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Unseen but unforgettable: refractive bacilli in the gram stain of a muscular ab...
Carvalho, Bruno; Velho Meirinhos, Sara; Jantarada Domingos, Gonçalo; Peixoto, Sara; Cristino, José MeloThe epidemiology of tuberculosis has been altered due to the increased use of immunosuppressive therapies (chemotherapy and biologic agents), the human immunodeficiency virus (HIV) epidemic, and the changing migration patterns. Extrapulmonary tuberculosis occurs most often in individuals with HIV infection. Osteoarticular tuberculosis is rare in Western countries, with its diagnosis being performed through cult...
Extensively drug-resistant Pseudomonas aeruginosa: clinical features and treatm...
Pedro, Diogo; Paulo, Sérgio; Mimoso Santos, Carla; Fonseca, Ana Bruschy; Cristino, José Melo; Ayres Pereira, Álvaro; Caneiras, CatiaIntroduction: 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...
Sustained increase of paediatric invasive Streptococcus pyogenes infections dom...
Gouveia, Catarina; Bajanca-Lavado, Maria Paula; Mamede, Rafael; Araújo Carvalho, Ana; Rodrigues, Fernanda; Cristino, José Melo; Ramirez, MárioSince autumn 2022, observed numbers of paediatric invasive group A Streptococcus infections in Portugal (n = 89) were higher than in pre-COVID-19 seasons. Between September 2022 and May 2023, the dominant diagnoses were pneumonia (25/79), mostly with empyema (20/25), and sepsis (22/79). A number of cases required admission to intensive care (27/79) and surgery (35/79), and the case fatality rate was 5.1% (4/79)...
Genomic characterisation of a novel KPC-98-producing clinical Klebsiella pneumo...
Mendes, Gabriel; Santos, Maria Leonor; Ramalho, João Francisco; Bruschy-Fonseca, Ana; Lito, Luís; Pedro, Diogo; Duarte, Aida; Cristino, José MeloCeftazidime/avibactam (CZA) is a novel drug that inactivates Ambler class A, including Klebsiella pneumoniae carbapenemases (KPC), class C and class D β-lactamases, but is not active against metallo-β-lactamases (class B). Despite its limited use worldwide, emerging cases of CZA-resistant isolates producing variants of the blaKPC gene have been reported. In this study, we report a novel KPC-98 variant conferrin...
Crystalline inclusions in chronic lymphocytic leukemia
Barros Pinto, Marco P.; Carriço, Fátima; Cristino, José MeloCrystalline inclusions in lymphocytes are unusual in chronic lymphocytic leukemia. They represent crystallized immunoglobulin (most frequently IgM-lambda) and their recognition facilitates the diagnosis of a lymphoproliferative disorder.
Continued vaccine breakthrough cases of serotype 3 complicated pneumonia in vac...
Silva-Costa, Catarina; Silva, Joana; Pinho, Marcos Daniel; Friães, Ana; Ramirez, Mário; Cristino, José Melo; Oliveira, Laura Andrade deWe previously reported that despite the use of pneumococcal conjugate vaccines (PCVs), vaccine serotypes remained important causes of pneumonia with pleural effusion and empyema (pediatric complicated pneumococcal pneumonia [PCPP]). We cultured and performed PCR on 174 pleural fluid samples recovered from pediatric patients in Portugal from 2016 to 2019 to identify and serotype Streptococcus pneumoniae. Most PC...
First description of Ceftazidime/Avibactam resistance in an ST13 KPC-70-produci...
Mendes, Gabriel; Ramalho, João Francisco; Bruschy-Fonseca, Ana; Lito, Luís; Duarte, Aida; Cristino, José Melo; Caneiras, CatiaThe 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...
Cryptococcus neoformans in cerebrospinal fluid and blood
Barros Pinto, Marco P.; Cristino, José MeloCryptococcosis have a worldwide distribution and is responsible for wide range of clinical presentations (mainly pulmonary, central nervous system, skin and prostate infections, but bone, peritoneum and urinary system infections are sometimes described). Infection start primarily by inhalation of environmental basidiospores or poorly encapsulated yeast cells (with less than 5 μm), that can disseminate, after a ...
Whole-genome sequencing enables molecular characterization of non-clonal group ...
Mendes, Gabriel; Ramalho, João Francisco; Bruschy Fonseca, Ana; Lito, Luís; Duarte, Aida; Cristino, José Melo; Caneiras, CatiaThe carbapenem-resistant Enterobacterales (CRE) strains have been identified by the World Health Organization as critical priority pathogens in research and development of diagnostics, treatments, and vaccines. However, recent molecular information about carbapenem-resistant K. pneumoniae (CRK) epidemiology in Portugal is still scarce. Thus, this study aimed to provide the molecular epidemiology, resistome, and...
Characteristics of Streptococcus agalactiae colonizing nonpregnant adults suppo...
Martins, Elisabete R.; Nascimento do Ó, Dulce; Marques Costa, Ana Luísa; Cristino, José Melo; Ramirez, MárioThe prevalence and lineages of Streptococcus agalactiae (group B streptococci [GBS]) colonizing pregnant women are well studied, but less is known about colonization of nonpregnant adults. We characterized GBS colonization in adults as a potential reservoir for infections and tested for the presence of clones with a potentially higher invasive disease potential. We evaluated GBS gastrointestinal, genitourinary,...