Cristiana M Nascimento-Carvalho

Cristiana M Nascimento-Carvalho
Universidade Federal da Bahia · Departamento de Pediatria

MD, PhD

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153
Publications
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Publications

Publications (153)
Article
Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality in adults. Bacterial pathogens are recognized to be frequent causative agents, which makes antibacterial treatment crucial for the evolution of these patients. There are several antimicrobial options available in daily practice. However, bacterial resistance is a probl...
Article
Aim to compare clinical features and outcome of children with severe acute lower respiratory infection (ALRI) with or without SARS-CoV-2 infection admitted to Paediatric Intensive Care Unit (PICU). Methods for this retrospective cohort study, all children aged<17 years admitted with severe ALRI at a PICU, in Salvador, Brazil were evaluated. Invest...
Article
Full-text available
Not every neonate with congenital Zika virus (ZIKV) infection (CZI) is born with microcephaly. We compared inflammation mediators in CSF (cerebrospinal fluid obtained from lumbar puncture) between ZIKV-exposed neonates with/without microcephaly (cases) and controls. In Brazil, in the same laboratory, we identified 14 ZIKV-exposed neonates during th...
Article
Objective The frequency and seasonality of viruses in tropical regions are scarcely reported. We estimated the frequency of 7 respiratory viruses and assessed seasonality of respiratory syncytial virus (RSV) and influenza viruses in a tropical city. Methods Children (age≤18 years) with acute respiratory infection were investigated in Salvador, Bra...
Article
Community-acquired pneumonia (CAP) diagnosis remains a challenge in paediatrics. Chest radiography is considered gold standard for definition of pneumonia, however no previous study assessed the relationship between immune response and radiographic-confirmed-pneumonia. We assessed association between cytokines/chemokines levels and radiographic abn...
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Background: Bacteremia is a serious condition. We aimed to assess the role of immature neutrophils in peripheral blood smears for prediction of bacteremia in children. Methods: In this cross-sectional study conducted in Salvador, Brazil, blood cultures collected from patients aged ≤18 years were identified. White Blood Cell count (WBC) was performe...
Article
Background: Early prediction of asthma is crucial for asthma prevention. Objective: We estimated the odds ratio (OR) of recurrent wheezing during the first 3 years of life, atopic rhinitis, and maternal asthma for asthma in school-age children (ages ≥ 6 years). Methods: This case-control study was conducted in Salvador, Brazil. Medical records of c...
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Objective To provide cutting‐edge information for the management of community‐acquired pneumonia in children under 5 years, based on the latest evidence published in the literature. Data source A comprehensive search was conducted in PubMed, by using the expressions: “community‐acquired pneumonia” AND “child” AND “etiology” OR “diagnosis” OR “seve...
Article
Objective: To compare immunoglobulin levels in cerebrospinal fluid (CSF) of neonates exposed to Zika virus (ZIKV) during foetal life (cases) with levels in CSF of control neonates. Methods: We identified 16 neonates who underwent lumbar puncture (LP), during the ZIKV epidemic (December/2015 to March/2016) whose mothers reported ZIKV clinical sym...
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Pathogenic bacteria, such as Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae and Moraxella catarrhalis, are important vaccine targets. The 10-valent pneumococcal conjugate vaccine (PCV10) acts on 10 differents S. pneumoniae serovars. However, this vaccine could also act on other bacteria genera, leading to dysbiosis. Moreove...
Article
Aim: To compare the systemic cytokines/chemokines levels over time during the evolution of children hospitalized with community-acquired pneumonia (CAP) with and without pneumococcal infection. Methods: Children less than 5-years-old hospitalized with CAP were prospectively investigated in Salvador, Brazil. Clinical data and biological samples w...
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Objective: To assess the gross motor development of children with presumed congenital Zika virus (ZIKV) infection over the first 2 years of their lives. Methods: Seventy-seven children were assessed at the median ages of 11, 18, and 24 months, using the evaluative instrument Gross Motor Function Measure (GMFM-66). At the third assessment, the ch...
Article
Aim To assess whether there was a difference in the frequency of symptoms and signs among children with community‐acquired pneumonia (CAP) with viral or bacterial infection. Methods A prospective cross‐sectional study was conducted in Salvador, Brazil. Children less than 5‐years‐old hospitalized with CAP were recruited. Viral or only bacterial inf...
