Browsing by Author "Pereira, Lucas Borges"

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    Antimicrobial stewardship for surgical antibiotic prophylaxis and surgical site infections : a systematic review.
    (2021) Martinez Sobalvarro, Joselin Valeska; Pereira Júnior, Antônio Alves; Pereira, Lucas Borges; Baldoni, André Oliveira; Ceron, Carla Speroni; Reis, Tiago Marques dos
    Background Surgical site infections account for 14–17% of all healthcare-associated infections. Antimicrobial stewardship (AMS) are complementary strategies developed to optimize the use of antimicrobials. Aim to evaluate the efectiveness of AMS in promoting adherence to surgical antibiotic prophylaxis protocols in hospitalized patients, reducing surgical site infection rate and cost–beneft ratio. Method This systematic review of randomized clinical trials, non-randomized clini- cal trials and before and after studies was performed using Pubmed, Cochrane, Web of Science, Scopus, Embase, Google Scholar and ClinicalTrials.gov, in addition to reference lists of included studies. The risk of bias of studies was measured by the ROBINS-I checklist and the quality of the evidence synthesis by GRADE. Results Fourteen before and after design studies were included. In 85.7% of the studies, AMS was efective in increasing adherence to surgical antibiotic prophylaxis protocols and in 28.5%, there was reduction in surgical site infection rate. Three studies evaluated cost–beneft ratio and found a favorable impact. Eight (57%) studies were at risk of moderate bias and six had severe bias. The evaluation of the synthesis of evidence showed quality ranging from low to very low. Conclusion AMS, such as audit, feedback, education, implementation of a protocol, and a computer-assisted decision support methodology, appear to be efective in promoting adherence to surgical antibiotic prophylaxis protocols, reducing surgical site infection rate with a positive economic impact. However, more studies, particularly randomized clinical trials, are needed to improve the level of evidence of available information on AMS in order to favor decision-making.
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    Recombinant leishmania (Leishmania) infantum ecto-nucleoside triphosphate diphosphohydrolase NTPDase-2 as a new antigen in canine visceral leishmaniasis diagnosis.
    (2013) Souza, Ronny Francisco de; Santos, Yaro Luciolo dos; Vasconcellos, Raphael de Souza; Pereira, Lucas Borges; Caldas, Ivo Santana; Almeida, Márcia Rogéria de; Bahia, Maria Terezinha; Fietto, Juliana Lopes Rangel
    Canine visceral leishmaniasis is an important public health concern. In the epidemiological context of human visceral leishmaniasis, dogs are considered the main reservoir of Leishmania parasites; therefore, dogs must be epidemiologically monitored constantly in endemic areas. Furthermore, dog to human transmission has been correlated with emerging urbanization and increasing rates of leishmaniasis infection worldwide. Leishmania (Leishmania) infantum (L. chagasi) is the etiologic agent of visceral leishmaniasis in the New World. In this work, a new L. (L.) infantum (L. chagasi) recombinant antigen, named ATP diphosphohydrolase (rLic-NTPDase-2), intended for use in the immunodiagnosis of CVL was produced and validated. The extracellular domain of ATP diphosphohydrolase was cloned and expressed in the pET21b-Escherichia coli expression system. Indirect ELISA assays were used to detect the purified rLic-NTPDase-2 antigen using a standard canine sera library. This library contained CVL-positive samples, leishmaniasis-negative samples and samples from Trypanosoma cruzi-infected dogs. The results show a high sensitivity of 100% (95% CI = 92.60–100.0%) and a high specificity of 100% (95% CI = 86.77–100.0%), with a high degree of confidence (k = 1). These findings demonstrate the potential use of this recombinant protein in immune diagnosis of canine leishmaniasis and open the possibility of its application to other diagnostic approaches, such as immunochromatography fast lateral flow assays and human leishmaniasis diagnosis.