Genetic diversity and virulence potential of clinical and environmental Aeromonas spp. isolates from a diarrhea outbreak.

BACKGROUND: Aeromonas spp. are gram-negative bacteria that can cause a variety of infections in both humans and animals and play a controversial role in diarrhea outbreaks. Our aim was to identify clinical and environmental Aeromonas isolates associated with a cholera outbreak in a northeast county of Brazil at the species level. We also aimed to determine the genetic structure of the bacterial population and the virulence potential of the Aeromonas isolates. METHODS AND RESULTS: Analysis based on concatenated sequences of the 16S rRNA and gyrB genes suggested the classification of the 119 isolates studied into the following species: A. caviae (66.9%), A. veronii (15.3%), A. aquariorum (9.3%), A. trota (3.4%), A. hydrophila (3.4%) and A. jandaei (1.7%). One isolate did not fit any Aeromonas species assessed, which might indicate a new species. The haplotype network based on 16S rRNA gene sequences identified 59 groups among the 119 isolates and 26 reference strains, and it clustered almost all A. caviae isolates into the same group. The analysis of the frequency patterns of seven virulence-associated genes (alt, ast, hlyA, aerA, exu, lip, flaA/B) revealed 29 virulence patterns composed of one to seven genes. All the isolates harbored at least one gene, and three of them harbored all seven virulence genes. CONCLUSION: The results emphasize the need to improve local water supply and maintain close monitoring of possible bacterial contamination in the drinking water.

Genomic Analysis of Yersinia pestis Strains from Brazil: Search for Virulence Factors and Association with Epidemiological Data.

Yersinia pestis, the etiological agent of the plague, is considered a genetically homogeneous species. Brazil is currently in a period of epidemiological silence but plague antibodies are still detected in sentinel animals, suggesting disease activity in the sylvatic cycle. The present study deployed an in silico approach to analyze virulence factors among 407 Brazilian genomes of Y. pestis belonging to the Fiocruz Collection (1966-1997). The pangenome analysis associated several known virulence factors of Y. pestis in clades according to the presence or absence of genes. Four main strain clades (C, E, G, and H) exhibited the absence of various virulence genes. Notably, clade G displayed the highest number of absent genes, while clade E showed a significant absence of genes related to the T6SS secretion system and clade H predominantly demonstrated the absence of plasmid-related genes. These results suggest attenuation of virulence in these strains over time. The cgMLST analysis associated genomic and epidemiological data highlighting evolutionary patterns related to the isolation years and outbreaks of Y. pestis in Brazil. Thus, the results contribute to the understanding of the genetic diversity and virulence within Y. pestis and the potential for utilizing genomic data in epidemiological investigations.

Evaluation of a multi-species Protein A-ELISA assay for plague serologic diagnosis in humans and other mammal hosts.

BACKGROUND: The Hemagglutination assay (HA) is widely used in plague diagnosis, however, it has a subjective interpretation and demands high amounts of antigen and other immunobiological supplies. On the other hand, the conventional Anti-IgG ELISA is limited by the need of specific conjugates for multiple plague hosts, which leaves a gap for new diagnostic methods able to cover both the diagnosis of human cases and the epidemiological surveillance of multiple sentinel species. METHODS: We developed an ELISA Protein A-peroxidase method to detect anti-F1 antibodies across several species, including humans. To determine the cut-off and performance rates, HA results from 288 samples (81 rabbits, 64 humans, 66 rodents and 77 dogs) were used as reference. Next, we evaluated the agreement between Protein A-ELISA and Anti-IgG ELISA in an expanded sample set (n = 487). RESULTS: Optimal conditions were found with 250ng/well of F1 and 1:500 serum dilution. Protein A-ELISA showed high repeatability and reproducibility. We observed good correlation rates between the Protein A and IgG ELISAs optical densities and a higher positive/negative OD ratio for the Protein A-ELISA method. The overall sensitivity, specificity and area under the curve for Protein A-ELISA were 94%, 99% and 0.99, respectively. Similar results were observed for each species separately. In the analysis of the expanded sample set, there was a strong agreement between Protein A and IgG assays (kappa = 0.97). Furthermore, there was no cross-reaction with other common infectious diseases, such as dengue, Zika, Chagas disease, tuberculosis (humans) and ehrlichiosis, anaplasmosis and leishmaniasis (dogs). CONCLUSIONS: Altogether, the Protein A-ELISA showed high performance when compared both to HA and Anti-IgG ELISA, with a polyvalent single protocol that requires reduced amounts of antigen and can be employed to any plague hosts.

