A perspective on research ethics committees in the Brazilian amazon

This study presents the importance of the Research Ethics Committees (CEP) in the context of the Brazilian North Region, formed by the Amazon rainforest, which is occupied by traditional populations and those constituted by migratory currents. This study aims to analyze the bioethical implications arising from the activities of CEPs in the ethical evaluation of research projects and their essential role in protecting vulnerable populations. The authors seek to highlight the importance of ethics committees in the Amazon and their importance face the modern bioethical values that can contribute to the preservation of one of the most valuable and diverse environments on earth.

Este estudio presenta la importancia de los comités de ética en investigación (CEP) en el contexto de la Región Norte de Brasil, formada por la selva amazónica, ocupada por poblaciones tradicionales y constituida por corrientes migratorias. Este estudio tiene como objetivo analizar las implicaciones bioéticas derivadas de las actividades de los CEP en la evaluación ética de los proyectos de investigación y su papel esencial en la protección de las poblaciones vulnerables. Los autores buscan destacar la importancia de los comités de ética en la Amazonia y su importancia frente a los valores bioéticos modernos que pueden contribuir a la preservación de uno de los ambientes más valiosos y diversos del planeta.

Esse estudo apresenta a importância dos Comitês de Ética em Pesquisa (CEPs) no contexto da Região Norte Brasileira, formada pela floresta amazônica e ocupada por populações tradicionais e aquelas constituídas por correntes migratórias. Esse estudo objetiva analisar as implicações bioéticas que surgem das atividades dos CEPs na avaliação ética de projetos de pesquisa e seu papel fundamental em proteger populações vulneráveis. Os autores procuram enfatizar a importância dos comitês de ética na Amazônia e sua importância face a valores bioéticos modernos, que podem contribuir para a preservação de um dos mais valiosos e diversos ambientes na terra.

Updating risk remediation-endpoints for petroleum-contaminated soils? A case study in the Ecuadorian Amazon region.

In Ecuador, the regulatory framework for the remediation of petroleum-contaminated soils is based on predefined concentration endpoints for a selected range of petroleum hydrocarbon compounds. However, such approach may lead to over or under-estimation of the environmental risk posed by contaminated soils. In this study, the end-point remediation criteria according to Ecuadorian Environmental legislation were evaluated using different approaches. The first one was based on Total Extractable Petroleum Hydrocarbons (TEPH) and the second one on Total Bioavailable Petroleum Hydrocarbons (TBPH). Both were compared with ecotoxicological determinations using EC50 -Microtox® bioassay at 5 and 15 min of exposure. The correlation (R2) between EC50 values vs TEPH was of 0.2 and 0.25 for 5 and 15 min, respectively. Meanwhile, R2 between EC50 and TBPH was of 0.9 and 0.65 for 5 and 15 min, respectively, demonstrating a stronger correlation. Our results suggest that a contaminated site where the concentration of the TEPH is higher than the relevant regulatory concentrations may be deemed to present an acceptable risk even though their concentrations exceed the target values in soils. The results also challenge the notion that hormesis is associated with TEPH, contrary to some literature. This study is the first in Ecuador to propose incorporating bioavailability into environmental regulations, highlighting the need for further research to establish realistic and achievable remediation goals based on toxicity studies involving various trophic levels.

Thermographic Profiles in Livestock Systems under Full Sun and Shaded Pastures during an Extreme Climate Event in the Eastern Amazon, Brazil: El Niño of 2023.

