LUIZ FELIPE DE ABREU GUIMARAES

@ufrj.br

Infectious Disease Physician at Hospital Universitário Clementino Fraga Filho
Universidade Federal do Rio de Janeiro

LUIZ FELIPE DE ABREU GUIMARAES


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https://researchid.co/luizfelipeag

RESEARCH, TEACHING, or OTHER INTERESTS

Infectious Diseases, Transplantation, Microbiology (medical)
8

Scopus Publications

Scopus Publications

  • Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Causing Healthcare-Associated Bloodstream Infections in Brazil: Results from A Prospective Countrywide Multicenter Study
    Laura C. Antochevis, Letícia O. Sudbrack, Robson S. Leão, Luiz F. Abreu Guimarães, João Paulo Telles, Ândrea C. Souza, Maria Helena Rigatto, Verônica F. D. Rocha, André Afonso M. Coelho, Elisa T. Mendes, Lívia Kmetzsch, Heryk Motta, Afonso Luís Barth, MRSA-ASCENSION Study Group, Alexandre P. Zavascki
    Infectious Diseases and Therapy, 2026
    INTRODUCTION: The molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) impact transmission, clinical presentation, and treatment. Contemporary data on the molecular epidemiology of MRSA causing healthcare-associated (HA) infections in Latin America are scarce. In this study, we aimed to assess the molecular epidemiology, virulence genes, and antimicrobial susceptibility of MRSA bloodstream infections (BSI) isolates from Brazil. METHODS: A multicenter, prospective study in 14 Brazilian hospitals was conducted from August/2022 to August/2023. MRSA isolates recovered from HA-BSIs were sent to a central laboratory for whole-genome sequencing (WGS) and antimicrobial susceptibility testing. RESULTS: Of 255 S. aureus, 66 (25.9%) were MRSA, and 47 were submitted to WGS. The most frequent clonal complex (CC) was CC5 (n = 34, 72.3%), mostly of sequence types (ST) 105 (19/34; 55.9%) and ST5 (6/34; 17.6%). ST105(CC5)-SCCmecII-t002 was the commonest strain (10/47, 56.2%), detected in three of four studied regions, followed by the ST8(CC8)-SCCmecIV strains with distinct spa types (9/47; 19.2%). Three new MLST alleles were discovered, resulting in new ST designations 10,174, 10,175, and 10,176. Furthermore, the resulting phylogeny revealed three well-defined clades. Twenty-eight virulence genes were detected. All isolates were susceptible to vancomycin, linezolid, and ceftaroline, while susceptibility to daptomycin and delafloxacin was 88.9% and 51.2%, respectively. CONCLUSIONS: The recently reported ST105(CC5)-SCCmecII-t002 clone has disseminated in hospitals from different Brazilian regions, together with other lineages that have been previously associated with community-associated infections, composed a new molecular landscape of MRSA causing HA BSIs in Brazil.
  • Clonal shift and impact of azithromycin use on antimicrobial resistance of Staphylococcus aureus isolated from bloodstream infection during the COVID-19 pandemic
    Carolina de Oliveira Whitaker, Tamara Lopes Rocha de Oliveira, Adriana Lúcia Pires Ferreira, Simone Aranha Nouér, , Anna Carla Castiñeiras, Christiany Moçali Gonzalez, Joana Freire, Luiz Felipe Guimarães, Claudia Regina da Costa, Raiane Cardoso Chamon, Kátia Regina Netto dos Santos
    Scientific Reports, 2025
    Staphylococcus aureus is a relevant pathogen in bloodstream infections (BSI), and the emergency of the COVID-19 pandemic increased its antimicrobial resistance. S. aureus isolates from BSI (September/2019 - March/2021) were analyzed phenotypically and molecularly, in addition to the clinical features of the patients. Of 88 S. aureus isolates recovered from 85 patients, 25 were isolated before the pandemic and 63 during it, and 16 were from patients with COVID-19. A rate of 45.5% of methicillin-resistant isolates (MRSA) were found, and 5% of them were ceftaroline susceptible dose-dependent. Daptomycin non-susceptibility was observed in 9.1% of isolates. The USA800/ST5/SCCmecIV lineage was prevalent among MRSA isolates (41.8%). Besides, 30.2% of the isolates were associated with community-associated MRSA (CA-MRSA) genotypes. There was a significant impact on the resistance rates for cefoxitin, clindamycin and erythromycin among S. aureus isolates from BSI in COVID-19 patients and association with the previous use of azithromycin by them (p < 0.05). A clonal alternation and an increase in the emergence of CA-MRSA lineages were also found, highlighting the importance of constant microbiological surveillance.
