School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Las Vegas, Nevada 89119, United States.
Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, Nevada 89193, United States.
Environ Sci Technol. 2023 Jan 31;57(4):1755-1763. doi: 10.1021/acs.est.2c07763. Epub 2023 Jan 19.
is an opportunistic fungal pathogen and an emerging global public health threat, given its high mortality among infected individuals, antifungal resistance, and persistence in healthcare environments. This study explored the applicability of wastewater surveillance for in a metropolitan area with reported outbreaks across multiple healthcare facilities. Influent or primary effluent samples were collected over 10 weeks from seven sewersheds in Southern Nevada. Pelleted solids were analyzed using an adapted quantitative polymerase chain reaction (qPCR) assay targeting the ITS2 region of the genome. Positive detection was observed in 72 of 91 samples (79%), with higher detection frequencies in sewersheds serving healthcare facilities involved in the outbreak (94 vs 20% sample positivity). Influent wastewater concentrations ranged from 2.8 to 5.7 log gene copies per liter (gc/L), and primary clarification achieved an average log reduction value (LRV) of 1.24 ± 0.34. Presumptive negative surface water and wastewater controls were non-detect. These results demonstrate that wastewater surveillance may assist in tracking the spread of and serve as an early warning tool for public health action. These findings provide the foundation for future application of wastewater-based epidemiology (WBE) to community- or facility-level surveillance of and other high consequence, healthcare-associated infectious agents.
是一种机会性真菌病原体，也是一种新出现的全球公共卫生威胁，因为其在感染个体中的高死亡率、抗真菌药物耐药性以及在医疗保健环境中的持久性。本研究探讨了污水监测在一个报告有多起疫情的大都市地区的适用性，该地区涉及多个医疗保健设施。在南内华达州的七个污水流域收集了 10 周的污水进水或初沉池污水样本。使用针对 基因组 ITS2 区域的改良定量聚合酶链反应 (qPCR) 检测方法对沉淀固体进行了分析。在 91 个样本中的 72 个（79%）中观察到阳性检测，在参与疫情的医疗保健设施服务的污水流域中检测频率更高（94%比 20%样本阳性）。污水进水浓度范围为 2.8 至 5.7 对数基因拷贝/升（gc/L），初级澄清实现了平均对数减少值（LRV）为 1.24 ± 0.34。假定的阴性地表水和污水对照物未检出。这些结果表明，污水监测可能有助于追踪 的传播，并作为公共卫生行动的早期预警工具。这些发现为未来应用基于污水的流行病学（WBE）进行社区或设施层面的 及其他高后果、与医疗保健相关的传染病原体监测提供了基础。
