Percorrer por autor "Castelo Branco, Miguel"
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- Community surveillance of Staphylococcus aureus and presumptive MRSA nasal colonization in rural Portugal: The BI-STAPH Project—Phase 2: FundãoPublication . Costa, Rodrigo; Cordero, Ainhoa Ferreira; Ferreira, Francisco; Metello, João; Santos, Carina; Belo, João; Coelho, Patricia; Mateus, Sónia; Castelo Branco, Miguel; Rodrigues, FranciscoStaphylococcus aureus is one of the leading causes of both community- and healthcareassociated infections. Nasal colonization constitutes the primary reservoir for subsequent infection and transmission, while methicillin-resistant Staphylococcus aureus (MRSA) remains a major public health concern because of its resistance to multiple antimicrobial agents. However, data regarding community nasal colonization in rural Portuguese populations remain scarce. The BI-STAPH Project was established to address this knowledge gap through systematic surveillance of rural communities in inland Portugal. To estimate the prevalence of presumptive nasal colonization by Staphylococcus aureus and MRSA among adults living in the municipality of Fundão, Portugal, and to explore potential associations between colonization and demographic, behavioural, occupational, and environmental characteristics. A prospective community-based cross-sectional study was conducted as the second phase of the BI-STAPH Project. A total of 200 adults were recruited from different parishes of the municipality of Fundão. Bilateral nasal swabs were collected and processed using standardized microbiological methods for the presumptive identification of S. aureus. Presumptive MRSA isolates were investigated using a PBP2′ latex agglutination assay. Sociodemographic and exposure-related information was obtained through structured questionnaires. Associations between presumptive colonization and participant characteristics were evaluated using Pearson’s chi-square or Fisher’s exact tests, as appropriate. Presumptive S. aureus nasal colonization was identified in 56 of 200 participants, corresponding to a prevalence of 28.0% (95% CI: 21.8–34.2%). No presumptive MRSA-positive isolates were identified, corresponding to an observed prevalence of 0% (95% CI: 0.0–1.8%). Colonization prevalence was 29.5% among females and 26.8% among males, and ranged from 25.8% to 31.1% across age groups; neither sex nor age was significantly associated with colonization. Participants reporting daily animal cont act had a colonization prevalenceof 32.3%, compared with 20.5% among those without animal contact, but this difference was not statistically significant (p = 0.075). Overall, no statistically significant associations were identified between presumptive S. aureus colonization and the demographic, behavioural, occupational, or environmental variables evaluated. Presumptive S. aureus nasal colonization was common among adults living in the rural municipality of Fundão, Portugal, whereas no presumptive MRSA-positive isolates were identified in this study population. No statistically significant associations were observed between colonization and the characteristics evaluated. These findings expand the epidemiological evidence generated by the BI-STAPH Project and support continued community-based surveillance of S. aureus in rural Portugal. Future multicentre studies incorporating molecular confirmation, antimicrobial susceptibility testing, and larger populations will be important to better characterize circulating strains and transmission patterns within a One Health framework.
- Decoding urinary tract infection trends: A 5-year snapshot from Central PortugalPublication . Rodrigues, Francisco; Coelho, Patrícia; Patricia Coelho; Mateus, Sónia; Caseiro, Armando; Eideh, Hatem; Gonçalves, Teresa; Castelo Branco, MiguelIntroduction: This study analyzes urinary tract infections (UTIs) in a hospital in Central Portugal over a five-year period, focusing on bacterial prevalence, patient demographics, and antibiotic resistance patterns. This investigation aims to provide insights that can guide improved infection control and treatment strategies. Methods: A total of 6161 positive urine cultures collected over five years were examined, with particular emphasis on 2019 due to a peak in infection rates. The analysis explored bacterial prevalence, demographic factors such as sex and clinical service origin, and antibiotic resistance. Special attention was given to hospitalized patients, especially those undergoing invasive procedures, due to their increased vulnerability to infection. Results: This study found that UTIs were more prevalent in female patients, reflecting anatomical susceptibilities. Hospitalized individuals, particularly those requiring invasive procedures, were at greater risk. The predominant bacteria were Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis, with differences in prevalence by patient sex and service origin. Resistance to Imipenem in E. coli increased, raising concerns about last-resort treatments. However, resistance to other antibiotics declined, suggesting improvements due to recent stewardship measures. During the COVID-19 pandemic, overall antibiotic consumption decreased due to changes in clinical practices. Conclusion: The findings highlight the importance of strict infection control, targeted prevention measures, and rational antibiotic use to combat resistance. Ongoing surveillance and personalized treatment approaches are essential to improve UTI management and outcomes.
- Determinants of multidrug resistance among gram-positive uropathogens in Central Portugal: A 5 year retrospective studyPublication . Adnan, Muhammad; Patricia Coelho; Mateus, Sónia; Castelo Branco, Miguel; Rodrigues, FranciscoUrinary tract infections (UTIs) are among the most common bacterial infections worldwide. Although Gram-negative bacteria predominate, Gram-positive cocci (GPC) are increasingly recognized as significant uropathogens. This retrospective study analyzed 655 patients with culture-confirmed GPC UTIs in a hospital in Central Portugal (2018–2022) to identify predictors of multidrug resistance (MDR). MDR was defined as resistance to three or more antimicrobial classes. The overall MDR prevalence was 83.7%, with Enterococcus spp. showing the highest MDR prevalence (98.2%). Multivariate analysis identified older age as na independent predictor of MDR, whereas Staphylococcus and Streptococcus species were associated with significantly lower odds compared to Enterococcus. A temporal increase in MDR risk was observed in 2021 and 2022. Despite the high overall resistance rates observed, oxazolidinones and cyclic lipopeptides retained near-complete activity against all GPC isolates, reinforcing their role as last-line therapeutic options.
- Rising trends of urinary infections among pregnant women: Insights from a Portuguese hospital (2018–2022)Publication . Rodrigues, Francisco; Patricia Coelho; Mateus, Sónia; Eideh, Hatem; Gonçalves, Teresa; Caseiro, Armando; Castelo Branco, MiguelThis study explores the prevalence and antibiotic resistance of urinary tract infections (UTIs) in pregnant women in central Portugal. A retrospective observational study was conducted on 201 positive urine cultures from pregnant women at a hospital center between January 2018 and December 2022. The data collected included age, hospital admission source, history of antibiotic therapy, catheterization status, identity of bacterial isolates, and their antibiotic profile. The most common bacterial strains were Escherichia coli (52.4%) and Streptococcus agalactiae (16.9%). In terms of antibiotic resistance, Escherichia coli demonstrated complete sensitivity to ertapenem, while Streptococcus agalactiae showed sensitivity to four antibiotics, including trimethoprim/sulfamethoxazole. Notably, most infections occurred in the third trimester, underscoring the need for continuous monitoring throughout pregnancy. This study emphasizes the importance of tailored treatment strategies to manage UTIs in pregnancy effectively, reducing the potential maternal and fetal complications. These findings contribute to regional data on UTI management in pregnant populations and aim to support improved healthcare practices. These regional data provide a solid foundation for optimizing healthcare practices in pregnant women, suggesting targeted approaches to combat antibiotic resistance and improve maternal–fetal safety during UTI treatment.