High-resolution genome-wide analysis is essential for the identification of ambiguous Aeromonas strains.

Aeromonads are mainly opportunistic pathogens; however, many species are emerging as important human pathogens. Therefore, monitoring these bacteria and their accurate characterization of its species is highly important. Aeromonas Aer593 strain was recovered from a diarrhoea outbreak and did not group with any previously described Aeromonas species by housekeeping gene sequencing. To clarify the taxonomic position of Aer593, its genome was sequenced and analysed by multilocus phylogenetic analysis (MLPA), in silico DNA-DNA hybridization (isDDH), average nucleotide identity (ANI) and core genome-based phylogenetic analyzes. The MLPA with the housekeeping genes gyrB, rpoD, recA, dnaJ, gyrA and dnaX ranked the Aer593 isolate into an independent branch suggesting that it could represent a new species. However, the identity percentages of Aer593 to A. caviae strains using robust genomic analysis by isDDH and ANI were at least 81.3% and 97.8%, respectively, defining Aer593 as A. caviae. Multilocus sequence typing (MLST) presented an exact match against only a single allele (groL96) and the novel ST648 was assigned for this strain. The core genome-based phylogenetic analyses with a total of 863 orthologous genes also grouped the Aer593 isolate with A. caviae reference strains. These findings warn about the possibility of misidentification of some Aeromonas strains by MLPA and show that high-resolution genome-wide analysis is essential for the correct identification of ambiguous Aeromonas strains.

Microscopic detection of Mycobacterium tuberculosis in direct or processed sputum smears.

INTRODUCTION: Microscopic identification of active pulmonary tuberculosis (PTB) from direct smears of sputum (DS) is widely used for detection, but has limited sensitivity. Here, we assessed the yield of acid-fast bacilli (AFB) detection in processed sputum smears (PSS). METHODS: Sputum samples were simultaneously analyzed by direct sputum smearing and after chemical treatment and spontaneous sedimentation. RESULTS: Of the 1,719 samples analyzed, 16.4% were positive for AFB in conventional DS and 21.4% in PSS, corresponding to a 30% increase in detection. CONCLUSIONS: Increased sensitivity from analyzing PSS and better safety protocols will contribute to improved detection and control of the disease.

[Secular plague trend in Ceará State, Brazil]. / Tendência secular da peste no Estado do Ceará, Brasil.

After its introduction into the State of Ceará, Brazil, in 1900, the plague was established in seven ecological complexes: Chapada do Araripe and the Ibiapaba, Baturité, Machado, Matas, Pedra Branca, and Uruburetama mountains. These natural foci were monitored successively from 1935 to 2004 by the National Health Department, National Plague Service, National Department of Rural Endemics, Superintendency of Public Health Campaigns, National Health Foundation, and finally by the National Health Surveillance Secretariat. Data analysis on human cases during these 70 years allowing identifying different plague circulation patterns in the human population, alternating high incidence with silent periods and characterizing a chronological periodicity with unique epidemiological characteristics, besides concluding that plague should still be considered a potential threat, thus justifying the revitalization of surveillance measures by strengthening all levels in the Unified National Health System.

Seroprevalence and spatial distribution dynamics of Yersinia pestis antibodies in dogs and cats from plague foci in the State of Ceará, Northeastern Brazil.

INTRODUCTION: In Brazil, the plague is established in several foci located mainly in the northeastern part of the country, where it alternates between active and quiescent periods. These foci in the State of Ceará have high epidemiological importance. In addition to other plague detection activities, plague areas can be monitored through serological surveys of dogs and cats (domestic carnivores), which, following feeding on plague-infected rodents, can develop mild to severe forms of the disease and produce long-lasting antibodies. This study aimed to characterize the circulation dynamics and spatial distribution of Yersinia pestis antibodies in dogs and cats in plague foci areas of Ceará. METHODS: An ecological study was conducted to analyze the temporal series and spatial distribution of secondary data obtained from domestic carnivore serum surveillance in Ceará's plague areas from 1990 to 2014. RESULTS: Joinpoint analysis revealed that the overall trend was a reduction in antibody-positive animals. The mean proportion of antibody-positivity during the whole study period was 1.5% (3,023/203,311) for dogs, and 0.7% (426/61,135) for cats, with more than 4% antibody-positivity in dogs in 1997 and 2002. Antibody titers ranging from 1/16 to 1/64 were frequent. Despite fluctuations and a significant reduction, in recent years, there were antibody-positive animals annually throughout the study period, and the localities containing antibody-positive animals increased in number. CONCLUSION: Yersinia pestis is actively circulating in the study areas, posing a danger to the human population.

