The western mesoregion of the state of Santa Catarina (SC), Southern Brazil, was heavily affected as a whole by the COVID-19 pandemic in early 2021. This study aimed to evaluate the dynamics of the SARS-CoV-2 virus spreading patterns in the SC state from March 2020 to April 2021 using genomic surveillance. During this period, there were 23 distinct variants, including Beta and Gamma, among which the Gamma and related lineages were predominant in the second pandemic wave within SC. A regionalization of P.1-like-II in the Western SC region was observed, concomitant to the increase in cases, mortality, and the case fatality rate (CFR) index. This is the first evidence of the regionalization of the SARS-CoV-2 transmission in SC and it highlights the importance of tracking the variants, dispersion, and impact of SARS-CoV-2 on the public health systems.

The Western mesoregion, the State of Santa Catarina (SC), Southern Brazil, was heavily affected as a whole by the COVID-19 pandemic in early 2021. This study aimed to evaluate the dynamics of the SARS-CoV-2 virus spreading patterns in the SC state through March 2020 to April 2021 using genomic surveillance. During this period, 23 distinct variants, including Beta and Gamma, among which, the Gamma and related lineages were predominant in the second pandemic wave within SC. A regionalization of P.1-like-II in the Western-SC region was observed, concomitant to the increase in cases, mortality, and case fatality rate (CFR) index. This is the first evidence of the regionalization of the SARS-CoV-2 in SC transmission and highlights the importance of tracking variants, dispersion, and impact of SARS-CoV-2 on the public health systems.

Over the past four years, angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) have been extensively studied, given their important role in SARS-CoV-2 replication; however, most studies have failed to compare their behavior in the face of different SARS-CoV-2 genomic variants. Therefore, this study evaluated the influence of different variants in ACE2/TMPRSS2 expressional and genomic profiles. To achieve this, 160 nasopharyngeal samples, previously detected with SARS-CoV-2 via RT-qPCR (June 2020–July 2022), were quantified for ACE2/TMPRSS2 expression levels, also using RT-qPCR; SARS-CoV-2 genomic variants, along with polymorphisms in the ACE2/TMPRSS2 coding genes, were identified using nanopore sequencing. In order of appearance, the B.1.1.28, Zeta, Gamma, and Omicron variants were identified in this study. The ACE2 levels were higher when B.1.1.28 was present, possibly due to the ACE2/spike binding affinity; the TMPRSS2 levels were also higher in the presence of B.1.1.28, probably attributable to inefficient usage of the TMPRSS2 pathway by the other variants, as well as to the decrease in protease transcription factors when in the presence of Omicron. The rs2285666 (ACE2) polymorphism was less frequent when B.1.1.28 was present, which is befitting, since rs2285666 increases ACE2/spike binding affinity. In conclusion, SARS-CoV-2 genomic variants appear to exhibit varying impacts in regards to ACE2/TMPRSS2 genomic and expressional behavior.

Introduction: Mycoplasma genitalium is a bacterium associated with sexually transmitted infections that can cause urethritis in men and complications in women, including preterm birth. Increasing macrolide resistance in M. genitalium poses challenges to treatment efficacy. Objective: To present a case of treatment failure of urethritis caused by macrolide-resistant M. genitalium. Case report: This case report describes a 20-year-old man with persistent urethral symptoms despite azithromycin treatment, wherein M. genitalium harbored the A2058G mutation in the 23S rRNA. Subsequent treatment with moxifloxacin resolved symptoms and cleared M. genitalium. Conclusion: The study highlights the importance of resistance testing to guide antimicrobial therapy and emphasizes the need for updated treatment guidelines in Brazil.

Mycoplasma genitalium is an emerging sexually transmitted pathogen with increasing antimicrobial resistance worldwide. In Brazil, molecular testing for M. genitalium and resistance-associated mutations is not routinely available, and national data remain scarce. We analyzed 118 M. genitalium-positive urethral and vaginal swab samples collected between 2018 and 2023 from sites across all five Brazilian geographic regions. PCR amplification and sequencing of 23S rRNA, parC, and gyrA identified macrolide and fluoroquinolone resistance-associated mutations. Among 79 samples successfully sequenced for 23S rRNA, 40.5% harbored macrolide resistance-associated mutations (A2058G, A2059G, or A2058T) detected in samples from all five regions at different frequencies. A total of 6.1% of sequenced samples presented parC mutations, including two with combined 23S rRNA and parC mutations. No resistance-associated mutations were detected in gyrA. While resistance-associated mutations occurred in both symptomatic men and pregnant women, these findings are not representative estimates for the Brazilian population since the study used convenience samples from two distinct surveillance populations. Nonetheless, they provide multicenter molecular data that may inform future surveillance, diagnostic strategies, antimicrobial stewardship, and resistance-guided management of M. genitalium in Brazil.

O surgimento de patógenos ao longo da história evolutiva que utilizam vias ambientais de infecção/contaminação denotou a necessidade das ferramentas de monitoramento. Em meio a pandemia de COVID-19, causada pelo vírus SARS-CoV-2, a detecção do RNA viral no esgoto bruto tornou-se possível e útil como uma ferramenta epidemiológica, já que o vírus é excretado pelas fezes humanas. Métodos focados na detecção do RNA viral (técnicas baseadas em biologia molecular) e de partículas virais infecciosas (por cultura celular) foram utilizados para a detecção do SARS-CoV-2 em amostras de secreção de pacientes infectados. O monitoramento se mostra eficaz para compreender a circulação de vírus que utilizam rota fecal-oral, podendo antecipar futuros surtos em regiões específicas. Além disso, possibilita a observação das mutações e variantes em circulação num dado momento, através do sequenciamento. Este capítulo é um reporte das bases da ferramenta epidemiológica para o monitoramento viral em esgoto sanitário implementada pelo Laboratório de Virologia Aplicada da Universidade Federal de Santa Catarina, denominado “VigEAI” - Vigilância Epidemiológica Ambiental Integrativa.