The El Niño represents a substantial threat to pastures, affecting the availability of water, forage and compromising the sustainability of grazing areas, especially in the northern region of Brazil. Therefore, the objective of this study was to characterize the thermographic profile of three production systems in the Eastern Amazon, Brazil. The study was conducted on a rural cattle farm in Mojuí dos Campos, Pará, Brazil, between August and November 2023. The experiment involved livestock production systems, including traditional, silvopastoral and integrated, with different conditions of shade and access to the bathing area. An infrared thermographic (IRT) camera was used, recording temperatures in different zones, such as areas with trees, pastures with forage and exposed pastures. The highest mean temperatures (p = 0.02) were observed in pastures with full sun from August to November. On the other hand, the lowest average temperatures were recorded in areas shaded by chestnut trees (Bertholletia excelsa). The highest temperature ranges were found in sunny areas and the lowest were recorded in shaded areas. The highest temperatures were observed in the pasture in full sun, while the lowest were recorded in areas shaded by chestnut trees (p < 0.0001). The interaction between the systems and treatments revealed significant temperature differences (p < 0.0001), with the native trees showing an average temperature of 35.9 °C, lower than the grasses and soil, which reached 61.2 °C. This research concludes that, under El Niño in the Eastern Amazon, areas shaded by Brazil nut trees had lower temperatures, demonstrating the effectiveness of shade. Native trees, compared to grasses and soil, showed the ability to create cooler environments, highlighting the positive influence on different species such as sheep, goats and cattle.

Seroprevalence of the Hepatitis E Virus in Indigenous and Non-Indigenous Communities from the Brazilian Amazon Basin.

Hepatitis E virus (HEV) infection is a common cause of acute viral hepatitis in tropical regions. In Brazil, HEV G3 is the only genotype detected to date. Reports on HEV prevalence are heterogeneous. We aimed to compare the prevalence of anti-HEV among three populations living in the Brazilian Amazon basin. Two cross-sectional studies were conducted in urban, rural, and Yanomami indigenous areas. Plasma samples from 428 indigenous and 383 non-indigenous subjects were tested for anti-HEV IgG using enzyme-linked immunosorbent assays. The overall prevalence of anti-HEV was 6.8% (95%CI: 5.25-8.72), with 2.8% (12/428) found in the Yanomami areas, 3% (3/101) in an urban area, and 14.2% (40/282) in a rural area. Multivariate logistic analysis indicated that patients aged 31-45 years or ≥46 years are more likely to present anti-HEV positivity, with a respective aOR of 2.76 (95%CI: 1.09-7.5) and 4.27 (95%CI: 1.58-12.35). Furthermore, residence in a rural area (aOR: 7.67; 95%CI: 2.50-33.67) represents a relevant risk factor for HEV infection. Additional studies detecting HEV RNA in fecal samples from both humans and potential animal reservoirs are necessary to comprehensively identify risk factors associated with HEV exposure.

Desafios avaliativos em cenário ribeirinho: pistas metodológicas para o acesso à rede de urgência e emergência / Evaluation challenges in a ribeirinho context: methodological clues in accessing the urgency and emergency network / Desafíos evaluativos en el escenario ribereño: pistas metodológicas para el acceso a la red de urgencia y emergencia

O acesso à saúde e às políticas públicas em áreas remotas é um desafio relevante aos sistemas públicos no Brasil, dada sua dimensão e diversidade territorial. Este artigo tem como proposta apresentar o modelo teórico-lógico elaborado para avaliar o acesso da população ribeirinha à rede de urgência e emergência (RUE) em cenário amazônico, com vistas a fortalecer o planejamento, o monitoramento e a avaliação em saúde voltados para populações específicas. O ponto de partida metodológico foi a revisão temática sobre o acesso à saúde e o contexto amazônico na sua inter-relação com a proposta da pesquisa, que foi problematizada em encontros com colaboradores. Em seguida, buscou-se compreender e analisar os componentes teórico e lógico do modelo e adaptá-los à tríade donabediana ­ estrutura, processo e resultado. O resultado configurou a construção do modelo propriamente dito, com centralidade nas características que representam a oferta dos serviços (sócio-organizacional) e que retratam principalmente o espaço (geográfico). Esses pontos de construção do modelo demonstram sua contribuição para subsidiar outros processos avaliativos e o impacto final na tomada de decisão para qualificar o acesso da população ribeirinha à saúde em momento de sofrimento agudo, auxiliando na superação das condições que segregam essas populações.

Access to health and public policies in remote areas is a major challenge for public systems in Brazil, given its dimension and territorial diversity. This article presents a theoretical-logical model designed to assess the ribeirinho population's access to the urgency and emergency network in the Amazon as to strengthen health planning, monitoring, and evaluation aimed at specific populations. Starting from a thematic review on access to health and the Amazon in its interrelation with the research proposal, which were problematized in meetings with collaborators, the research sought to understand and analyze the model's theoretical and logical components and adapt them to the Donabedian triad (structure, process and result). This resulted in the model itself, centered on service provision (socio-organizational) and the space (geographic). These points demonstrate its contribution to support other evaluation processes and the final impact on decision-making to qualify this population's access to health under acute suffering, helping to overcome current restrictive conditions.