  • High colonization by multidrug-resistant and virulent Staphylococcus aureus genotypes among critically ill patients in the COVID-19 pandemic in a Brazilian hospital
    Tamara Lopes Rocha De Oliveira, Thaís Campos Macharete, Evellyn Max Guedes, Gabriel Freire Igari, Andryelle Cristina de Sant’Ana, Adriana Lúcia Pires Ferreira, Fernanda Sampaio Cavalcante, Claudia Regina da Costa de Souza, Simone Aranha Nouér, Kátia Regina Netto Dos Santos, , Anna Carla Castiñeiras, Christiany Moçali Gonzalez, Joana Pantoja Freire, Luiz Felipe Abreu Guimarães, Vânia Carvalho Ávila
    BMC Microbiology, 2025
    BACKGROUND: The COVID-19 pandemic has dramatically impacted in patients from Intensive Care Units (ICUs), making them more vulnerable to infection/colonization by clinically relevant pathogens. However, little is known about the Staphylococcus aureus isolates that colonized these patients during the pandemic. METHODS: Consecutive S. aureus isolates from surveillance swabs of patients of two ICUs of a hospital in Rio de Janeiro, between September 2020 and September 2021, were evaluated for phenotypic antimicrobial resistance. Methicillin-resistant S. aureus (MRSA) isolates were evaluated for resistance and virulence genes, biofilm production, and their genotypic profiles. Medical records were accessed for clinical and demographic data. RESULTS: Among 255 patients colonized by S. aureus, 79 (30.9%) were in the cICU (COVID-19 ICU) and 176 (69.1%) in the ncICU (non-COVID-19 ICU). COVID-19 patients made greater use of antimicrobials during hospitalization (p < 0.05). Higher rates of resistance for erythromycin and clindamycin, as well as the inducible macrolide-lincosamide-streptogramin B resistance phenotype and multidrug resistance were found in cICU isolates (p < 0.05). An overall rate of 36.5% of MRSA isolates was detected, with 41.7% in cICU and 34% in ncICU (p = 0.22). SCCmec types II (22.6%) and IV (71%) were the most found, and the latter was more frequent in the ncICU (p < 0.01). More than 50% of the isolates carried the resistance genes erm(C), msr(A), mrs(B), mph(C), aph(3')-III3a and smr, and the virulence genes icaA, sasG, ebpS, scn, egc cluster, fnbpB and cna. The cICU presented isolates that primarily carried the erm(C), smr, and cna genes and that showed strong biofilm production (p < 0.05). Clonal complex (CC) 5 was prevalent (65.6%) and associated with the hospital clones USA800/ST5-IV and USA100/ST105-II, which were most found in ncICU and cICU, respectively (p < 0.05). Community MRSA comprised 31.2% of isolates and mainly included the USA300/ST8-IV lineage (18.3%), with all isolates carrying the pvl genes. CONCLUSIONS: The significant impact on antimicrobial resistance rates and the emergence of virulent lineages among S. aureus isolates during the COVID-19 pandemic highlights the close relationship between this disease and antimicrobial resistance and the importance of constant microbiological surveillance to reduce the risks associated with future pandemics.
  • Persisting Gaps in Cytomegalovirus Prevention and Management After Solid Organ Transplantation in a Resource-Limited Setting
    Guilherme Santoro‐Lopes, Luiz Felipe Abreu Guimarães, Wanessa Trindade Clemente, Raquel Silveira Bello Stucchi, Edson Abdala, Daniel Wagner de Castro Lima Santos, Gustavo Fernandes Ferreira, Luciana Bertocco Paiva Haddad, Ligia Camera Pierrotti
    Transplant Infectious Disease, 2025
