Navegando por Autor "BARRETTO, Adriana Rodrigues"

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Acesso aberto (Open Access)
Clinical aspects in patients with pulmonary infection caused by mycobacteria of the Mycobacterium abscessus complex, in the Brazilian Amazon
(Sociedade Brasileira de Pneumologia e Tisiologia, 2018-04) MONTEIRO, José Tadeu Colares; LIMA, Karla Valéria Batista; BARRETTO, Adriana Rodrigues; FURLANETO, Ismari Perini; GONÇALVES, Glenda Moraes; COSTA, Ana Roberta Fusco da; LOPES, Maria Luiza; DALCOLMO, Margareth Pretti
Objective: To describe the clinical manifestations of patients with pulmonary infection caused by mycobacteria of the Mycobacterium abscessus complex (MABSC), and to compare these manifestations with those of patients infected with other nontuberculous mycobacteria (NTM). Methods: This was a retrospective cohort study involving 43 patients divided into two groups: the MABSC group, consisting of patients with pulmonary infection caused by MABSC (n = 17); and the NTM group, consisting of patients with pulmonary infection caused by NTM other than MABSC (n = 26). Patients were previously treated with a regimen of rifampin, isoniazid, pyrazinamide, and ethambutol before the diagnosis of NTM was confirmed by two culture-positive sputum samples. The nucleotide sequences of the hsp65, 16S rRNA, and/or rpoB genes were analyzed to identify the mycobacteria. Data were collected on demographic, clinical, and radiological characteristics, as well as on treatment responses and outcomes. Results: Loss of appetite was the only clinical manifestation that was significantly more common in the MABSC group than in the NTM group (p = 0.0306). The chance of having to use a second treatment regimen was almost 12 times higher in the MABSC group than in the NTM group. Treatment success was significantly higher in the NTM group than in the MABSC group (83.2% vs. 17.6%; p < 0.0001). The chance of recurrence was approximately 37 times higher in the MABSC group than in the NTM group. Conclusions: In the study sample, treatment response of pulmonary disease caused by MABSC was less favorable than that of pulmonary disease caused by other NTM.
Acesso aberto (Open Access)
Micobacteriose não tuberculosa pulmonar em hospital de referência no Estado do Pará: espécies mais frequentes, apresentação radiológica e evolução clínica
(Universidade Federal do Pará, 2013-12-27) BARRETTO, Adriana Rodrigues; YAMADA, Elizabeth Sumi; http://lattes.cnpq.br/7240314827308306; FELÍCIO, João Soares; http://lattes.cnpq.br/8482132737976863
The nontuberculous mycobacteria are present in environment and has been isolated from natural waters, soil, animals and water distribution systems. It’s characterized by the presence of mycolic acid in the cell wall. In general, the disease is acquired through inhalation of droplets containing mycobacteria. This disease can manifest itself in many ways as lymphadenitis, pulmonary, cutaneous and disseminated. They are opportunistic pathogens of variable pathogenicity. Immunity defects, local or systemic, are required to cause disease in humans. We evaluated epidemiological, clinical and radiological features of 44 cases with pulmonary nontuberculous mycobacteriosis at Hospital Universitário João de Barros Barreto. In addition, we treated and followed 21/44 (47,7%) patients during a period of six to seventeen months in a prospective cohort study. There was an increase more than 100% in the number of cases in 2010 when compared to previous years. The most frequently isolated mycobacterias were M. intracellulare (22.7%) and M. massiliense (20.5%). The conditions associated included previous treatment for tuberculosis (93.2%), bronchiectasis (59%), HIV (11.4%), asthma (9.1%) and chronic obstructive pulmonary disease (9.1%). In general, there were no differences between NTM groups in radiological aspects, but when we analyzed chest radiographs, we found atelectasis more frequently in M. massiliense group vs. M. abscessus group. When we considered mycobacterial cultures, there was a good treatment outcome. Negative, persistent positive and positive after an initial negative culture occurred in 58,8%, 11,7% and 11,7% of patients, respectively. During the follow-up period, the death rate was 17,7%. Our data suggest that of pulmonary nontuberculous mycobacteriosis has become a disease with increasing importance in our region. Additionally, the response to treatment performed in major hospital has been quite satisfactory when compared to literature. However, it is necessary to follow these patients for a longer period to determine the actual success rate of our therapeutic approach.