Parasitological, microbiological, and antimicrobial resistance profiles of raw and drinking water in a tourist city in the tri-border region of South America.

Despite the large amounts of freshwater available in Brazil, the deterioration of surface water can represent a risk of waterborne disease for national and international tourists. The main goal of this study was to assess the quality of drinking water in the triple border region of Brazil before and after being treated in water treatment plants (WTPs) and in Municipal Early Childhood Education Centers (MECECs), in terms of parasitological, microbiological, and physical-chemical aspects. Different water samples were monitored: raw water (RW), treated water (TW), and tap water from the MECECs, giving 60 samples in total, to investigate the presence of Giardia and Cryptosporidium, microbiological indicators, Pseudomonas aeruginosa, and antimicrobial resistance profiles using conventional microbiological assays and parasitological, immunological, and molecular techniques. The results obtained were compared with the reference values recommended by the legislation of drinking water in Brazil. For the first time, contamination by Cryptosporidium and Giardia was demonstrated in RW used to supply WTPs, in TW of Foz do Iguaçu, and in water destined for consumption by children. A total of 52 bacterial isolates were obtained, with high percentages of multidrug resistance to antibiotics, including a carbapenem-resistant profile, highlighting the need to improve quality control standards.

Toxoplasmagondii oocysts, Giardia cysts and Cryptosporidium oocysts in outdoor swimming pools in Brazil.

The accidental ingestion of treated recreational water is an important transmission route of waterborne protozoa worldwide. The present study aimed to provide the first evaluation of swimming pools in Brazil, analysing the presence of pathogenic protozoa (Toxoplasma gondii, Cryptosporidium spp. and Giardia spp.) by parasitological and molecular methods. A total of 57 samples were collected from 21 public swimming pools, either directly from the pool or filter backwash water and concentrated using the membrane filtration technique. Giardia cysts and Cryptosporidium oocysts were visualized by direct immunofluorescence assay after purification by immunomagnetic separation. Toxoplasma gondii oocysts were detected by autofluorescence visualization using the supernatant discarded during the purification step as a sample. Positive samples were submitted to molecular analysis. The molecular markers were used: SSU-rRNA, tpi, gdh and bg, for Giardia DNA amplification, and 18S rRNA gene fragment amplification was used for the Cryptosporidium oocysts. The 529-bp repeat element (REP529) fragment and the 35-fold repetitive B1 gene were employed as a target for T. gondii. Amplified products were submitted to sequencing and phylogenetic analysis. Giardia cysts were detected in 19.0% and Cryptosporidium oocysts in 9.5% of swimming pools. In one swimming pool (4.7%), both protozoa were detected on at least one occasion. Structures similar to T. gondii oocysts were detected in 33.3% of the samples, ranging from one to 23 per slide. Giardia was confirmed by DNA amplification in three swimming pools; Giardia duodenalis Assemblage A was identified by the phylogenetic positioning of the ß-giardin gene. Toxoplasma gondii DNA was detected in 14.2% of swimming pools. The present study represents the first report of the occurrence of T. gondii oocysts in swimming pools. Recreational activity in swimming pools contaminated by chlorine-resistant protozoa can represent a high risk of infection for bathers and swimmers.

Genotypic characterization and assessment of infectivity of human waterborne pathogens recovered from oysters and estuarine waters in Brazil.

Waterborne, food-borne and sewage-borne pathogens are a major global concern, with the annual recurrence, most notably during the summer, of outbreaks of gastroenteritis of unconfirmed etiology associated with recreational activities in marine environments. The consumption of contaminated water-based foodstuffs is also related to outbreaks of human illness. The main goals of the present study were: i) to identify the genetic assemblages of Giardia duodenalis cysts in growing and depurated oysters destined for human consumption on the southern coast of São Paulo, Brazil; ii) to verify the main circulating G. duodenalis assemblages and their subtypes in different brackish waters used for the production of mollusks and for recreational purposes; iii) to track the contamination of growing and depurated oysters by the human adenovirus and identify the infectivity of adenoviral particles recovered from oysters before and after depuration; iv) to evaluate the occurrence and genotype of the free-living amoebae of the genus Acanthamoeba in brackish water and oysters from all the sites described above. Four sampling sites in the Cananeia estuary were selected to search for pathogenic and amphizoic protozoa (Giardia and Acanthamoeba respectively): site 1: oyster growth, site 2: catchment water (before UV depuration procedure), site 3: filter backwash (filtration stage of water treatment) and site 4: oyster depuration tank. Oysters at sites 1 and 4 were evaluated for the presence of adenovirus (HAdV). Analysis consisted of conventional microbiological as well as molecular methods. Giardia duodenalis were detected in all the water sites analyzed and the molecular analysis revealed that sub-assemblage AII was the most frequently distributed throughout the estuarine environment, although one sample was identified as belonging to the assemblage C. Acanthamoeba were also isolated from different locations of the estuarine area, and were detected at all the analyzed sites. The majority of isolates belonged to the T3 genotype, while the T4 genotype was identified once. The sequencing reaction of Giardia duodenalis revealed the contamination of three batches of depurated oysters by the sub-assemblage AII. With respect to viruses, seven batches of oysters (four growing and three depurated) were found to be harboring infectious HAdV particles when submitted to plaque assay. Overall, the results of the sequencing reactions combined with the plaque assay revealed that the isolates of Giardia duodenalis and the infectious HAdV particles identified in oyster tissues have the potential to infect humans and pose a threat if consumed raw or lightly cooked. This is the first report on the sub-assemblage AII identified in oysters which are submitted to a cleaning and disinfection procedure prior to human consumption in Brazil. Acanthamoeba specific genotypes were also identified for the first time in a recreational estuarine area in Brazil, contributing to knowledge of their molecular and environmental epidemiology, which is considered scarce even in marine and estuarine areas of the world.

