Percorrer por autor "Caneiras, Cátia"
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- Bridging generations through integrative learning, research, and community care : The ESPIEM ProjectPublication . Auxtero, Maria Deolinda; Costa, Isabel Margarida; Brito, José; Figueiredo, Alexandra; Ascenso, Carla; Miranda, Margarida; Caneiras, Cátia; Fernandes, Ana IsabelCommunication abstract presented at the EAFP Annual Conference 2025 – “Pharmaceutical Education & Research: SWOT Analysis”. Faculty of Pharmacy, University of Coimbra, 13th-15th of May 2025
- Bridging generations through integrative learning, research, and community care : the ESPIEM projectPublication . Auxtero, Maria Deolinda; Costa, Isabel Margarida; Brito, José; Figueiredo, Alexandra; Ascenso, Carla; Miranda, Margarida; Caneiras, Cátia; Fernandes, Ana IsabelCommunication presented at the EAFP - Annual Conference 2025 "Pharmaceutical Education and Research: SWOT Analysis." Coimbra, Portugal, 13-15 May 2025
- Effectiveness and use of home high flow nasal cannula in Portugal : where are we?Publication . Jácome, Cristina; Duarte, Mónica; Winck, João Carlos; Lobato, Salvador Díaz; Caneiras, Cátia
- Effectiveness, adherence and safety of home high flow nasal cannula in chronic respiratory disease and respiratory insufficiency : a systematic reviewPublication . Jácome, Cristina; Jácome, Marta; Correia, Sara; Flores, Inês; Farinha, Patrícia; Duarte, Mónica; Winck, João Carlos; Catalan, Javier Sayas; Lobato, Salvador Díaz; Luján, Manel; Caneiras, CátiaIntroduction: The effectiveness of home high flow nasal cannula (HFNC) for the treatment of chronic respiratory failure in patients with chronic respiratory diseases (CRDs) has not been summarized. We aimed to conduct a systematic review of the effectiveness, adherence, and safety of HFNC in the long-term treatment of patients with chronic respiratory diseases and respiratory failure. Methods: A systematic review was conducted. PubMed, Web of science, and SCOPUS were search up to August 2023. Long-term HFNC studies (≥4 weeks) reporting dyspnea; exacerbations, hospitalizations; peripheral oxygen saturation (SpO2), comfort; patient experience, health-related quality of life or partial pressure of carbon dioxide (paCO2) were included. Results: Thirteen articles (701 patients) based on 10 studies were selected: randomized control trials (n = 3), randomized crossover trials (n = 2), crossover (n = 3) and retrospective (n = 2) studies. COPD (n = 6), bronchiectasis (n = 2), COPD/bronchiectasis (n = 1) and ILD (n = 1) were the underlined CRDs. HFNC reduced exacerbations when compared to usual care/home respiratory therapies (n = 6). Quality of life outcomes were also in favor of HFNC in patients with COPD and bronchiectasis (n = 6). HFNC had significant effects on hospitalizations, paCO2, and lung function. Adherence ranged from 5.2 to 8.6 h/day (n = 5). Three studies reported no events, 3 non-serious events and 2 no differences compared with other home respiratory therapies. Conclusions: HFNC seems more effective than usual care or other home respiratory therapies in reducing exacerbations and improving quality of life in patients with COPD and bronchiectasis, while presenting good adherence and being safe. Its apparently superior effectiveness needs to be better studied in future real-world pragmatic trials.
- Enterobacter roggenkampii producing KPC-3 collected from a hospital sink drain in Portugal during the COVID-19 pandemicPublication . Mendes, Gabriel; Santos, Maria Leonor; Ramalho, João F.; Duarte, Aida; Pedrosa, Adriana; Silva, Ana Cristina; Méndez, Lucía; Caneiras, CátiaLetter to the Editor
- Extensively drug-resistant Pseudomonas aeruginosa: clinical features and treatment with ceftazidime/avibactam and ceftolozane/tazobactam in a tertiary care university hospital center in Portugal : a cross-sectional and retrospective observational studyPublication . Pedro, Diogo Mendes; Paulo, Sérgio Eduardo; Santos, Carla Mimoso; Fonseca, Ana Bruschy; Cristino, José Melo; Pereira, Álvaro Ayres; Caneiras, CátiaIntroduction: Extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) is a growing concern due to its increasing incidence, limited therapeutic options, limited data on the optimal treatment, and high mortality rates. The study aimed to characterize the population, the outcome and the microbiological characteristics of XDR-PA identified in a Portuguese university hospital center. Methods: All XDR-PA isolates between January 2019 and December 2021 were identified. XDR-PA was defined as resistance to piperacillin-tazobactam, third and fourth generation cephalosporins, carbapenems, aminoglycosides and fluoroquinolones. A retrospective analysis of the medical records was performed. Results: One hundred seventy-eight individual episodes among 130 patients with XDR-PA detection were identified. The most common sources of infection were respiratory (32%) and urinary tracts (30%), although skin and soft tissue infections (18%) and primary bacteremia (14%) were also prevalent. Colonization was admitted in 64 cases. Several patients had risk factors for complicated infections, most notably immunosuppression, structural lung abnormalities, major surgery, hemodialysis or foreign intravascular or urinary devices. XDR-PA identification was more frequent in male patients with an average age of 64.3 ± 17.5 years. One non-susceptibility to colistin was reported. Only 12.4% were susceptible to