El acceso a la salud y a las políticas públicas en áreas remotas es un desafío relevante para el sistema público en Brasil dada su dimensión y diversidad territorial. El objetivo de este artículo es presentar un modelo teórico-lógico desarrollado para validar el acceso de la población ribereña a la red de urgencia y emergencia en el escenario amazónico, para fortalecer la planificación, la vigilancia y la evaluación de los resultados de salud de poblaciones específicas. El punto de partida metodológico fue la revisión temática sobre el acceso a la salud en el contexto amazónico, en especial su interrelación con la propuesta de investigación, que fue problematizada en reuniones con colaboradores. Después, se buscó comprender y analizar los componentes teórico y lógico del modelo y adaptarlos a la tríada donabediana ­estructura, proceso y resultado. El resultado configuró la construcción del modelo propiamente dicho, con foco en las características que representan la prestación de los servicios (social-organizacional) y que retratan principalmente el espacio (geográfico). Estos puntos de construcción del modelo destacan su contribución para subsidiar otros procesos evaluativos y el impacto final en la toma de decisiones para calificar el acceso de la población ribereña a la salud en un momento de sufrimiento agudo, ayudando a superar las condiciones que segregan a estas poblaciones.

Metagenomic of Liver Tissue Identified at Least Two Genera of Totivirus-like Viruses in Molossus molossus Bats.

The Totiviridae family of viruses has a unique genome consisting of double-stranded RNA with two open reading frames that encode the capsid protein (Cap) and the RNA-dependent RNA polymerase (RdRpol). Most virions in this family are isometric in shape, approximately 40 nm in diameter, and lack an envelope. There are five genera within this family, including Totivirus, Victorivirus, Giardiavirus, Leishmaniavirus, and Trichomonasvirus. While Totivirus and Victorivirus primarily infect fungi, Giardiavirus, Leishmaniavirus, and Trichomonasvirus infect diverse hosts, including protists, insects, and vertebrates. Recently, new totivirus-like species have been discovered in fish and plant hosts, and through metagenomic analysis, a novel totivirus-like virus (named Tianjin totivirus) has been isolated from bat guano. Interestingly, Tianjin totivirus causes cytopathic effects in insect cells but cannot grow in mammalian cells, suggesting that it infects insects consumed by insectivorous bats. In this study, we used next-generation sequencing and identified totivirus-like viruses in liver tissue from Molossus molossus bats in the Amazon region of Brazil. Comparative phylogenetic analysis based on the RNA-dependent RNA polymerase region revealed that the viruses identified in Molossus bats belong to two distinct phylogenetic clades, possibly comprising different genera within the Totiviridae family. Notably, the mean similarity between the Tianjin totivirus and the totiviruses identified in Molossus bats is less than 18%. These findings suggest that the diversity of totiviruses in bats is more extensive than previously recognized and highlight the potential for bats to serve as reservoirs for novel toti-like viruses.

Use of the gonadal structures of the mangrove crab Ucides cordatus as a biomarker for environmental contamination by metals.

This study investigates the concentration of metals in the different developmental phases of the gonads of Ucides cordatus from mangrove areas of Vila do Bacuriteua on the Bragança Peninsula, Caeté-Taperaçu Marine Extractive Reserve, state of Pará, on the Brazilian Amazon coast. Elemental analysis was determined by inductively coupled plasma optical emission spectrometry (ECP-OES). Metal concentration in males ranged from Cd = 0.04 to Cu = 2.27 mg kg-1 ww in the Developing and Developed gonadal stages, respectively. In females it was from Cd = 0.11 to Cu = 8.43 mg kg-1 ww only in the Developed stage). The elements Cr and Pb, for both sexes, presented concentrations above the limits allowed by the Brazilian regulatory body and only Pb by the international agencies, revealing a higher degree of contamination of these metals in the gonads of the mangrove crabs. Increasing mangrove crab consumption amplifies the risks of metal contamination among the human population and may cause public health problems.