Giardiasis as a neglected disease in Brazil: Systematic review of 20 years of publications.

INTRODUCTION: Giardiasis is an intestinal infection that affects more than two hundred million people annually worldwide; it is caused by the flagellated protozoan Giardia duodenalis. In tropical countries and in low or middle-income settings, like Brazil, its prevalence can be high. There is currently no systematic review on the presence of G. duodenalis in patients, animals or water sources in Brazil. METHODS: This systematic review was performed according to recommendations established by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). As databases for our searches, we have used PubMed, Embase, Scopus and the Brazilian database SciELO using the keywords «Giardia*¼ and «Brazil¼. RESULTS: This systematic review identified research studies related to G. duodenalis in water, giardiasis in animals, prevalence of giardiasis across Brazilian regions, genotyping of strains isolated in humans, and giardiasis in indigenous populations. We also propose a network of G. duodenalis transmission in Brazil based on genotypes analyses. CONCLUSION: This is the first time within the last twenty years that a review is being published on the occurrence of G. duodenalis in Brazil, addressing relevant issues such as prevalence, molecular epidemiology and analytical methods for parasite detection.

Virus, protozoa and organic compounds decay in depurated oysters.

AIMS: (1) Evaluate the dynamic of the depuration process of Crassostrea gigas oysters using different ultraviolet doses with different amounts of contaminants (virus, protozoa and organic contaminants) and (2) investigate the morphological changes in the oysters' tissues produced by the depuration procedures. METHODS: The oysters were allocated in sites with different degrees of contamination and analyzed after 14 days. Some animals were used as positive controls by artificial bioaccumulation with HAdV2 and MNV1 and subjected to depuration assays using UV lamps (18 or 36 W) for 168 h. The following pollutants were researched in the naturally contaminated oysters, oysters after 14 days in sites and oysters during the depuration processes: virus (HAdV, HAV, HuNoV GI/GII and JCPyV), by (RT) qPCR; protozoa (Cryptosporidium and Giardia species), by immunomagnetic separation and immunofluorescence; and organic compounds (AHs, PAHs, LABs, PCBs and organochlorine pesticides-OCs), by chromatography. Changes in the oysters' tissues produced by the depuration processes were also evaluated using histochemical analysis by light microscopy. In the artificially bioaccumulated oysters, only HAdV2 and MNV1 were investigated by (RT) qPCR before the depuration procedures and after 96 and 168 h of these procedures. RESULTS: At 14 days post-allocation, HAdV was found in all the sites (6.2 × 105 to 4.4 × 107 GC g(-1)), and Giardia species in only one site. Levels of PCBs and OCs in the oyster's tissues were below the detection limit for all samples. AHs (3.5 to 4.4 µg g(-1)), PAHs (11 to 191 ng g(-1)) and LABs (57 to 751 ng g(-1)) were detected in the samples from 3 sites. During the depuration assays, we found HAdV, Giardia and Cryptosporidium species until 168 h, independent of UV treatment. AHs, PAHs and LABs were found also after 168 h of depuration (36 W and without UV lamp). The depuration procedures did not produce changes in the oysters' tissues. In the artificially contaminated and depurated oysters, we detected HAdV until 168 h and MNV1 until 96 h of depuration. CONCLUSION: The applied depuration treatments were unable to eliminate the protozoa or to degrade the HAdV genomes but were able to degrade the MNV1 genomes. Similarly, the UV water treatment was not efficient for aliphatic hydrocarbons, PAHs and LABs, as their concentrations were equivalent or higher to the concentrations of the control samples and samples from depuration tanks without UV treatment.