aztreonam. Ceftazidime-avibactam (CZA) was susceptible in 71.5% of the tested isolates. Ceftolozane-tazobactam (C/T) was susceptible in 77.5% of the tested isolates. Antibiotic regimens with XDR-PA coverage were reserved for patients with declared infection, except to cystic fibrosis. The most frequently administered antibiotics were colistin (41 cases), CZA (39 cases), and C/T (16 cases). When combination therapy was used, CZA plus colistin was preferred. The global mortality rate among infected patients was 35.1%, significantly higher in those with hematologic malignancy (50.0%, p < 0.05), followed by the ones with bacteremia (44.4%, p < 0.05) and those medicated with colistin (39.0%, p < 0.05), especially the ones with respiratory infections (60.0%). Among patients treated with CZA or C/T, the mortality rate seemed to be lower. Discussion: XDR-PA infections can be severe and difficult to treat, with a high mortality rate. Even though colistin seems to be a viable option, it is likely less safe and efficient than CZA and C/T. To the best of the authors’ knowledge, this is the first description of the clinical infection characteristics and treatment of XDR-PA in Portugal.
- First description of Ceftazidime/Avibactam resistance in a ST13 KPC-70-producing Klebsiella pneumoniae strain from PortugalPublication . Mendes, Gabriel; Ramalho, João F.; Bruschy-Fonseca, Ana; Lito, Luís; Duarte, Aida; Melo-Cristino, José; Caneiras, CátiaThe combination of ceftazidime/avibactam (CZA) is a novel β-lactam/β-lactamase inhibitor with activity against Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacterales. Emerging cases caused by CZA-resistant strains that produce variants of KPC genes have already been reported worldwide. However, to the best of our knowledge, no CZA-resistant strains were reported in Portugal. In September 2019, a K. pneumoniae CZA-resistant strain was collected from ascitic fluid at a surgery ward of a tertiary University Hospital Center in Lisboa, Portugal. The strain was resistant to ceftazidime/avibactam, as well as to ceftazidime, cefoxitin, gentamicin, amoxicillin/clavulanic acid, and ertapenem, being susceptible to imipenem and tigecycline. A hypermucoviscosity phenotype was confirmed by string test. Whole-genome sequencing (WGS) analysis revealed the presence of an ST13 KPC70-producing K. pneumoniae, a KPC-3 variant, differing in two amino-acid substitutions (D179Y and T263A). The D179Y mutation in the KPC Ω-loop region is the most common amino-acid substitution in KPC-2 and KPC-3, further leading to CZA resistance. The second mutation causes a KPC-70 variant in which threonine replaces alanine (T263A). The CZA-resistant strain showed the capsular locus KL3 and antigen locus O1v2. Other important virulence factors were identified: fimbrial adhesins type 1 and type 3, as well as the cluster of iron uptake systems aerobactin, enterobactin, salmochelin, and yersiniabactin included in integrative conjugative element 10 (ICEKp10) with the genotoxin colibactin cluster. Herein, we report the molecular characterization of the first hypervirulent CZA-resistant ST13 KPC-70-producing K. pneumoniae strain in Portugal. The emergence of CZA-resistant strains might pose a serious threat to public health and suggests an urgent need for enhanced clinical awareness and epidemiologic surveillance.
- First outbreak of NDM-1-producing Klebsiella pneumoniae ST11 in a Portuguese hospital centre during the COVID-19 pandemicPublication . Mendes, Gabriel; Ramalho, João F.; Duarte, Aida; Pedrosa, Adriana; Silva, Ana Cristina; Méndez, Lucía; Caneiras, CátiaNew Delhi metallo-β-lactamase (NDM) carbapenemase has been considered a global threat due to its worldwide widespread in recent years. In Portugal, a very low number of infections with NDM-producing Enterobacterales has been reported. A total of 52 strains from 40 patients and 1 environmental sample isolated during COVID-19 pandemic were included in this study. Wholegenome sequencing (WGS) was performed on 20 carbapenemase-producing strains, including 17 NDM-1-producing Klebsiella pneumoniae ST11-KL105 lineage strains, one NDM-1-producing Escherichia coli ST58 strain and one KPC-3-producing K. pneumoniae ST147 strain, recovered from a total of 19 patients. Of interest, also one NDM-1-producing K. pneumoniae ST11-KL105 was collected from the hospital environment. Genome-wide phylogenetic analysis revealed an ongoing dissemination of NDM-1-producing K. pneumoniae ST11 strains (n = 18) with the same genetic features seen across multiple wards. Furthermore, the ST58 E. coli strain, collected from a patient rectal swab that was also colonised with a K. pneumoniae strain, also showed the IncFIA plasmid replicon and the blaNDM-1 gene (preceded by IS30 and followed by genes bleMBL, trpF, dsbC, cutA, groES and groEL). The blaNDM-1 is part of Tn125-like identical to those reported in Poland, Italy and India. The blaKPC-3 K. pneumoniae ST147-KL64 strain has the genetic environment Tn4401d isoform. In conclusion, herein we report the molecular epidemiology, resistome, virulome and mobilome of the first NDM-1 carbapenemase outbreak caused by K. pneumoniae ST11-KL105 lineage during the COVID-19 pandemic in Portugal. Moreover, the outbreak strains characterised included seventeen different patients (infected and colonised) and one environmental sample which also emphasises the role of commensal and hospital environment strains in the dissemination of the outbreak.