Malaria in a vulnerable population living in quilombo remnant communities in the Brazilian Amazon: a cross-sectional study from 2005-2020

ABSTRACT Quilombo remnant communities are areas officially recognized by the Brazilian government as historical communities founded by formerly enslaved individuals. These communities are mostly located in the endemic areas of malaria in the Brazilian Amazon. We retrospectively described the prevalence of malaria among individuals living in 32 recognized quilombo remnant communities in the Baiao and Oriximina municipalities located in the Para State. The number of malaria cases and the Annual Parasitic Incidence (API) recorded by the Brazilian malaria surveillance system (SIVEP-Malaria) from January 2005 to December 2020 were analyzed. We found that all communities registered at least one case over the 16-year period, the most frequent parasitic species being Plasmodium vivax (76.1%). During this period, 0.44% (4,470/1,008,714) of the malaria cases registered in Para State were reported in these quilombo remnant communities, with frequencies of 10.9% (856/7,859) in Baiao municipality and 39.1% (3,614/9,238) in Oriximina municipality, showing that individuals living in these rural communities are exposed to malaria. These data indicate that effective surveillance requires improved measures to identify malaria transmission among vulnerable populations living in quilombo remnant communities in the Brazilian Amazon.

Epidemiological and molecular surveillance of norovirus in the Brazilian Amazon: description of recombinant genotypes and improvement of evolutionary analysis

ABSTRACT Noroviruses are highly infectious, genetically diverse viruses. Global outbreaks occur frequently, making molecular surveillance important for infection monitoring. This cross-sectional descriptive study aimed to monitor cases of norovirus gastroenteritis in the Brazilian Amazon. Fecal samples were tested by immunoenzymatic assay, RT-PCR and genetic sequencing for the ORF1/ORF2 and protease regions. Bayesian inference with a molecular clock was employed to construct the phylogeny. The norovirus prevalence was 25.8%, with a higher positivity rate among children aged 0-24 months. Genogroup GII accounted for 98.1% of the sequenced samples, while GI accounted for 1.9% of them. The GII.P16/GII.4 genotype was the most prevalent, with an evolution rate of 2.87x10−3 and TMRCA estimated in 2012. This study demonstrates that norovirus is a primary causative agent of gastroenteritis and provides data on viral genetic diversity that may facilitate infection surveillance and vaccine development.

Seasonal dynamics of Amblyomma cajennense (Fabricius, 1787) sensu stricto in a degraded area of the Amazon biome, with notes on Rickettsia amblyommatis infection.

BACKGROUND: The tick Amblyomma cajennense sensu stricto (A. cajennense s.s.) frequently parasitizes animals and humans in the Amazon biome, in addition to being a vector of Rickettsia amblyommatis. In the present study, we evaluated both the population dynamics of A. cajennense s.s. in a degraded area of the Amazon biome and the presence of rickettsial organisms in this tick population. METHODS: The study was carried out in a rural area of the Santa Inês municipality (altitude: 24 m a.s.l.), Maranhão state, Brazil. Ticks were collected from the environment for 24 consecutive months, from June 2021 to May 2023. The region is characterized by two warm seasons: a rainy season (November-May) and a dry season (June-October). We characterized the temporal activity of A. cajennense s.s. on the vegetation by examining questing activity for each life stage (larvae, nymphs, adults [males and females]) in relation to the dry and rainy season. Ticks collected in this study were randomly selected and individually tested by a TaqMan real-time PCR assay that targeted a 147-bp fragment of the rickettsial gltA gene. RESULTS: Overall, 1843 (62.4%) adults (52.6% females, 47.4% males), 1110 (37.6%) nymphs and 398 larval clusters were collected. All adult females and nymphs were morphologically identified as A. cajennense s.s. Larval activity was observed from April to December, with a peak from June to September (dry season); nymph abundance peaked from September to November (transition period between dry and rainy seasons); and adult ticks were abundant from October to May (spring/summer/early autumn). The infection rate by R. amblyommatis in A. cajennense s.s. ticks was at least 7% (7/99). CONCLUSION: Our data suggest a 1-year generation pattern for A. cajennense s.s., with a well-defined seasonality of larvae, nymphs and adults in the Amazon biome. Larvae predominate during the dry season, nymphs are most abundant in the dry-rainy season transition and adults are most abundant in the rainy season. The presence of R. amblyommatis in adult ticks suggests that animals and humans in the study region are at risk of infection by this species belonging to the spotted fever group of Rickettsia.