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Zika virus (ZIKV) infection appeared in Brazil in 2015, causing an epidemic outbreak with increased rates of microcephaly and other serious birth disorders. We reviewed 102 cases of children who were diagnosed with microcephaly at birth and who had gestational exposure to ZIKV during the outbreak. We describe the clinical, neuroimaging, and neuroph...
Article
Introduction: Community-acquired pneumonia (CAP) is the leading cause of mortality among children under 5 years worldwide. However, the choices of chemical therapy for the empirical treatment of CAP are frequently debated. Areas covered: The authors provide an update on the chemical management recommendations for childhood CAP. The authors have per...
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Acute respiratory infection (ARI) is the most frequent cause for hospitalization in infants and young children. Using multiplexed nCounter technology to digitally quantify 600 human mRNAs in parallel with 14 virus- and 5 bacterium-specific RNAs, we characterized viral and bacterial presence in nasopharyngeal aspirates (NPA) of 58 children with ARI...
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Streptococcus pneumoniae remains an important cause of pneumonia and invasive bacterial disease, primarily meningitis and sepsis. The greatest burden of disease occurs in low-and middle-income countries, and the risk of serious pneumococcal disease peaks at the extreme ages of life. Young children are at highest risk, but older adults and people wi...
Article
Background: Community-acquired pneumonia (CAP) causes a major burden to the health care system among children under-5 years worldwide. Information on respiratory viruses in non-severe CAP cases is scarce. Objectives: To estimate the frequency of respiratory viruses among non-severe CAP cases. Study design: Prospective study conducted in Salvad...
Article
The aim of this study was to compare the results of serological assays using pneumococcal proteins or polysaccharides for the detection of pneumococcal infection in childhood pneumonia. Serological assays measured IgG against eight pneumococcal proteins (Ply,CbpA,PspA1,PspA2,PcpA,PhtD,StkP-C,PcsB-N), C-polysaccharide [in the whole study population,...
Article
Background: We studied Immunoglobulin G (IgG) antibody responses against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in young children with acute viral type respiratory infection and analyzed the findings in a multivariate model including age, nasopharyngeal carriage of the tested bacteria and pneumococcal vaccination...
Article
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The measurement of antibody levels is a common test for the diagnosis of Streptococcus pneumoniae infection in research. However, the quality of antibody response, reflected by avidity, has not been adequately evaluated. We aimed to evaluate the role of avidity of IgG against eight pneumococcal proteins in etiologic diagnosis. Eight pneumococcal pr...
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Objective: Community‐acquired pneumonia is an important cause of morbidity in childhood, but the detection of its causative agent remains a diagnostic challenge. The authors aimed to evaluate the role of the chest radiograph to identify cases of community‐aquired pneumonia caused by typical bacteria. Methods: The frequency of infection by Streptoco...
Article
Background: Childhood community-acquired pneumonia is a common and potentially life-threatening illness in developing countries. We assessed the prognostic value of serum procalcitonin level upon admission on clinical response to antibiotic treatment. Methods: Out of 89 patients, the median (IQR) age was 19(12-29) months and 60% were boys. Viral...
Article
Community-acquired pneumonia (CAP) is the main cause of death in children under-5 years worldwide and Streptococcus pneumoniae is the most common bacterial agent. However, it is difficult to identify pneumococcal infection among children with CAP. We aimed to assess association between any cytokine/chemokine and pneumococcal infection in childhood...
Article
Aim: To assess the role of human bocavirus 1 (HBoV1) as a causative agent of non-severe community-acquired pneumonia (CAP) in children. Methods: Patients aged 2-59 months with non-severe CAP (respiratory complaints and radiographic pulmonary infiltrate/consolidation) attending a University Hospital in Salvador, Brazil were enrolled in a prospect...
Article
Introduction: Sepsis is a major cause of childhood death worldwide. In developing countries, epidemiological data about sepsis is scarce. This study describes and compares the frequency of etiological agents and initial sites of infection in children with or without sepsis, identifying risk factors and assessing outcomes. Methodology: Clinical and...
Article
Background: The effect of pneumococcal vaccination is widely variable when measured by nasopharyngeal carriage of vaccine and non-vaccine targets. The aim of this study was to compare the carriage rates and metabolic activity of Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae and Moraxella catarrhalis among children who wer...
