http://hdl.handle.net/11422/25226 Thu, 30 Jul 2026 13:19:15 GMT 2026-07-30T13:19:15Z http://hdl.handle.net/11422/29525 Title: Perfil clínico e desfechos de pacientes colonizados por Staphylococcus aureus resistentes à meticilina (MRSA) em um hospital terciário do Rio de Janeiro Author(s)/Inventor(s): Bernardes, Juliana Lopes Advisor: Mendes, Isabel Cristina Melo Abstract: Introduction: Staphylococcus aureus is an important human pathogen capable of causing conditions ranging from superficial skin infections to severe invasive diseases such as bacteremia and endocarditis. The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has increased the clinical impact of this microorganism, becoming a significant public health concern associated with antimicrobial resistance. MRSA colonization constitutes an important reservoir for hospital transmission and is associated with a higher risk of subsequent invasive infections, especially among hospitalized patients with multiple comorbidities, immunosuppression, and exposure to invasive devices. Objective: To analyze the clinical profile, risk factors, and hospital outcomes of patients colonized with MRSA in a tertiary-level university hospital in Rio de Janeiro. Methods: A retrospective observational study was conducted using data from hospitalized patients between January and December 2024. A total of 162 adult patients with positive MRSA surveillance cultures were included. Clinical and demographic variables were collected from electronic medical records. Statistical analysis was performed using Excel and R software, applying Chi-square, Fisher’s exact, and Mann–Whitney tests to compare groups, considering a significance level of p < 0.05. Results: The sample (N=162) showed a predominance of females, 93/162 (57.4%), and a high prevalence6 immunosuppression 82/162 (50.6%), diabetes mellitus 66/162 (40.7%), and chronic kidney disease 26/162 (16.0%). During hospitalization, 44.4% of patients progressed to active infection and 45.1% received systemic antibiotic therapy. The overall mortality rate was 25.9%. Conclusion: MRSA colonization in the hospital setting represents an important marker of clinical vulnerability. The high frequency of infection and mortality in the cohort reinforce the need for integrated epidemiological surveillance strategies, adherence to infection prevention measures, and strengthening of antimicrobial stewardship programs. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/11422/29525 2025-01-01T00:00:00Z http://hdl.handle.net/11422/26170 Title: COVID-19 pediátrico: perfil epidemiológico, sintomático e performance de testes diagnósticos Author(s)/Inventor(s): Leitão, Isabela de Carvalho; Calzolari, Yasmin Cerqueira Advisor: Castiñeiras, Terezinha Marta Pereira Pinto Abstract: With the first cases of SARS-CoV-2 infection in December 2019 and its global spread, the scientific community quickly mobilized to research and produce studies aimed at understanding this previously unknown disease. Initially, the majority of those affected were adults, and academic efforts were directed towards this age group. However, as the pandemic progressed, an increase in paediatric COVID-19 cases was observed, including severe outcomes, with a rising trend in the percentage of Severe Acute Respiratory Syndrome (SARS) due to COVID-19 in children in Brazil. Despite this, studies on clinical presentation, outcomes, and diagnostic test performance in this population are still scarce. In this context, this study aims to describe the clinical manifestations of COVID-19 in individuals under 18 years of age, comparing them to the adult population, and to assess the performance of rapid antigen tests in diagnosing COVID-19 in this age group. This is a prospective observational cohort study conducted at the Centro de Triagem e Diagnóstico de COVID-19 at the Universidade Federal do Rio de Janeiro (CTD-UFRJ), analysing samples collected from August 2020 to November 2023. The cohort included 1,063 patients aged 0 to 18 years, representing 3.1% of the total number of individuals tested. Among children, the most prevalent symptoms were cough, runny nose, sneezing, and nasal congestion. Unlike adults, there was no association between COVID-19 diagnosis and the presence of cough, ageusia, chills, myalgia, or asthenia. However, in this age group, there was a positive association between headache and conjunctival congestion with a positive result, which was not seen in adults. Symptom distribution varied when comparing different paediatric age groups. Headache was positively associated with a COVID-19 diagnosis in those aged 6 to 12 years, while in those aged 13 to 18 years, fever and anosmia were positively associated, resembling the adult population. In the 0 to 5-year age group, no symptoms were positively associated with a COVID-19 diagnosis, and cough, nasal congestion, nausea, and vomiting were negatively