- Fungal DNA-barcoding on a chip : magnetoresistive biosensors for yeast infection diagnosisPublication . Zolotareva, Maria; Cascalheira, Francisco; Afonso, Rúben; Corado, Maria; Martins, Ana; Caneiras, Cátia; Bárbara, Cristina; Teixeira, Miguel Cacho; Caetano, Diogo MiguelThe worldwide burden of fungal infection has been increasing due to the expansion of the endemic borders, the host range of certain mycosis, and the emergence of novel opportunistic, drug and multi-drug-resistant fungal pathogens. Many deaths can be attributed to slow, inaccurate, or absent diagnostic testing and a lack of timely administration of effective antifungal treatment. Panfungal PCR followed by sequence identification has the practical advantage of rapidly and accurately detecting slow-growing, unculturable and even rare, unexpected or novel pathogens. We have developed and tested a robust and flexible biosensing diagnostic strategy, consisting of panfungal rDNA amplification, DNA hybridization, and magnetic labeling on a portable microfluidic setup. We designed DNA-capture probes specific for Candida albicans, Candida auris, Nakaseomyces glabratus, and Cryptococcus neoformans, and evaluated them for diagnostic sensitivity and specificity assessment, first in silico against a dataset of 58 pathogenic species (1239 DNA sequences), and then in vitro against the four species and 30 unsequenced clinical isolates of N. glabratus. On-chip, our assay performed with 95% accuracy, 91% sensitivity, and 98% specificity under a limit of detection of 600 single-stranded amplified ITS DNA sequences. Our results demonstrate the diagnostic value of DNA-barcoding and magnetoresistive biosensing, emphasizing the revolutionizing potential of DNA-sequence-based technologies in clinical practice.
- Genome-wide analysis and longitudinal study of Klebsiella pneumoniae in Portugal : tracing the evolution and spread of carbapenem resistancePublication . Elias, Rita; Phelan, Jody E.; Lito, Luís; Caneiras, Cátia; Marques, Cátia; Pinto, Margarida; Cavaco-Silva, Patrícia; Ferreira, Helena; Pomba, Constança; Silva, Gabriela J. da; Saavedra, Maria José; Coelho, Rosário; Lourinho, Rita; Gonçalves, Luísa; Hinthong, Woranich; Rosa, Maria João; Melo-Cristino, José; Campino, Susana; Portugal, Isabel; Duarte, Aida; Perdigão, JoãoBackground: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has high incidence in Portugal, causing severe and often fatal infections. Objectives: Characterize the evolutionary history and epidemiology of CRKP in Portugal over a 40-year period. Methods: WGS was performed using the Illumina platform. In silico multilocus sequence typing, surface antigen characterization, and resistance gene detection were subsequently carried out. Core and pan-genome analyses were conducted using Roary. Genomic clusters (GCs) were identified based on a 21-SNP threshold. To estimate the divergence times of the most prevalent sequence types (ST) in the dataset, Bayesian evolutionary analysis was performed using BEAST. Results: Nineteen GCs harboring carbapenemases were identified. The blaKPC-3 gene was the most prevalent carbapenemase, linked to strains circulating in both hospital and community settings, with dissemination patterns at regional, interregional, and international levels. ST15 was the most established sequence type in Portugal, with nine distinct GCs identified in both clinical and environmental samples. Towards the end of 2010s, ST147 and ST13 were responsible for significant outbreaks associated with blaKPC-3. Conclusions: This study underscores the value of genomic-based surveillance in understanding the evolution of high-risk clones coupled with the spread of AMR determinants. The data obtained highlights a shift in ST predominance across the country from an ST15-dominated period and strongly associated with ESBL dissemination, to the emergence of ST147 and ST13 CRKP clones, the latter associated with international transmission. This work further stresses the importance of cross-border surveillance efforts to monitor the emergence and dissemination of CRKP strains and inform risk assessment and prevention.
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