    Background Cytomegalovirus (CMV) infection remains among the leading complications after solid organ transplantation (SOT). Large international surveys mainly focused on high‐income countries, detected considerable variability in the management of this infection after SOT. Limited data are available from resource‐limited settings. Methods A questionnaire‐based cross‐sectional study was performed. All transplant programs (TP) registered at the Brazilian Organ Transplantation Society (ABTO) were invited to participate. Results Sixty‐one TP participated in the study. Of these, 59 (97%) reported using at least 1 preventive strategy (prophylaxis or preemptive therapy [PET]). Prophylaxis was reported by only 39 (64%). PET was used by 52 (85%), predominantly for R+ recipients ( n = 42/61; 70%). CMV monitoring was performed weekly in only 22 of 52 (42%) TP. This was significantly more common in TP reporting turnaround times ≤72 h for quantitative nuclear acid amplification tests ( p &lt; 0.001). Intravenous (IV) ganciclovir was the predominant drug chosen for prophylaxis (21/39 TP; 54%) and for PET (44/52 TP; 77%). Lack of regular access to valganciclovir was significantly associated with the choice of IV ganciclovir for prophylaxis and PET ( p = 0.002 for both comparisons). Only 8 (13%) TP had access to molecular diagnostic tests for ganciclovir resistance, and 14 (23%) had access to effective therapy for highly resistant infections. Conclusion These results suggest that strategies to improve the management of CMV after SOT in such a resource‐limited setting are needed and should include not only targeted educational programs but also initiatives to tackle economic and structural barriers. image
  • Can habits and behaviors predict colonization by community-associated MRSA in patients admitted to a Brazilian hospital?
    Marcos Vinicius de Barros Pinheiro, Fernanda Sampaio Cavalcante, Dennis de Carvalho Ferreira, Ana Carolina Fonseca Guimarães, Adriana Lúcia Pires Ferreira, Claudia Regina da Costa, Kátia Regina Netto dos Santos, Simone Aranha Nouér
    Revista do Instituto De Medicina Tropical De Sao Paulo, 2024
    This study aimed to identify factors associated with colonization by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in adult patients admitted to a Brazilian hospital. This is a cross-sectional study, in which patients underwent a nasal swab and were asked about hygiene behavior, habits, and clinical history. Among the 702 patients, 180 (25.6%) had S. aureus and 21 (2.9%) MRSA. The factors associated with MRSA colonization were attending a gym (OR 4.71; 95% CI; 1.42 - 15.06), smoking habit in the last year (OR 2.37; 95% CI; 0.88 - 6.38), previous hospitalization (OR 2.18; CI 95%; 0.89 - 5.25), and shared personal hygiene items (OR 1.99; 95% CI; 0.71 - 5.55). At the time of admission, colonization by CA-MRSA isolates was higher than that found in the general population. This can be an important public health problem, already endemic in hospitals, whose factors such as those associated with habits (smoking cigarettes) and behaviors (team sports practice and activities in gyms) have been strongly highlighted. These findings may help developing infection control policies, allowing targeting patients on higher-risk populations for MRSA colonization.
  • Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections
    Mariana Fernandes Augusto, Débora Cristina da Silva Fernandes, Tamara Lopes Rocha de Oliveira, Fernanda Sampaio Cavalcante, Raiane Cardoso Chamon, Adriana Lúcia Pires Ferreira, Simone Aranha Nouér, , Ana Pereira Rangel, Anna Carla Castiñeiras, Christiany Moçali Gonçalez, Joana Freire, Luiz Felipe Guimarães, Raquel Batista, Kátia Regina Netto dos Santos
    Antimicrobial Resistance and Infection Control, 2022