Avaliação da performance de metodologias de detecção de Cryptosporidium spp. e Giardia spp. em água destinada ao consumo humano, para o atendimento às demandas da Vigilância em Saúde Ambiental no Brasil / Performance evaluation of different methodologies for detection of Cryptosporidium spp. and Giardia spp. in water for human consumption to meet the demands of the Environmental Health Surveillance in Brazil

Objetivo: avaliar a performance de três protocolos de concentração de cistos e oocistos em amostras de água bruta de rios brasileiros. Métodos: os protocolos estudados foram precipitação química, filtração em membranas de 47mm de diâmetro e 3μm de porosidade nominal e filtração com o sistema Filta-Max®. Amostras de água bruta coletadas de rios nos estados de São Paulo e Minas Gerais foram analisadas após contaminação artificial. Os resultados de precisão inicial e recuperação de organismos marcados (Color-Seed®) foram comparados com os critérios da Agencia de Proteção Ambiental dos Estados Unidos da Améri¬ca (USEPA). Resultados: Nos ensaios de precisão inicial para cistos de Giardia, a filtração em membranas e com Filta-Max® atingiram os critérios da USEPA para recuperação de cistos. Para Cryptosporidium, somente o procedimento com Filta-Max® alcançou os critérios. Conclusão: o sistema Filta-Max® foi o único método que atingiu todos os critérios para identificação de Cryptosporidium e Giardia em água.

Objective: this study aimed to evaluate three different concentration protocols of cysts and oocysts in raw water samples in Brazilian rivers. Methods: the protocols studied were chemical precipitation, filtration in membranes of 47mm of diameter versus nominal porosity of 3µm and filtration using Filta-Max® system. The raw water samples collectedfrom rivers in the states of São Paulo andMinas Gerais were analyzed after being seeded with Color-Seed®. The results of initial precision using filtration in membranes and recovery of Color-Seed® organisms were compared to the acceptance criteria established by the United States Environmental Protection Agency (USEPA). Results: The study of initial precision to Giardia using filtration in membranes and recovery of Color-Seed® met the USEPA criteria; for Cryptosporidium only the Filta-Max® achieved the established criteria. Conclusion: Filta-Max® system showed to be the only method that achieved all the performance criteria for identification of Giardia and Cryptosporidium in water.

Parasitologia ambiental: métodos de concentração e detecção de Cryptosporidium spp. e Giardia spp. em amostras de água / Environmental parasitology: methods of concentration and detection of Cryptosporidium spp. and Giardia spp. in water samples

A transmissão de protozoários patogênicos pela água é um dos mais relevantes problemas de saúde pública na atualidade. Numerosos surtos epidêmicos causados pelos protozoários Giardia e Cryptosporidium ocorreram ao redor do mundo em passado recente. Entretanto, os métodos utilizados para a detecção de cistos e oocistos em amostras de água são influenciados porcaracterísticas físico-químicas da matriz de água, como a turbidez. Esta revisão apresenta uma análise crítica das diferentes metodologias de concentração de cistos de Giardia e de oocistos de Cryptosporidium em amostras de águas destinadas ao consumo humano. A implantação domonitoramento desses protozoários é uma necessidade no Brasil dada a recente revisão da Portarianúmero 518 do Ministério da Saúde.

A parasitological survey of natural water springs and inhabitants of a tourist city in southeastern Brazil.

The goals of this study were to investigate the occurrence of Cryptosporidium oocysts and Giardia cysts in main springs of Campos do Jordão, an important tourist city, in Brazil and to gather the largest amount of parasitological data from autochthonous population that live in rural areas of this city. The membrane filtration technique followed by direct immunofluorescence assay was employed for concentration and visualization of waterborne protozoa. In the period between June 2003 and May 2004, the presence of at least one pathogenic protozoa was detected in 25.0% (3/12) of the springs studied, with mean concentrations ranging from 0.2 to 0.3 Cryptosporidium sp. oocysts and 0.07 to 0.1 Giardia sp. cysts/L. The coproparasitological investigation conducted in dwellers from two rural communities from this city revealed that 49.2% (91/185) of people had intestinal parasites. Among pathogenic protozoa, Cryptosporidium was the most prevalent species (8.1%) followed by Giardia duodenalis (5.9%), Entamoeba histolytica/Entamoeba dispar (2.7%), and Blastocystis hominis (2.2%). The most prevalent geohelminths were Ascaris lumbricoides (14.9%) and Trichuris trichiura (9.7%). This study demonstrated the contamination and the distribution of intestinal parasites, especially Cryptosporidium and Giardia species, in different springs of an important tourist city in Brazil, highlighting the need of monitoring natural water sources. The high prevalence of intestinal parasitosis detected in some specific populations of this city may function as a link of transmission of different intestinal parasitosis due to soil and water contamination, contributing to the maintenance of parasite life cycles. Therefore, the inclusion of consistent public health interventions with measures that include the protection of springs, the installation of minimum health infrastructure, and primary education of the population are widely necessary, aiming the control and prevention of parasite infections.