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Full-text available
Objective: Community-acquired pneumonia (CAP) is an important cause of morbidity in childhood, but the detection of its causative agent remains a diagnostic challenge. The authors aimed to evaluate the role of the chest radiograph to identify cases of CAP caused by typical bacteria. Methods: The frequency of infection by Streptococcus pneumoniae...
Article
Background: Atypical bacteria are treatable causative agents of community-acquired pneumonia (CAP). However, there is no conclusive evidence that a child with CAP should receive empirical treatment against such agents. Objectives: We assessed the possibility of association between clinical failure and acute infection by these bacteria among chil...
Article
Respiratory syncytial virus (RSV) is one of the most common etiological agents of childhood respiratory infections globally. Information on seasonality of different antigenic groups is scarce. We aimed to describe the frequency, seasonality, and age of children infected by RSV antigenic groups A (RSVA) and B (RSVB) among children with ARI in a 4-ye...
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Conserved protein antigens have been investigated as vaccine candidates against respiratory pathogens. We evaluated the natural development of antibodies against Streptococcus pneumoniae , Haemophilus influenzae , and Moraxella catarrhalis proteins during childhood. Fifty healthy children had serum samples collected from their first months up to th...
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Background: The comparison of the frequencies of bacterial and viral infections among children with community-acquired pneumonia (CAP) admitted in distinct severity categories, in an original study, is lacking in literature to-date. We aimed to achieve this goal. Methods: Children aged 2-59-months-old hospitalized with CAP were included in this...
Article
Background: Acute respiratory infection (ARI) is the most frequent reason for children being seen by doctors worldwide. We aimed to estimate the frequency of complications in children aged 6-23 months during ARI episode and to evaluate risk factors present on recruitment associated with complications after the universal implementation of pneumococ...
Article
The etiological diagnosis of infection by Streptococcus pneumoniae in children is difficult, and the use of indirect techniques is frequently warranted. We aimed to study the use of pneumococcal proteins for the serological diagnosis of pneumococcal infection in children with pneumonia. We analyzed paired serum samples from 13 Brazilian children wi...
Article
Background: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are common causative agents of respiratory infections. Pneumococcal conjugate vaccines (PCV) have been introduced recently, but their effect on the natural immunity against protein antigens from these pathogens has not been elucidated. Methods: This was an age...
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Invasive pneumococcal disease is a relevant public health problem in Brazil, especially among children and the elderly. In July/2010 a 10-valent pneumococcal conjugate vaccine was introduced to the immunization schedule of Brazilian children under two years of age. Between July/2010 and December/2013 we conducted a case-series study on invasive pne...
Article
Introduction: Community-acquired pneumonia (CAP) is a leading cause of death and a major cause of morbidity in children under the age of 5. Appropriate antimicrobial use is one crucial tool in controlling childhood CAP mortality and suffering. Areas covered: Structured search of current literature. PubMed was consulted for published trials conduct...
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Background: The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods: Children aged ≥ 2 months, hospitalized with CAP diagnosed...
Article
The role of chest radiograph (CXR) among children with community-acquired pneumonia is controversial. We aimed to assess if there is association between a specific etiology and radiologically confirmed pneumonia. This was a prospective cross-sectional study. Based on report of respiratory complaints and fever/difficulty breathing plus the detection...
Article
We evaluated the effects of combining different numbers of pneumococcal antigens, pre-existing antibody levels, sampling interval, age, and duration of illness on the detection of IgG responses against eight Streptococcus pneumoniae proteins, three Haemophilus influenzae proteins, and five Moraxella catarrhalis proteins in 690 children aged <5 year...
Conference Paper
Purpose: Streptococcus pneumoniaeis a leading cause of invasive pneumococcal disease (IPD) in older children and adults, with considerable morbidity and mortality and health system costs in the region of Latin America. The present study aims to fill important gaps in our understanding of the economic burden of IPD in this population. Methods:...
Article
Background: Wheezing is one of the most frequent causes of visit to emergency rooms among children. However, data on wheezing burden are mostly provided at healthcare setting, and particularly only for infants. Aims: We sought to estimate the prevalence of wheezing in children under 4 years and to assess potential risk factors in the community. Des...