Exposure to Treponema pallidum Infection among Adolescent and Young Adult Women in Roraima, Amazon Region of Brazil.

BACKGROUND: Syphilis is a chronic infectious disease, and its prevalence has been described since the 15th century. Because of the high prevalence of this infection in Brazil, this study aimed to evaluate the prevalence of syphilis and its associated factors among adolescent and young women living in the city of Boa Vista, Roraima, Brazil. METHODS: The present study was cross-sectional, descriptive, analytical and quantitative. It involved 200 young and adolescent women. Laboratory tests were performed to diagnose syphilis, and a sociodemographic and epidemiological questionnaire was employed. RESULTS: In the studied sample, 10 women had a positive result for syphilis, characterizing a prevalence of 5% for infection with Treponema pallidum. There was a statistically significant association between a monthly family income of less than 1 minimum wage and syphilis (p = 0.0449) and between illicit drug use and syphilis (p = 0.0234). CONCLUSIONS: These results indicate the need for public health interventions, action plans, and the implementation of risk reduction strategies focused on this population.

G6P[8] Rotavirus a Possessing a Wa-like VP3 Gene from a Child with Acute Gastroenteritis Living in the Northwest Amazon Region.

The introduction of rotavirus A (RVA) vaccines has considerably reduced the RVA-associated mortality among children under 5 years of age worldwide. The ability of RVA to reassort gives rise to different combinations of surface proteins G (glycoprotein, VP7) and P (protease sensitive, VP4) RVA types infecting children. During the epidemiological surveillance of RVA in the Northwest Amazon region, an unusual rotavirus genotype G6P[8] was detected in feces of a 2-year-old child with acute gastroenteritis (AGE) that had been vaccinated with one dose of Rotarix® (RV1). The G6P[8] sample had a DS-1-like constellation with a Wa-like VP3 gene mono-reassortment similar to equine-like G3P[8] that has been frequently detected in Brazil previously. The results presented here reinforce the evolutionary dynamics of RVA and the importance of constant molecular surveillance.

MADERA: A standardized Pan-Amazonian dataset for tropical timber species.

We compiled and presented a dataset for all timber species reported in the Amazon region from all nine South American Amazonian countries. This was based on official information from every country, as well as from two substantial scientific references. We verified the standard taxonomic names from each individual source, using the Taxonomic Name Resolution Service (TNRS) and considered all Amazonian tree species with diameter at breast height (DBH) ≥10 cm. We also obtained estimates of the current population size for most species from a published approach based on data from 1900 tree inventory plots (1-ha each) distributed across the Amazon region and part from the Amazon Tree Diversity Network (ATDN). We then identified the hyperdominant timber species. In addition, we overlapped our timber species list with data for species that are used for commercial purposes, according to the International Tropical Timber Organization (ITTO), the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) and the International Union for Conservation of Nature (IUCN) taxa assessment and Red List categories. Finally, we also included IUCN Red List categories based on combined deforestation, and climate change scenarios for these species. Our final Amazonian timber species dataset contains 1112 unique species records, which belong to 337 genera and 72 families from the lowland Amazonian rainforest, with associated information related to population, conservation, and trade status of each species. The authors of this research expect that the information provided will be useful to strengthen the public forestry policies of the Amazon countries, inform ecological studies, as well for forest management purposes. The data are released under the Creative Commons Attribution 4.0 International license.

Environmental DNA and visual encounter surveys for amphibian biomonitoring in aquatic environments of the Ecuadorian Amazon.

