Environmental health of water bodies from a Brazilian Amazon Metropolis based on a conventional and metagenomic approach.

AIMS: The present study aimed to use a conventional and metagenomic approach to investigate the microbiological diversity of water bodies in a network of drainage channels and rivers located in the central area of the city of Belém, northern Brazil, which is considered one of the largest cities in the Brazilian Amazon. METHODS AND RESULTS: In eight of the analyzed points, both bacterial and viral microbiological indicators of environmental contamination-physical-chemical and metals-were assessed. The bacterial resistance genes, drug resistance mechanisms, and viral viability in the environment were also assessed. A total of 473 families of bacteria and 83 families of viruses were identified. Based on the analysis of metals, the levels of three metals (Cd, Fe, and Mn) were found to be above the recommended acceptable level by local legislation. The levels of the following three physicochemical parameters were also higher than recommended: biochemical oxygen demand, dissolved oxygen, and turbidity. Sixty-three bacterial resistance genes that conferred resistance to 13 different classes of antimicrobials were identified. Further, five mechanisms of antimicrobial resistance were identified and viral viability in the environment was confirmed. CONCLUSIONS: Intense human actions combined with a lack of public policies and poor environmental education of the population cause environmental degradation, especially in water bodies. Thus, urgent interventions are warranted to restore the quality of this precious and scarce asset worldwide.

Exploring the Bacteriome and Resistome of Humans and Food-Producing Animals in Brazil.

The epidemiology of antimicrobial resistance (AMR) is complex, with multiple interfaces (human-animal-environment). In this context, One Health surveillance is essential for understanding the distribution of microorganisms and antimicrobial resistance genes (ARGs). This report describes a multicentric study undertaken to evaluate the bacterial communities and resistomes of food-producing animals (cattle, poultry, and swine) and healthy humans sampled simultaneously from five Brazilian regions. Metagenomic analysis showed that a total of 21,029 unique species were identified in 107 rectal swabs collected from distinct hosts, the highest numbers of which belonged to the domain Bacteria, mainly Ruminiclostridium spp. and Bacteroides spp., and the order Enterobacterales. We detected 405 ARGs for 12 distinct antimicrobial classes. Genes encoding antibiotic-modifying enzymes were the most frequent, followed by genes related to target alteration and efflux systems. Interestingly, carbapenemase-encoding genes such as blaAIM-1, blaCAM-1, blaGIM-2, and blaHMB-1 were identified in distinct hosts. Our results revealed that, in general, the bacterial communities from humans were present in isolated clusters, except for the Northeastern region, where an overlap of the bacterial species from humans and food-producing animals was observed. Additionally, a large resistome was observed among all analyzed hosts, with emphasis on the presence of carbapenemase-encoding genes not previously reported in Latin America. IMPORTANCE Humans and food production animals have been reported to be important reservoirs of antimicrobial resistance (AMR) genes (ARGs). The frequency of these multidrug-resistant (MDR) bacteria tends to be higher in low- and middle-income countries (LMICs), due mainly to a lack of public health policies. Although studies on AMR in humans or animals have been carried out in Brazil, this is the first multicenter study that simultaneously collected rectal swabs from humans and food-producing animals for metagenomics. Our results indicate high microbial diversity among all analyzed hosts, and several ARGs for different antimicrobial classes were also found. As far as we know, we have detected for the first time ARGs encoding carbapenemases, such as blaAIM-1, blaCAM-1, blaGIM-2, and blaHMB-1, in Latin America. Thus, our results support the importance of metagenomics as a tool to track the colonization of food-producing animals and humans by antimicrobial-resistant bacteria. In addition, a network surveillance system called GUARANI, created for this study, is ready to be expanded and to collect additional data.

H. pylori Infection and Virulence Factors cagA and vacA (s and m Regions) in Gastric Adenocarcinoma from Pará State, Brazil.

H. pylori shows a great variability in genes associated with virulence, which may influence properties related to gastric adenocarcinoma initiation and progression. Among them, cagA and vacA show a strong positive association with the disease. Therefore, a cross-sectional study was carried out with 281 samples of gastric adenocarcinoma, collected at a cancer reference center in the Brazilian Amazon. Detection of H. pylori was proceeded by PCR of the ureA and 16S genes. Positive samples were subjected to the cagA detection and vacA typing. The bacteria were observed in 32.03% of the samples. Positivity for H. pylori was associated with advanced age (p = 0.0093) and metastases (p = 0.0073). Among the positive cases, 80% (72/90) had the cagA gene. For the "s" position of the vacA gene, 98.8% (83/84) of the bacteria had genotype s1 and 1.2% (1/84) were genotyped as s2. For the "m" position, the results were: 63.6% (56/88) with m1 genotype, 2.3% (2/88) genotyped as m2 and 34.1% (30/88) m1/m2. Virulence factors did not impact an increase in the association with age or metastases. In conclusion, H. pylori infection is associated with malignant phenotype cases of gastric adenocarcinoma, involving metastases. The virulence factors related to the cagA and vacA genes showed a high prevalence in the Brazilian Amazon.