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During the influenza pandemic of 2009, the A(H1N1)pdm09, A/H3N2 seasonal and influenza B viruses were observed to be co-circulating with other respiratory viruses. To observe the epidemiological pattern of the influenza virus between May 2009-August 2011, 467 nasopharyngeal aspirates were collected from children less than five years of age in the c...
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Oral amoxicillin (50 mg/kg/day) thrice daily is the first-line therapy for non-severe childhood pneumonia. Compliance could be enhanced if two daily doses are employed. We assessed the equivalence of oral amoxicillin (50 mg/kg/day) thrice or twice daily in those patients. This randomized (1 : 1), controlled, triple-blinded investigation conducted a...
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We compared bacteremic pneumococcal pneumonia (BPP) and pneumococcal empiema (PE), in terms of clinical, radiological, and laboratory findings, in under-fives. A cross-sectional nested cohort study, involving under-fives (102 with PE and 128 with BPP), was conducted at 12 centers in Argentina, Brazil, and the Dominican Republic. Among those with P...
Article
Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are pathogens commonly associated with infectious diseases in childhood. This study aimed to develop a fluorescent multiplexed bead-based immunoassay (FMIA) using recombinant proteins for the quantitation of serum IgG antibodies against these bacteria. Eight pneumococcal pr...
Article
Full-text available
Community-acquired pneumonia (CAP) is an important health problem in childhood. Penicillin remains appropriate for treating children with CAP. Clinical data on evolution of those children treated with different posologic schemes of aqueous penicillin G are lacking. To assess if there were differences in evolution between children with CAP treated w...
Article
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Methicillin-resistant Staphylococcus aureus has emerged as a pathogen associated with community-acquired infections worldwide. We report the spectrum of community-acquired S. aureus infections and compare the patients infected with methicillin-susceptible or methicillin-resistant strains among patients aged <20 years. Overall, 90 cases of community...
Article
This study assessed the inter-observer agreement in the interpretation of several radiographic features in the chest radiographs (CXR) of 803 children aged 2-59 months with non-severe acute lower respiratory tract infection (ALRI). Inclusion criteria comprised: report of respiratory complaints, detection of lower respiratory findings, and presence...
Article
Full-text available
Pleural effusion (PE), a complication of community-acquired pneumonia (CAP), is usually attributed to a bacterial infection. Nonetheless, viral infections have not been investigated routinely. We searched for bacterial and viral infections among 277 children hospitalized with CAP. Among these children 206 (74%) had radiographic confirmation, of who...
Article
Background: Estimates of the disease burden from childhood pneumonia are available for most developed countries, but they are based mainly on models. Measured country-specific pneumonia burden data are limited to a few nations and differ in case definitions and case ascertainment methods. This review describes pneumonia disease burden in developed...
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To estimate the frequency and describe the clinical characteristics and respective treatments of previous history of wheezing. Infants aged 6-23 months with upper respiratory tract complaints and reporting previous wheezing were followed-up retrospectively. Data were registered on a validated standardized form. Out of 451 infants, 164 (36.4%; 95%CI...
Article
Clinical prediction rules (CPR) are tools including appropriately weighted clinical aspects (history, physical examination and/or complementary tests) showing the odds for a specific diagnosis or prognosis. Their development includes a complex and strict process to achieve the scientific strength which supports use in clinical settings. Although CP...
Article
Human bocavirus (HBoV) is a human virus associated with respiratory disease in children. Limited information is available on acute infection with HBoV among children admitted to hospital with community-acquired pneumonia in tropical regions and the current diagnosis is inadequate. The aims were to diagnose and describe acute HBoV infections among c...
Article
Cellulitis is an important cause of hospitalization in pediatrics. Because Staphylococcus aureus is the main pathogen of cellulitis, medicinal therapeutics should take the changing resistance profile of this organism into consideration. The aim of this study was to evaluate the progression and outcomes of children hospitalized for cellulitis and tr...
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Full-text available
To identify differences in the evolution of children with non-severe acute lower respiratory tract infection between those with and without radiographically diagnosed pneumonia. Prospective cohort study. A public university pediatric hospital in Salvador, Northeast Brazil. Children aged 2-59 months. By active surveillance, the pneumonia cases were...