Background: The development of anthropogenic activities has generated a decline in aquatic fauna populations, and amphibians have been the most affected. The decline of batrachofauna is concerning, as 41% of all species worldwide are endangered. For this reason, rapid, efficient, and non-invasive biodiversity monitoring techniques are needed, and environmental DNA (eDNA) is one such tool that has been sparsely applied in Ecuador. This technique has allowed scientists generates information on species diversity and amphibian community composition from a water sample. This study applied eDNA-based biomonitoring analyses and visual encounter surveys (VES) as inventory techniques to identify the diversity of aquatic amphibians in the Tena River micro-basin (TRMB). Methods: The experimental design was divided into three components: (1) fieldwork: all amphibians were recorded by the VES technique and water samples were collected; (2) laboratory work: DNA isolation from amphibian tissue samples and eDNA-containing filters, amplification, electrophoresis, and sequencing were performed; (3) Data analysis: a local DNA reference database was constructed, and eDNA sequence data were processed for classification, taxonomic assignment, and ecological interpretation. Results: Using both eDNA and VES, we detected 33 amphibian species (13 with eDNA only, five with VES only, and 15 with both methods). These species belonged to six amphibian families: Hylidae being the richest with 14 species (three eDNA, one VES, and 10 with both methods), followed by Strabomantidae with nine species (six eDNA, one VES, and two with both methods). All families were detected with both methods, except for the Aromobatidae, having one single record (Allobates aff. insperatus) by VES. Individually, eDNA detected 28 species and had a detection probability (DP) of 0.42 CI [0.40-0.45], while VES recorded 20 species with a DP of 0.17 CI [0.14-0.20]. Similarly, using VES, Cochranella resplendens was detected for the first time in TRMB, while with eDNA, four mountain frogs Pristimantis acerus, Pristimantis eriphus, Pristimantis mallii, and Pristimantis sp. (INABIO 15591) previously recorded at 1,518 m.a.s.l. at altitudes below 600 m.a.s.l. were detected. Conclusions: Results obtained in this study showed that eDNA-based detection had a greater capacity to detect amphibians in aquatic environments compared to VES. The combination of VES and eDNA improves the sensitivity of species detection and provides more reliable, robust, and detailed information. The latter is essential for developing conservation strategies in the Ecuadorian Amazon.

Clonal dissemination of highly virulent Serratia marcescens strains producing KPC-2 in food-producing animals.

Serratia marcescens is a Gram-negative bacterium presenting intrinsic resistance to polymyxins that has emerged as an important human pathogen. Although previous studies reported the occurrence of multidrug-resistance (MDR) S. marcescens isolates in the nosocomial settings, herein, we described isolates of this extensively drug-resistant (XDR) species recovered from stool samples of food-producing animals in the Brazilian Amazon region. Three carbapenem-resistant S. marcescens strains were recovered from stool samples of poultry and cattle. Genetic similarity analysis showed that these strains belonged to the same clone. Whole-genome sequencing of a representative strain (SMA412) revealed a resistome composed of genes encoding resistance to ß-lactams [blaKPC-2, blaSRT-2], aminoglycosides [aac(6')-Ib3, aac(6')-Ic, aph(3')-VIa], quinolones [aac(6')-Ib-cr], sulfonamides [sul2], and tetracyclines [tet(41)]. In addition, the analysis of the virulome demonstrated the presence of important genes involved in the pathogenicity of this species (lipBCD, pigP, flhC, flhD, phlA, shlA, and shlB). Our data demonstrate that food-animal production can act as reservoirs for MDR and virulent strains of S. marcescens.

Bacterial Microbiota from Lab-Reared and Field-Captured Anopheles darlingi Midgut and Salivary Gland.

Anopheles darlingi is a major malaria vector in the Amazon region and, like other vectors, harbors a community of microorganisms with which it shares a network of interactions. Here, we describe the diversity and bacterial composition from the midguts and salivary glands of lab-reared and field-captured An. darlingi using metagenome sequencing of the 16S rRNA gene. The libraries were built using the amplification of the region V3-V4 16S rRNA gene. The bacterial community from the salivary glands was more diverse and richer than the community from the midguts. However, the salivary glands and midguts only showed dissimilarities in beta diversity between lab-reared mosquitoes. Despite that, intra-variability was observed in the samples. Acinetobacter and Pseudomonas were dominant in the tissues of lab-reared mosquitoes. Sequences of Wolbachia and Asaia were both found in the tissue of lab-reared mosquitoes; however, only Asaia was found in field-captured An. darlingi, but in low abundance. This is the first report on the characterization of microbiota composition from the salivary glands of An. darlingi from lab-reared and field-captured individuals. This study can provide invaluable insights for future investigations regarding mosquito development and interaction between mosquito microbiota and Plasmodium sp.