Morbimortalidade por gastroenterites no Estado do Pará / Morbidity and mortality caused by gastroenteritis in Pará State, Brazil

No Brasil, as gastroenterites acometem principalmente as crianças menores de 5 anos de idade e são consideradas um importante problema de saúde pública. O declínio da morbimortalidade por enteroinfecções resulta na queda da mortalidade infantil e da mortalidade por doenças infecciosas nos países em desenvolvimento. O presente trabalho é um estudo descritivo, realizado em colaboração com o Departamento de Epidemiologia do Estado do Pará, desenvolvido com intuito de conhecer a importância das gastroenterites como causa de internações e óbitos no Estado do Pará. Realizou-se: o levantamento de dados sobre mortalidade e internação por meio dos Sistemas de Informação em Saúde edo Monitoramento das Doenças Diarreicas Agudas durante o período de 2000 a 2004; além dos cálculos dos indicadores de saúde. No cômputo geral, foram notificados 590.595 casos de diarreia. Foi observado um aumento no número de casos de diarreia notificados no Monitoramento das Doenças Diarreicas Agudas durante este período, sendo as maiores frequências encontradas na faixa etária de 1 a 4 anos de idade (média de 48.887 casos), seguido de 33.151 casos em menores de 1 ano de idade. A taxa de internação por diarreia em menores de 1 ano de idade foi de 35 por mil nascidos vivos em 2004. No período estudado, o coeficiente de mortalidade diminuiu, atingindo em 2004 o valor de 2,91 paracada 100 mil habitantes, seguindo a tendência de diminuição das taxas de mortalidade por diarreia no Brasil. Mesmo com este declínio, a diarreia ainda se apresenta como uma das principais causas de morbimortalidade no Estado do Pará, acometendo especialmente crianças menores de 1 ano de idade.

In Brazil, gastroenteritis mainly affects children aged 0 to 5 years and is considered a significant public health problem.The reduction of the morbidity and mortality rates caused by gastroenteritis is responsible for the decrease in the rates of overall infant mortality and infant mortality due to infectious diseases in developing countries. This work is a descriptive study developed in collaboration with the Epidemiology Department of Pará State in order to determine the importance of gastroenteritis as a cause of hospitalizations and deaths in Pará State. Initially, data about morbidity and hospitalization were obtained from Information Systems on mortality, health and hospital admissions and from health indicators and the Monitoring of Acute Diarrheal Diseases (MADD) program in the period between 2000 and 2004.There were 590,595 recorded cases of diarrhea. There was an increase in the number of cases of diarrhea notified by MADD during this period, with the highest frequency rates found in children aged 1 to 4 years old (average of 48,887 cases), followed by 33,151 cases in children below 1 year of age. In 2004, the hospitalization rate due to diarrhea in children below one was of 35 per 1 thousand live births. The coefficient of mortality decreased during the period studied, reaching 2.91 per 100 thousand inhabitants in 2004, following the reduction trend of mortality rates by diarrhea in Brazil. Despite this reduction, diarrhea remains a major cause of morbidity and mortality in Pará State, especially affecting children below 1 year of age.

Resistência antimicrobiana de Salmonella Typhi identificadas no Estado do Pará, Brasil / Antimicrobial resistance of Salmonella Typhi isolated in the State of Pará, Brazil

A resistência antimicrobiana é um assunto amplamente estudado em todos os gêneros bacterianos, sobretudo entre agentes responsáveis por doenças epidêmicas como a febre tifoide. A incidência de surtos contribui para o aumento abusivo da administração errônea de antimicrobianos colaborando para o surgimento de amostras bacterianas resistentes. Portanto, o presente estudo avaliou a resistência de 44 amostras de Salmonella Typhi aos principais antimicrobianos utilizados no tratamento da febre tifoide. Das 44 amostras isoladas no período de 2003 a 2005, dez (22,7 por cento) foram resistentes a pelo menos um antimicrobiano. Dentre as dez amostras de Salmonella Typhi resistentes, observou-se que nove apresentaram monorresistência à nitrofurantoína ou à tetraciclina. Apenas um caso de resistência concomitante a duas drogas (cloranfenicol e nitrofurantoína) foi observado no ano de 2005. A Região Norte, por ser considerada área endêmica para febre tifoide e ter apresentado resistência crescente em relação aos três anos em estudo, deve permanecer com o monitoramento da resistência de Salmonella Typhi aos antimicrobianos, principalmente ao cloranfenicol, para garantir que o mesmo continue sendo o medicamento de escolha para o tratamento da febre tifoide na Região, além de possuir baixo custo e boa aceitabilidade do paciente ao tratamento...