Ehrlichia canis and Rickettsia spp. in dogs from urban areas in Paraiba state, northeastern Brazil.

The aims of our study was to identify Ehrlichia canis and antibodies against Rickettsia spp. belonging to the spotted fever group (SFG) in dogs sampled from Paraiba state, northeastern Brazil. Blood and serum samples collected by convenience from dogs in urban areas of five municipalities were analyzed by real-time PCR for the detection of E. canis DNA and by immunofluorescence assay test (IFAT) for the identification of antibodies against Rickettsia rickettsii, R. felis, R. parkeri, R. amblyommii and R. rhipicephali antigens. E. canis DNA was detected in 8.9% (64/719) of the blood samples, whereas 5.63% (43/763) of the serum samples were positive for at least one of the Rickettsia antigens tested by IFAT. This study showed for the first time the occurrence of E. canis and suggested the circulation of SFG Rickettsia in dogs in the study region of Paraiba state, northeastern Brazil.

[Surveillance of plague in the State of Ceará: 1990-1999]. / Vigilância da peste no Estado do Ceará: 1990-1999.

Serological surveillance activities regarding the foci of plague in Ceará State have detected a rising number of sentinel animals with antiplague antibodies in 1995, with a peak in 1997 demonstrating an increase in the plague bacteria activities throughout all the foci investigated. From a total of 110,725 serum samples collected from rodents (7,873) and domestic carnivores (102,852) analyzed by the Hemaglutination technique (HA) for antibodies against F1 antigen of Yersinia pestis 905 samples tested positive. In these samples there were 15 rodents (4 Rattus rattus and 11 Galea spp), 720 dogs and 170 cats. Of the 652 human suspected and contact cases investigated by HA, only two were positive. A third case had a positive hemoculture for Y. pestis. The isolate is highly pathogenic for laboratory animals and showed sensitivity to the antimicrobial drugs used for plague treatment.

Incremento da baciloscopia no diagnóstico de tuberculose pulmonar em pessoas privadas de liberdade / Increment of the microscopy in the diagnosis of pulmonary tuberculosis in inmates

Objetivo: Avaliar um procedimento de fácil execução e baixo custo para incrementar o diagnóstico da tuberculose entre pessoas privadas de liberdade sem riscos de contaminação para profissionais de laboratório. Métodos: Amostras de escarro foram analisadas por baciloscopia após tratamento com hipoclorito de sódio e sedimentação espontânea em comparação à baciloscopia direta convencional, cultura pelo método Ogawa-Kudoh e o teste molecular rápido pelo sistema Xpert®MTB/RIF. Para as análises estatísticas foram empregados os programas Open Epi e SPSS. Resultados: De 436 amostras de escarro submetidas ao cultivo 71 foram positivas (verdadeiros positivos) e dessas 50 foram positivas pela baciloscopia direta convencional e 67 pela baciloscopia do escarro processado, o que corresponde a um incremento de 29% na positividade. Conclusão: O procedimento proposto preserva as vantagens e aumenta a sensibilidade da baciloscopia direta convencional. A implementação dessa técnica para diagnóstico entre grupos vulneráveis em locais de acesso e recursos limitados poderá aumentar a identificação de casos de tuberculose pulmonar.

Microscopic detection of Mycobacterium tuberculosis in direct or processed sputum smears

Abstract INTRODUCTION: Microscopic identification of active pulmonary tuberculosis (PTB) from direct smears of sputum (DS) is widely used for detection, but has limited sensitivity. Here, we assessed the yield of acid-fast bacilli (AFB) detection in processed sputum smears (PSS). METHODS: Sputum samples were simultaneously analyzed by direct sputum smearing and after chemical treatment and spontaneous sedimentation. RESULTS: Of the 1,719 samples analyzed, 16.4% were positive for AFB in conventional DS and 21.4% in PSS, corresponding to a 30% increase in detection. CONCLUSIONS: Increased sensitivity from analyzing PSS and better safety protocols will contribute to improved detection and control of the disease.