First molecular detection of Leishmania (Leishmania) infantum chagasi in a domestic cat (Felis catus) from an urban area in eastern Amazon.

Background: Domestic cats have been implicated as accidental hosts of Leishmania sp. However, in recent years, the recurrent description of new cases in endemic and nonendemic areas draw attention to the potential epidemiological role of cats as reservoir hosts. Although dogs are considered urban reservoirs, cats could act as a secondary natural reservoirs in these areas. Thus, feline leishmaniasis has become an emerging disease in several countries worldwide. Case presentation: This study aimed to describe the first case of feline leishmaniasis in a stray animal that presented lesions compatible with the disease in Belém, Pará, Brazil, an important urban area in eastern Amazon. Serological tests for Leishmania infantum (ELISA and IFA) were nonreactive, whereas histopathological examination indicated infectious dermatitis caused by Leishmania spp. or Toxoplasma gondii. Cytopathological study of lesion aspirate confirmed the presence of Leishmania sp. amastigotes within macrophages. Finally, molecular analyses revealed that the feline infection was caused by Leishmania (Leishmania) infantum chagasi. Conclusion: To the best of the authors' knowledge, this study reports the first case of natural infection by Leishmania (Leishmania) infantum chagasi in a feline from eastern Amazon. These findings suggest domestic cats as potential secondary reservoir hosts of Leishmania spp. in Belém, which reinforces the importance of further epidemiological investigation of feline leishmaniasis, especially in urban areas with human cases.

Genotoxicity biomarkers on native fish species from the Araguari River (Amazon biome).

The Araguari River, one of the most important waterways in the Brazilian state of Amapá, is ecologically relevant and essential for the conservation of Amazonian fish biodiversity. Our previous studies demonstrated contamination of water and fish by metals. In particular, water samples showed genotoxic damage in Danio rerio. Here, we extended our studies of potential genotoxic damage to native fish from sampling sites located in the Araguari River lower section. To accomplish this, we collected samples of fish with different feeding behaviors, but in the same sampling sites, and evaluated the same genotoxicity biomarkers in erythrocytes. All eleven species of fish collected in the Araguari River lower section showed profiles and frequencies of genotoxic damage similar to those previously observed in tests with D. rerio, confirming that genotoxic pollutants present in these waters are also causing damage to native fish species.

Genomic analysis of Klebsiella pneumoniae high-risk clone ST11 co-harbouring MCR-1.27 and KPC-2 recovered at a paediatric oncologic hospital in the Brazilian Amazon region.

OBJECTIVES: The horizontal transfer of antibiotic resistance genes in Gram-negative bacteria, mainly through plasmids, is one of the greatest concerns for health systems worldwide and has been a growing threat in hospitals related to healthcare-associated infections by multidrug-resistant bacteria. Here we present p henotypic and genomic characterization of a KPC-2 and MCR-1.27-producing Klebsiella pneumoniae strain isolated from a paediatric patient at an oncologic hospital in Belém, Pará State, Brazilian Amazon region. METHODS: Antibiotic susceptibility test, whole genome sequencing, and in silico analysis were used to characterize the bacterial isolate (IEC48020) received in the Evandro Chagas Institute. RESULTS: The isolate was resistant to carbapenems, colistin, polymyxin B, and several other antimicrobials and was susceptible in vitro just to tigecycline, classified as an extensively drug-resistant phenotype. Genomic analysis revealed IEC48020 strain belonged to sequence type 11, clonal complex 258 high-risk clone and the presence of eight plasmids, two of them harbouring mcr-1.27 and blaKPC-2 genes, and the presence of virulence-related genes encoding yersiniabactin, phospholipase D, and traT genes. CONCLUSIONS: The presence and dissemination of high-risk clone bacteria with high disseminating plasmids containing antibiotic resistance genes for last resource antibiotics treatment options is a threat to the healthcare system and demands efforts in surveillance and epidemiological research for better knowledge of the actual situation of antibiotic resistance in the healthcare system, especially in the Amazon region, Brazil.

