Browsing by Author "Gorgulho, A"
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- Carbapenemase-producing Enterobacteriaceae in a Portuguese hospital – a five-year retrospective studyPublication . Gorgulho, A; Grilo, AM; Figueiredo, M; Selada, JBackground: Our hospital experienced an outbreak of OXA-48-producing Enterobacteriaceae, triggering this study. We aimed to describe the population with carbapenemase-producing Enterobacteriaceae (CPE) in our hospital from 2014 to 2018, the phenotypic and genotypic characteristics of isolates, and strategies to stop the outbreak. Methods: We performed a retrospective study, including every patient with CPE species in a clinical sample. Epidemiology, risk factors, treatment and outcomes were gathered from medical records. Results: A total 113 patients were included, ranging from 5 in 2015 to 83 in 2018. In 2018 the number of CPE went from 4 in May to 20 in July. With the implemented measures, propagation stopped. Implantable devices were present in 36% of patients and open wounds in 34%. Antibiotics had been prescribed to 71% of patients in the prior 30 days and most of the patients had been hospitalized for more than 5 days prior to sample collection or had a hospital stay in the previous year.Klebsiella pneumoniae was the most common species (87%). OXA-48 (62%) and Klebsiella pneumoniae-carbapenemase (KPC) (15%) were the most common carbapenemases, with OXA-48 being implicated in the 2018 outbreak. The case fatality rate at 30 days was 32%. Combination therapy resulted in less mortality. Conclusions: While KPC is the most common carbapenemase in Europe and Portugal, we experienced an important OXA-48 outbreak. Surveillance should be in place as these isolates are probably spreading. Effective communication, multidisciplinary team work and proper infection control measures are some of the best strategies during outbreaks.
- Catheter-associated urinary tract infection in medical patients of a Portuguese hospital: incidence and risk factorsPublication . Lobão, MJ; Taborda, AL; Grilo, A; Sepúlveda, C; Taborda, F; Castro, J; Gorgulho, A; Sousa, P
- Cutaneous Manifestations in Four Patients with COVID-19Publication . Grilo, AM; Ramos, MD; Taborda, F; Nabais, I; Antunes, AP; Andrade, MM; Gorgulho, AAs the numbers of SARS-CoV-2 infections increased globally, reports of cutaneous manifestations started to emerge. We describe several patients with COVID-19 who presented with skin changes. We noted such manifestations in four out of 110 patients (3.63%) and describe the clinical situation of each of these patients. Each patient had either a maculopapular or a urticariform rash. These manifestations have a broad differential diagnosis and it was difficult to exclude drug reactions. We hope to raise awareness of this possible manifestation of COVID-19 in order to raise suspicion of this diagnosis among clinicians when they encounter patients with fever and rash. Larger series that also include patients with mild disease and skin biopsies may be useful.
- Cutaneous Manifestations in Four Patients with COVID-19Publication . Gorgulho, A; Andrade, MM; Antunes, AP; Nabais, I; Taborda, F; Dias Ramos, M; Grilo, AMAs the numbers of SARS-CoV-2 infections increased globally, reports of cutaneous manifestations started to emerge. We describe several patients with COVID-19 who presented with skin changes. We noted such manifestations in four out of 110 patients (3.63%) and describe the clinical situation of each of these patients. Each patient had either a maculopapular or a urticariform rash. These manifestations have a broad differential diagnosis and it was difficult to exclude drug reactions. We hope to raise awareness of this possible manifestation of COVID-19 in order to raise suspicion of this diagnosis among clinicians when they encounter patients with fever and rash. Larger series that also include patients with mild disease and skin biopsies may be useful.
- Emergency department contribution to HCV elimination in the Iberian PeninsulaPublication . Buti, M; Vaz-Pinto, I; Magno Pereira, V; Casado, M; Llaneras, J; Barreira, A; Esteves, C; Guimarães, M; Gorgulho, A; Mourão, T; Xavier, E; Jasmins, L; Reis, AP; Faria, N; Freitas, B; Andrade, G; Camelo-Castillo, A; Rodríguez-Maresca, MÁ; Carrodeguas, A; Medina, D; Esteban, RBackground: Undiagnosed cases of hepatitis C virus (HCV) infection result in significant morbidity and mortality, further transmission, and increased public health costs. Testing in emergency departments (EDs) is an opportunity to expand HCV screening. The goal of this project was to increase the proportion of eligible patients screened for HCV in urban areas. Methods: An opportunistic automated HCV screening program was implemented in the EDs of 4 public hospitals in Spain and Portugal at different periods between 2018 and 2023. HCV prevalence was prospectively evaluated, and single-step or reflex testing was used for confirmation in the same sample. Results: More than 90% of the population eligible for testing were screened in the participating centers. We found HCV antibody seroprevalence rates ranging from 0.6 to 3.9%, with between 19 and 53% of viremic individuals. Conclusions: Opportunistic HCV screening in EDs is feasible, does not disrupt ED activities, is highly effective in increasing diagnosis, and contributes to WHO's HCV elimination goals.
- The use of technology and information systems in a quality improvement project developed in a Portuguese Internal Medicine Department: innovative ideas from RITUAL projectPublication . Lobão, MJ; Carvalho, J; Antunes, C; Adão e Silva, A; Grilo, A; Raposo, AF; Torres, R; Lourenço, F; Gorgulho, A; Sousa, P; RITUAL Team
- The use of technology and information systems in a quality improvement project developed in a Portuguese Internal Medicine Department: innovative ideas from RITUAL projectPublication . Lobão, MJ; Carvalho, J; Antunes, C; Adão e Silva, A; Grilo, A; Raposo, AF; Torres, R; Lourenço, P; Taborda, F; Gorgulho, A; Sousa, P; RITUAL Team