Evaluation of tropical water sources and mollusks in southern Brazil using microbiological, biochemical, and chemical parameters.

Florianópolis, a city located in the Santa Catarina State in southern Brazil, is the national leading producer of bivalve mollusks. The quality of bivalve mollusks is closely related to the sanitary conditions of surrounding waters where they are cultivated. Presently, cultivation areas receive large amounts of effluents derived mainly from treated and non-treated domestic, rural, and urban sewage. This contributes to the contamination of mollusks with trace metals, pesticides, other organic compounds, and human pathogens such as viruses, bacteria, and protozoan. The aim of this study was to perform a thorough diagnosis of the shellfish growing areas in Florianópolis, on the coast of Santa Catarina. The contamination levels of seawater, sediments, and oysters were evaluated for their microbiological, biochemical, and chemical parameters at five sea sites in Florianópolis, namely three regular oyster cultivation areas (Sites 1, 2, and oyster supplier), a polluted site (Site 3), and a heavily polluted site (Site 4). Samples were evaluated at day zero and after 14 days. Seawater and sediment samples were collected just once, at the end of the experiment. Antioxidant defenses, which may occur in contaminated environments in response to the increased production of reactive oxygen species (ROS) by organisms, were analyzed in oysters, as well as organic compounds (in oysters and sediment samples) and microbiological contamination (in oysters and seawater samples). The results showed the presence of the following contaminants: fecal coliforms in seawater samples (four sites), human adenovirus (all sites), human noroviruses GI and GII (two sites), Hepatitis A viruses (one site), JC Polyomavirus in an oyster sample from the oyster supplier, Giardia duodenalis cysts, and Cryptosporidium sp oocysts (one site). Among organochlorine pesticides, only DDT (dichlorodiphenyltrichloroethane) and HCH (hexachlorocyclohexane) were detected in some sediment and oysters samples in very low levels; site 4 had the highest concentrations of total aliphatic hydrocarbons, PAHs, and linear alkylbenzenes (LABs) found either in oysters or in sediment samples. The major concentration of fecal sterol coprostanol was found at site 4, followed by site 3. After 14 days of allocation in the four selected sites, there was a significant difference in the enzymes analyzed at the monitored spots. The detection of different contaminants in oysters, seawater, and sediment samples in the present study shows the impact untreated or inadequately treated effluents have on coastal areas. These results highlight the need for public investment in adequate wastewater treatment and adequate treatment of oysters, ensuring safe areas for shellfish production as well as healthier bivalve mollusks for consumption.

Moluscos bivalves destinados ao consumo humano como vetores de protozoários patogênicos: metodologias de detecção e normas de controle / Bivalve molluscs destined for human consumption as vectors of pathogenic protozoa: detection methodologies and control rules

As áreas costeiras e marinhas albergam uma larga variedade de espécies animais que servem como fonte de alimento para toda a humanidade. Dentre todas estas espécies, os moluscos bivalves marinhos têm atraído a atenção mundial, não somente devido ao crescente aumento de sua produção e consumo nas últimas décadas, mas especialmente porque eles podem atuar como indicadores biológicos de poluição fecal de seres humanos e animais nos locais onde estes são cultivados ou coletados para o consumo humano. Ademais, são capazes de filtrar grandes volumes de água por dia e, se patógenos humanos de veiculação hídrica, como Cryptosporidium e Giardia, estiverem presentes nos arredores das áreas onde os moluscos vivem, estes ou outros patógenos podem ficar acumulados e concentrados, especialmente no intestino, brânquias ou na hemolinfa dos animais. Muitos surtos associados ao consumo de moluscos bivalves têm sido reportados no mundo todo, especialmente relacionados com a ingestão de alimentos crus, como as ostras, mas, até os dias de hoje, não existem relatos de surtos de protozoários patogênicos associados ao consumo de moluscos bivalves. Entretanto, é notável que a ingestão de mariscos pode representar uma ameaça e um risco de aquisição de doenças emergentes para populações imunocomprometidas ou imunocompetentes. No Brasil, a população não está ciente dos riscos potenciais de aquisição de infecções parasitárias associados à ingestão de bivalves, principalmente aqueles ingeridos crus. Esta revisão elucida diversos aspectos sobre a ocorrência natural de protozoários patogênicos em moluscos bivalves reportada em muitos países e inclusive no Brasil. Além disso, enfatiza as principais metodologias e técnicas disponíveis para a sua detecção, as normas de controle e a legislação brasileira vigente para o cultivo, produção e consumo de moluscos bivalves em nosso país.