Deaths by COVID-19 in a hospital from a city from Legal Amazon region: what lessons could be learned? / Mortes por COVID-19 em um hospital de uma cidade da região da Amazônia Legal: que lições podem ser aprendidas?

Objective: Describe the epidemiology of COVID-19 deaths within a hospital in the Amazon region in a period of 64 days, which corresponds to the growth curve of the COVID-19 first-wave pandemic in 2020. Methods: The data were obtained from medical records of 152 deaths registered for adults and elderly hospitalized. The data were also compared with the number of deaths in previous years during the same period studied to assess the impact of the pandemic on this hospital. The study also assesses the impact of intra-hospital transfers, accounting for the number of times patients who died performed transfers between sectors of the hospital. Results: During the period analyzed, there was an increase in deaths compared to the previous years. The majority of dead patients were male, aged between 34 and 96 years. The deaths were associated comorbidities such as arterial hypertension, diabetes mellitus, and kidney disease. The SARS-CoV-2 infection was confirmed in 91 cases. Among them, 15 individuals were admitted without conditions related to SARS-CoV-2 infection; they had a three-fold higher number of hospital transfers than those admitted with SARS-CoV-2 infection symptoms. Sixteen patients with SARS-CoV-2 infection developed respiratory symptoms just after hospitalization. The diagnostic exam for SARS-CoV-2 infection was performed on average 4 (± 6) days after the onset of symptoms and 6 (± 6) days after admission, and the average time from the onset of respiratory symptoms to death was 4 (± 6) days. Conclusions: These data suggest the high presence of hospital infection by SARS-CoV-2 in the Brazilian Amazon region, which may be related to the number of sectorial transfers, delay in confirming the diagnosis, and lack of management. We report a serious public health problem, as it demonstrates the fragility of healthcare institutions in the hospital environmen (AU).

Objetivo: Descrever a epidemiologia de mortes por COVID-19 em um hospital na região da Amazônia em um período de 64 dias, que corresponde à curva de crescimento da primeira onda da pandemia de COVID-19 em 2020. Métodos: Os dados foram obtidos de 152 óbitos registrados em prontuários de adultos e idosos hospitalizados. Os dados foram também comparados com o número de óbitos em anos anteriores, no mesmo período estudado, de forma a avaliar o impacto da pandemia neste hospital. O estudo também avalia o impacto das transferências intra-hospitalares, contabilizando o número de vezes que os pacientes que faleceram realizaram transferências entre setores do hospital. Resultados: No período analisado, houve aumento de óbitos em relação aos anos anteriores. A maioria dos pacientes mortos era do sexo masculino, com idade entre 34 e 96 anos. Os óbitos foram associados a comorbidades como hipertensão arterial, diabetes mellitus e doença renal. A infecção por SARS-CoV-2 foi confirmada em 91 casos. Entre eles, 15 indivíduos foram internados sem condições relacionadas à infecção por SARS-CoV-2; eles tiveram um número três vezes maior de transferências hospitalares do que aqueles admitidos com sintomas de infecção por SARS-CoV-2. Dezesseis pacientes com infecção por SARS-CoV-2 desenvolveram sintomas respiratórios logo após a hospitalização. O exame diagnóstico para infecção por SARS-CoV-2 foi realizado em média 4 (± 6) dias após o início dos sintomas e 6 (± 6) dias após a admissão, e o tempo médio do início dos sintomas respiratórios até o óbito foi de 4 ( ± 6) dias. Conclusões: Esses dados sugerem alta presença de infecção hospitalar por SARS-CoV-2 na região amazônica brasileira, o que pode estar relacionado ao número de transferências setoriais, demora na confirmação do diagnóstico e falta de manejo. Relatamos um grave problema de saúde pública, pois demonstra a fragilidade das instituições de saúde no ambiente hospitalar (AU).