Seroprevalence and spatial distribution dynamics of Yersinia pestis antibodies in dogs and cats from plague foci in the State of Ceará, Northeastern Brazil

Abstract INTRODUCTION: In Brazil, the plague is established in several foci located mainly in the northeastern part of the country, where it alternates between active and quiescent periods. These foci in the State of Ceará have high epidemiological importance. In addition to other plague detection activities, plague areas can be monitored through serological surveys of dogs and cats (domestic carnivores), which, following feeding on plague-infected rodents, can develop mild to severe forms of the disease and produce long-lasting antibodies. This study aimed to characterize the circulation dynamics and spatial distribution of Yersinia pestis antibodies in dogs and cats in plague foci areas of Ceará. METHODS: An ecological study was conducted to analyze the temporal series and spatial distribution of secondary data obtained from domestic carnivore serum surveillance in Ceará's plague areas from 1990 to 2014. RESULTS: Joinpoint analysis revealed that the overall trend was a reduction in antibody-positive animals. The mean proportion of antibody-positivity during the whole study period was 1.5% (3,023/203,311) for dogs, and 0.7% (426/61,135) for cats, with more than 4% antibody-positivity in dogs in 1997 and 2002. Antibody titers ranging from 1/16 to 1/64 were frequent. Despite fluctuations and a significant reduction, in recent years, there were antibody-positive animals annually throughout the study period, and the localities containing antibody-positive animals increased in number. CONCLUSION: Yersinia pestis is actively circulating in the study areas, posing a danger to the human population.

Ehrlichia canis and Rickettsia spp. in dogs from urban areas in Paraiba state, northeastern Brazil / Ehrlichia canis e Rickettsia spp. em cães de áreas urbanas da Paraíba, nordeste do Brasil

Abstract The aims of our study was to identify Ehrlichia canis and antibodies against Rickettsia spp. belonging to the spotted fever group (SFG) in dogs sampled from Paraiba state, northeastern Brazil. Blood and serum samples collected by convenience from dogs in urban areas of five municipalities were analyzed by real-time PCR for the detection of E. canis DNA and by immunofluorescence assay test (IFAT) for the identification of antibodies against Rickettsia rickettsii, R. felis, R. parkeri, R. amblyommii and R. rhipicephali antigens. E. canis DNA was detected in 8.9% (64/719) of the blood samples, whereas 5.63% (43/763) of the serum samples were positive for at least one of the Rickettsia antigens tested by IFAT. This study showed for the first time the occurrence of E. canis and suggested the circulation of SFG Rickettsia in dogs in the study region of Paraiba state, northeastern Brazil.

Resumo Os objetivos do nosso estudo foram identificar Ehrlichia canis e anticorpos contra Rickettsia spp. pertencentes ao Grupo da Febre Maculosa (GFM) em cães amostrados no estado da Paraíba, nordeste do Brasil. As amostras de sangue e soro, coletados por conveniência, de cães em áreas urbanas de cinco municípios foram analisadas por PCR em tempo real para a detecção de DNA de E. canis e pela Reação de Imunofluorescência Indireta (RIFI) para identificação de anticorpos contra Rickettsia rickettsii, R. felis, R. parkeri, R. amblyommii e R. rhipicephali. O DNA de E. canis foi detectado em 8,9% (64/719) das amostras de sangue, enquanto que 5,63% (43/763) das amostras de soro foram positivas para pelo menos um dos antígenos de Rickettsia testados por RIFI. Este estudo mostrou pela primeira vez a ocorrência de E. canis e sugere a circulação de Rickettsia do GFM em cães na região em estudo do estado da Paraíba, Nordeste do Brasil.

Survey of Ehrlichia canis, Babesia spp. and Hepatozoon spp. in dogs from a semiarid region of Brazil / Pesquisa de Ehrlichia canis, Babesia spp. e Hepatozoon spp. em cães de uma região semiárida do Brasil

This study assessed the occurrence of Ehrlichia spp., Babesia spp. and Hepatozoon spp. infections in 100 tick-harboring dogs from a semiarid region of the State of Paraíba, Northeastern Brazil. Blood samples and ticks were collected from the animals, and a questionnaire was submitted to dog owners to obtain general data. Blood samples were used to perform hemogram, direct blood smear and immunological and molecular hemoparasite detection. The 1,151 ticks collected were identified as Rhipicephalus sanguineus; direct smears revealed E. canis-like morulae in the monocytes of 4% (4/100) of the non-vaccinated female dogs, and 34% and 25% of the dogs tested positive for Ehrlichia canis by indirect immunofluorescence assay (IFA) and polymerase chain reaction (PCR), respectively. Blood smear examination revealed Babesia-suggestive merozoites in the erythrocytes of 2% (2/100) of the animals. Babesia vogeli was detected by PCR in ten animals (10%) and was correlated with young age (p = 0.007) and thrombocytopenia (p = 0.01). None of the animals showed Hepatozoon spp. positivity. These results indicate that E. canis is the main tick-borne canine pathogen in the study area and provide the first report of B. vogeli infection in dogs from Paraiba State.

