread of NDM-1 producers.
- Madeira 2010 – Aftermath of flashfloods and mudslides on bathing water quality indicators and on sand microbial levelsPublication . Romão, Daniela; Abreu, Roberto; Calado, Graça; Freitas, Fabíola; Rodrigues, Paulo; Ferreira, Carmen; Campos, Ana; Temtem, Rita; Freitas, Conceição; Andrade, César; Prada, Susana; Figueira, Celso; Brandão, JoãoRecent and past studies indicate that infectious disease outbreaks often take place after extreme weather events, as microbes, vectors and reservoir animal hosts are able to exploit the disrupted environmental conditions (1). Beaches, due to their proximity to oceans and cities, are often setting of such events affecting microbial communities, both in sand and bathing water (1 and 2). On 20th of February 2010, a series of storms, caused by an active cold front combined with Atlantic low-pressure and temperature differences of the sea surface across the Atlantic Ocean with unusually warm waters from West Africa, affected several countries, such as Portugal, Spain, Morocco and the Canary Islands, causing flooding, rain and strong winds. Madeira, an island with different types of beaches within a small coastline was severely affected. Between 6 a.m. and 11 a.m., 108 mm of rain were recorded at Funchal weather station and 165 mm at Pico do Areeiro (1818m of altitude). The entire February’s month average rainfall in Funchal is 88.0 mm. The South of the island was severely affected by flashfloods, originating mudslides that tore down everything along the way. The degree of devastation was highly substantial and costly, both in lives and economically. The areas affected the most were Funchal, Ribeira Brava, Câmara de Lobos and Santa Cruz. The impact of this event in microbiological communities caused a notorious peak of Enterococcus spp., E. coli and sporulating fungi, both in sand and water until September of the same year. Bathing water and sand quality monitoring months later revealed thus that both water and sand profiles were profoundly altered for months to follow. Contaminated sand is a known source of coastal water pollution, due to tides in the swash zone and run-offs. Our analysis shows the disruptive effect of the storm on beach sand quality, as published in 2016 (2), combined with a comparison of the subsequent expected effect on bathing waters for the island of Madeira for 2010 and 2011
- NDM-1-producing Providencia stuartii isolates in a Portuguese HospitalPublication . Manageiro, Vera; Ferreira, Eugénia; Rodrigues, João; Sampaio, Daniel A; Vieira, Luís; Pereira, Patrícia; Rodrigues, Paulo; Palos, Carlos; Caniça, ManuelaObjective: Providencia stuartii is an opportunistic pathogen typically associated with urinary infections, and is intrinsically resistance to a wide range of antibiotics. The main aim of this study was to characterize five carbapenemase (CA) NDM-1-producing P. stuartii isolates obtained during an outbreak detected in a Hospital. Methods: MICs were obtained by the reference microdilution broth method, according to EUCAST guidelines. PCR amplification and DNA sequencing were applied to identify the presence of CA genes from class A, B and D. Direct transfer of the CA resistance phenotype was attempted by mating-out assays. Genetic relatedness was examined by PFGE. One isolate, INSRA21868, recovered from the urine of an 88-year-old male patient admitted to the intensive care unit, was selected for genetic characterization using whole-genome sequencing (WGS), performed using 150 bp paired-end reads on a MiSeq (Illumina). A set of bioinformatic web tools were used to estimate the presence of pathogenicity determinants, antibiotic resistance (AR) genes, and clinically relevant mobile genetic elements. Results: All isolates, genetically indistinguishable by PFGE, presented multidrug-resistance with non-susceptibility to all carbapenems tested. Transconjugants had AR profiles similar to those of their parental clinical isolates. All NDM-1 determinants tested were found to be carried on conjugative plasmids. In silico AR analyses using ResFinder-v2.1 revealed genes conferring resistance to β-lactams [blaNDM-1, blaCMY-4 and ΔblaDHA-1), aminoglycosides (aac(2’)-Ia, armA), tetracycline (tetB), macrolides (mphE and msrE), chloramphenicol (catB3), and sulfonamides (sul1). PlasmidFinder-v1.2 analyses revealed the presence of an IncA/C2, which has been associated with wide dissemination of blaNDM-1. In the 3’ region, the blaNDM-1 gene was adjacent to a bleomycin resistance-encoding gene (bleMBL), followed by a trpF and part of the blaDHA-1-ampR region. The ISAba125 element upstream of blaNDM-1 was interrupted by an IS26 element. Conclusion: This study emphasizes the elements involved in dissemination of nosocomial infections and the potential of WGS in epidemiological investigations in the prevention of CA dissemination among hospitals as well as to other bacterial genera.
- NDM-producing Enterobacteriaceae responsible for environmental contamination of internal medicine wards in a Portuguese HospitalPublication . Manageiro, Vera; Ferreira, Eugénia; Romão, Raquel; Rodrigues, João; Pereira, Patrícia; Cano, Manuela; Rodrigues, Paulo; Palos, Carlos; Caniça, ManuelaObjective: The hospital environment plays a role in the cross-transmission of multidrug-resistant bacteria. The aim of this study was to identify potential carbapenemase-producing Enterobacteriaceae (CPE) reservoirs that might be responsible for a NDM-1 outbreak at a hospital in Portugal. Methods: An environmental investigation was instituted in a Portuguese hospital, after the occurrence of NDM-1-producing Providencia stuartii in five patients characterized by whole-genome sequencing. CPE screening was performed in critical infection sites of internal medicine wards and intensive care units where the patients stayed during hospitalization, by using MacConkey agar supplemented with ertapenem. Air samples were also obtained for the same locations. Antimicrobial susceptibility was determined by the disk diffusion method according to EUCAST guidelines. PCR and sequencing were applied to detect and identify carbapenemase-encoding genes. PCR-based replicon typing was used to characterize the plasmids. The genetic relationship between CPE was evaluated by PFGE. Results: Sixty-three Gram-negative isolates (Acinetobacter baumannii, Burkholderia cepacia, Klebsiella pneumoniae, Providentia stuartii and Pseudomonas spp.) were obtained from the 91 surface samples collected. A total of 17 NDM-1-producers were found: 9 K. pneumoniae and 8 P. stuartii in flush handles, bathroom door handles, dinamap monitors and/or hygiene cars from internal medicine wards. No CPE were obtained from air samples. The five NDM-1-producing P. stuartii clinical strains obtained during the outbreak were all genetically indistinguishable from those collected in the hospital environment. Regarding NDM-1-producing K. pneumoniae, no clinical cases were described. However, PFGE analysis identified two clusters, one of them indistinguishable, consisting of 7 NDM-1-K. pneumoniae producers and 7 K. pneumoniae non-CPE. PCR-based replicon typing revealed the presence of the same plasmid type among NDM-1-producers, suggesting horizontal transfer within the hospital surfaces. Conclusion: These results showed the importance of the hospital environment as a potential reservoir and source of CPE. This study also emphasizes the need of early environmental screening to interrupt the transmission of CPE.