Antimicrobial resistance has been widely studied in every bacterial genus, especially among those agents responsible for epidemic diseases, such as typhoid fever. Outbreaks have lead to increased usage and erroneous administration of antimicrobial drugs, contributing to the emergence of resistant bacterial strains. Therefore, this study evaluated the resistance of 44 strains of Salmonella Typhi to the main antibiotics used in the treatment of typhoid fever. Of the 44 strains isolated from 2003 to 2005, ten (2.7 per cent) were resistant to at least one microbial drug. Among the ten resistant Salmonella Typhi strains, nine showed monoresistance to nitrofurantoin or tetracycline. Only one case of concomitant resistance to two drugs (chloramphenicol and nitrofurantoin) was observed, in 2005. The Northern Region of Brazil is considered an endemic area for typhoid fever and has shown growing drug resistance in the three years studied. Thus, we must continue to monitor the resistance of Salmonella Typhi to antimicrobial drugs, especially chloramphenicol, to ensure that it remains the drug of choice for the treatment of typhoid fever in the Region, as it is inexpensive and the disease responds well to it...

Variabilidade genética de amostras de Salmonella Typhi isoladas de surto e de casos esporádicos ocorridos em Belém, Brasil / Genetic variability of Salmonella Typhi samples isolated from outbreaks and sporadic cases of typhoid fever in Belém, Brazil

INTRODUÇÃO: Salmonella Typhi é o agente da febre tifóide (doença caracterizada por febre, cefaléia, mialgia, artralgia, diarréia ou constipação), cujo quadro pode se complicar e levar o paciente a óbito. No Brasil, a febre tifóide é endêmica nas regiões Norte e Nordeste, com surtos ocorridos nos meses de intenso calor. OBJETIVO: Analisar e comparar a variabilidade genética de S. Typhi isoladas de surto e casos esporádicos de febre tifóide ocorridos em determinado período na cidade de Belém (PA). MATERIAL E MÉTODOS: Foram analisadas 20 amostras de S. Typhi: 10 isoladas de um surto ocorrido no bairro do Guamá, Belém, entre os meses de dezembro/2005 e março/2006, e 10 de casos esporádicos ocorridos em diferentes localidades da mesma cidade e no mesmo período do surto. A caracterização genética foi realizada pela análise do perfil de macrorrestrição obtido pela enzima XbaI e definido por eletroforese em gel de campo pulsado (PFGE). RESULTADOS: A análise de XbaI-PFGE das amostras estudadas demonstrou uma similaridade genética de 83 por cento a 100 por cento. CONCLUSÃO: Este estudo pôde demonstrar a relação clonal das amostras S. Typhi causadoras de surto e de casos esporádicos de febre tifóide ocorridos na cidade de Belém no período de dezembro/2005 a março/2006.

BACKGROUND: Salmonella Typhi is the causative agent of typhoid fever, illness characterized by fever, migraine, myalgia, arthralgia, diarrhea or constipation, which may have complications and cause death. In Brazil, the typhoid fever is endemic in the Northern and Northeastern regions, with outbreaks occurring in scorching months. OBJECTIVE: To analyse and compare the genetic variability of S. Typhi strains isolated from outbreaks and sporadic cases of typhoid fever occurred in the city of Belém (PA) between December 2005 and March 2006. MATERIAL AND METHODS: Twenty samples of S. Typhi were analyzed: 10 of them were isolated from an outbreak occurred in Guamá neighborhood in Belém, between December 2005 and March 2006, and the other 10 were isolated from sporadic cases in different neighborhoods of the same city in the same outbreak period. The genetic characterization was performed by macrorestriction analysis of genomic DNA with XbaI enzyme defined by pulsed-field gel electrophoresis (PFGE). RESULTS: The Xbal-PFGE analysis of the studied samples revealed a genetic similarity of 83 percent to 100 percent. CONCLUSION: This study demonstrated the clonal relation between the S. Typhi samples from the outbreak and from the sporadic cases of typhoid fever occurred in the city of Belém between December 2005 and March 2006.

Perfil de resistência antimicrobiana de pseudomonas aeruginosa isoladas de fezes de pacientes infectados pelo vírus da imunodeficiência humana / Antimicrobial resistance profile of pseudomonas aeruginosa isolated in feces of patients infected with human immunodeficiency virus

Pseudomonas aeruginosa é uma bactéria oportunista em indivíduos imunodeprimidos. A ocorrência de infecção periretal e enterocolite necrotizante por esse microrganismo tem sido relatada em pacientes imunocomprometidos que fazem uso frequente de antimicrobianos. Com o intuito de avaliar a resistência aos antimicrobianos de Pseudomonas aeruginosa isoladas das fezes de pacientes infectados pelo Vírus da Imunodeficiência Humana (HIV) internados e atendidos em ambulatório, 64 amostras de P. aeruginosa foram testadas pelo método de difusão em sistema de disco. Dentre as 64 amostras de P. aeruginosa, 73 por cento (47 por 64) apresentaram sensibilidade a todos os antimicrobianos testados. Algumas amostras apresentaram resistência, principalmente, para gentamicina CN (20 por cento), amicacina AK (14 por cento), cefoperazona CFP (11 por cento) e piperacilina, PRL (9 por cento). Foram identificados onze modelos de resistência, sendo que todos os modelos multidroga-resistentes foram identificados em amostras isoladas de pacientes hospitalizados. A prevalência dos modelos de resistência em amostras de origem hospitalar demonstra que os pacientes hospitalizados estão mais expostos ao risco de infecções secundárias por amostras multirresistentes, além de colaborar com a disseminação da mesma no ambiente hospitalar.