    Background Staphylococcus aureus is one of the leading causes of bloodstream infections (BSI) worldwide. In Brazil, the hospital-acquired methicillin-resistant S. aureus USA100/SCCmecII lineage replaced the previously well-established clones. However, the emergence of community-associated (CA) MRSA lineages among hospitalized patients is an increasing issue. Methods Consecutive S. aureus isolates recovered from BSI episodes of patients admitted between January 2016 and December 2018 in a Brazilian teaching hospital were tested for antimicrobial resistance, their genotypic features were characterized, and the clinical characteristics of the patients were evaluated. Results A total of 123 S. aureus isolates were recovered from 113 patients. All isolates were susceptible to linezolid, teicoplanin and vancomycin and 13.8% were not susceptible to daptomycin. Vancomycin MIC50 and MIC90 of 2 mg/L were found for both MRSA and MSSA isolates. The MRSA isolation rate was 30.1% (37/123), and 51.4% of them carried the SCCmec type II, followed by SCCmecIV (40.5%). Among the 37 MRSA isolates, the main lineages found were USA100/SCCmecII/ST5 and ST105 (53.7%) and USA800/ST5/SCCmecIV (18.9%). Surprisingly, six (16%) CA-MRSA isolates, belonging to USA300/ST8/SCCmecIVa that carried PVL genes and the ACME cassette type I, were detected. These six patients with USA300 BSI had severe comorbidities, including cancer, and most had a Charlson score ≥ 5; furthermore, they were in wards attended by the same health professionals. MRSA isolates were associated with hospital acquired infections (p = 0.02) in more elderly patients (p = 0.03) and those diagnosed with hematologic cancer (p = 0.04). Among patients diagnosed with MRSA BSI, 19 (54.3%) died. Conclusions The pandemic MRSA USA300 was detected for the first time in the Brazilian teaching hospital under study, and its cross-transmission most probably occurred between patients with BSI. This lineage may already be circulating among other Brazilian hospitals, which highlights the importance of carrying out surveillance programs to fight multidrug resistant and hypervirulent isolates.
  • Increased incidence of candidemia in a tertiary care hospital with the COVID-19 pandemic
    Marcio Nucci, Gloria Barreiros, Luiz Felipe Guimarães, Vitor A.S. Deriquehem, Anna Carla Castiñeiras, Simone A. Nouér
    Mycoses, 2021
    BackgroundThe incidence of candidemia in our hospital has been stable over an 18‐year period (1.3 episodes per 1000 admissions). Since March 2020, we have observed an increase in cases of candidemia.MethodsIn March 2020, the hospital was prepared to receive patients with COVID‐19, with cancellation of elective procedures, discharge of less sick patients and the activation of beds for COVID‐19. We compared the incidence of candidemia in 2 periods: from January 2019 to February 2020 (period 1) and from March to September 2020 (period 2).ResultsWe diagnosed 41 episodes of candidemia, 16 in period 1 and 25 in period 2 (9 COVID‐19 patients). Compared with non‐COVID‐19 patients, COVID‐19 patients with candidemia were more likely to be under mechanical ventilation (100% vs. 34.4%, P &lt; .001). The median number of monthly admissions in period 1 and 2 was 723 (interquartile range 655‐836) and 523 (interquartile range 389‐574), respectively. The incidence of candidemia (per 1000 admissions) was 1.54 in period 1 and 7.44 in period 2 (P &lt; .001). In period 2, the incidence of candidemia (per 1000 admissions) was 4.76 if we consider only cases of candidemia in non‐COVID‐19 patients, 2.68 if we consider only cases of candidemia in COVID‐19 patients and 14.80 considering only admissions of patients with COVID‐19.ConclusionsThe increase in the incidence of candidemia in our hospital may be attributed to 2 factors: a reduction in the number of admissions (denominator) and the occurrence of candidemia in COVID‐19 patients.
  • Invasive Fungal Disease in Renal Transplant Recipients at a Brazilian Center: Local Epidemiology Matters
    L.F.A. Guimarães, M. Halpern, A.S. de Lemos, E.F. de Gouvêa, R.T. Gonçalves, M.A.A. da Rosa Santos, M. Nucci, G. Santoro-Lopes
    Transplantation Proceedings, 2016