associated. Regarding the comparison of viral load in respiratory samples, individuals under 18 had significantly lower values than adults, particularly those under 5 years of age. This lower viral load might correlate with poorer performance of antigen tests, as reported in the literature. However, it should be noted that test performance is associated with the type of sample collected, and no difference was found between adults and children when only nasal swabs were compared. In conclusion, clinical presentation in individuals under 18 differs from that in adults. Additionally, it varies within the paediatric population across different age groups, and symptoms, in general, have low predictive value for diagnosing COVID-19 in this population. Finally, the lower viral load detected in respiratory samples appears to be associated with the type of collection method (nasal vs nasopharyngeal) rather than the specific population. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização Mon, 01 Jan 2024 00:00:00 GMT http://hdl.handle.net/11422/26170 2024-01-01T00:00:00Z http://hdl.handle.net/11422/26169 Title: Perfil clínico e epidemiológico das infecções invasivas causadas por Candida spp. de um hospital terciário em 2023 Author(s)/Inventor(s): Baleta, Winnever Batista Advisor: Castiñeiras, Anna Carla Pinto Abstract: Candidemia has become an important cause of healthcare-associated infections (HAIs), being the fourth most isolated agent worldwide for bloodstream infections. Although Candida has been well-studied in immunocompromised patients due to hematological diseases or transplants, its role in critically ill surgical patients has been increasing. Materials and Methods: Twenty-five patients who were admitted from January 1 to December 31, 2023, to a tertiary hospital in Rio de Janeiro (HUCFF/UFRJ), Brazil, were included. A review of medical records was conducted for a period of 30 days or until clinical outcome (discharge or death). Episodes of candidemia were identified through microbiology laboratory records. Candidemia was defined as the first isolation of Candida spp. in a blood culture from a patient showing signs of infection. Results: Candidemia manifestations mainly occurred in elderly patients, those requiring intensive therapy support or were using central venous catheters (CVC). Only 5 transplanted patients were included, of which only 1 was hematological. The main isolates were C. albicans (32%; n=8), C. glabrata (12%; n=3), and C. tropicalis (8%; n=2). The 30-day mortality rate was 64%. Conclusion: The patients most affected by candidemia were those requiring intensive therapy, using CVC, and elderly patients. Patients in tertiary hospitals present high complexity, often having multiple comorbidities and risk factors for candidemia, which may contribute to the high mortality observed in the study. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização Mon, 01 Jan 2024 00:00:00 GMT http://hdl.handle.net/11422/26169 2024-01-01T00:00:00Z http://hdl.handle.net/11422/26168 Title: Tuberculose em pacientes submetidos a transplante renal: série de casos do HUCFF Author(s)/Inventor(s): Khalil, Lucas Chiarella Advisor: Lopes, Guilherme Santoro Abstract: Introduction: The objective of this study was to analyze the prognosis of tuberculosis (TB) in renal transplant patients, considering TB treatment outcomes and the occurrence of graft dysfunction. Methods: This was a retrospective descriptive case series study including patients who underwent renal transplantation at the Clementino Fraga Filho University Hospital between 1989 and 2012, with a microbiological diagnosis of TB. Data collected from physical and electronic medical records included demographic variables, transplant characteristics, immunosuppression regimens, TB diagnosis, treatment, and case progression. Results: Among the patients included in the study (n=14), the majority were male (n=10/14, 71.4%). The incidence of TB was predominantly observed in the first-year post-transplant, with clinical manifestations including fever, cough, and significant weight loss. Complications such as graft dysfunction and mortality were reported, with extrapulmonary and disseminated TB being frequent due to immunosuppression. Clinical and microbiological cure was achieved in eleven (78.6%) patients, clinical cure in two (14.3%), with one death (7.1%) attributed to TB. Three (21.4%) patients followed in the study returned to dialysis. Conclusions: The study concludes that TB in renal transplant patients represents a significant challenge, with high morbidity and a numerically higher risk of death compared to TB cases in immunocompetent individuals. The analysis underscores the need for screening and prevention strategies for latent TB in transplant candidates. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização Mon, 01 Jan 2024 00:00:00 GMT http://hdl.handle.net/11422/26168 2024-01-01T00:00:00Z