O presente estudo avaliou a ocorrência de infecção por Ehrlichia spp., Babesia spp. e Hepatozoon spp. em 100 cães, infestados por carrapatos, oriundos de uma região semiárida do Estado da Paraíba, Nordeste do Brasil. Amostras de sangue e de carrapatos foram coletadas dos animais, e um questionário foi submetido aos proprietários dos cães para obter dados gerais. As amostras de sangue foram utilizadas para realização de hemograma, esfregaço sanguíneo e detecção molecular dos hemoparasitos. Os 1.151 carrapatos coletados foram identificados como Rhipicephalus sanguineus; os esfregaços sanguíneos revelaram mórulas sugestivas de E. canis em 4% (4/100) de cães fêmeas não vacinadas, e 34% e 25% dos cães foram positivos para Ehrlichia canis pela imunofluorescência indireta (IFI) e reação em cadeia pela polimerase (PCR), respectivamente. Os esfregaços sanguíneos revelaram merozoítas sugestivas de Babesia em eritrócitos de 2% (2/100) dos animais. Babesia vogeli foi detectada por PCR em dez animais (10%) e foi correlacionada com a idade jovem (p=0,007) e trombocitopenia (p=0,01). Nenhum dos animais apresentou positividade para Hepatozoon spp. Esses resultados indicam que E. canis é o principal patógeno canino transmitido por carrapato, na área estudada, e fornece o primeiro relato de infecção por B. vogeli em cães do Estado da Paraíba.

[Prevalence of antibodies against Yersinia pestis in domestic carnivores, in plague foci in the State of Ceará]. / Prevalência de anticorpos contra Yersinia pestis em carnívoros domésticos nos focos pestosos, do Estado do Ceará

The prevalence of antibodies against Yersinia pestis in domestic carnivores (dogs and cats), in plague areas in the State of Ceará, was analyzed to establish the importance of monitoring these animals within the routine practice of the plague control program. Over the decade 1997-2006, 146,732 serum samples were examined (95,883 from dogs and 50,849 from cats), of which 2,629 (2,234 from dogs and 395 from cats) proved to be positive. The prevalence among dogs (85%) was higher than among cats (15%) throughout the decade and in all places, except in Ibiapina in 1998. The significance of these findings has not yet been determined. Studies on this zoonosis in Brazil have been based on paradigms that did not cover all the elements involved in the zoonosis, thus making it impossible to properly understand the role of these carnivores. Monitoring of plague foci conducted exclusively by means of dog surveys may result in progressive lack of knowledge of the epidemiological situation of plague, if supplementary inter-institutional research is not developed.

Biossegurança, Proteção Ambiental e Saúde: compondo o mosaico / Biosafety, Environmental Protection and Health: completing the puzzle

O presente trabalho faz uma reflexão sobre a construção do campo da Biossegurança, apresenta sua abrangência, os complexos temas tratados e sua perspectiva interdisciplinar. O objetivo desse campo é propor ações capazes de prevenir e controlar riscos de agravos à saúde ambiental e humana, respondendo aos desafios teóricos e práticos impostos pelas constantes mudanças no mundo, decorrentes das intervenções humanas sobre a natureza, mediadas pelos avanços científicos e tecnológicos. São abordadas questões que inserem a Biossegurança como ferramenta na busca de um modelo de desenvolvimento sustentável, resgatando a relação entre degradação ambiental, condições precárias de saúde e controle do surgimento e ressurgimento de doenças nas populações.

This work reflects on the development of the field of Biosafety. The scope of this field is presented, as well as its complex themes and its interdisciplinary perspective. The scope of this field is to propose actions capable of preventing and controlling the risk of worsening human and environmental health. This is done in order to provide alternatives to the theoretical and practical challenges posed by the rapid changes in the world, resulting from human intervention in nature and mediated by scientific and technological advances. We address questions that place Biosafety as a tool in the search for a model of sustainable development, establishing the relationship between environmental degradation, precarious health conditions, and control of the emergence and reemergence of diseases in populations.