Rao Gouthami, Capone Drew, Zhu Kevin, Knoble Abigail, Linden Yarrow, Clark Ryan, Lai Amanda, Kim Juhee, Huang Ching-Hua, Bivins Aaron, Brown Joe
Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, USA.
medRxiv. 2023 Dec 5:2023.06.23.23291792. doi: 10.1101/2023.06.23.23291792.
Wastewater-based epidemiology has emerged as a critical tool for public health surveillance, building on decades of environmental surveillance work for pathogens such as poliovirus. Work to date has been limited to monitoring a single pathogen or small numbers of pathogens in targeted studies; however, few studies consider simultaneous quantitative analysis of a wide variety of pathogens, which could greatly increase the utility of wastewater surveillance. We developed a novel quantitative multi-pathogen surveillance approach (35 pathogen targets including bacteria, viruses, protozoa, and helminths) using TaqMan Array Cards (TAC) and applied the method on concentrated wastewater samples collected at four wastewater treatment plants in Atlanta, GA from February to October of 2020. From sewersheds serving approximately 2 million people, we detected a wide range of targets including many we expected to find in wastewater (e.g., enterotoxigenic and in 97% of 29 samples at stable concentrations) as well as unexpected targets including (a human threadworm rarely observed in the USA). Other notable detections included SARS-CoV-2, but also several pathogen targets that are not commonly included in wastewater surveillance like spp., , astrovirus, norovirus, and sapovirus. Our data suggest broad utility in expanding the scope of enteric pathogen surveillance in wastewaters, with potential for application in a variety of settings where pathogen quantification in fecal waste streams can inform public health surveillance and selection of control measures to limit infections.
基于废水的流行病学已成为公共卫生监测的关键工具，它建立在对脊髓灰质炎病毒等病原体进行数十年环境监测工作的基础之上。迄今为止的工作仅限于在针对性研究中监测单一病原体或少数病原体；然而，很少有研究考虑对多种病原体进行同步定量分析，而这可能会大大提高废水监测的效用。我们开发了一种使用TaqMan Array Cards（TAC）的新型定量多病原体监测方法（包括细菌、病毒、原生动物和蠕虫在内的35种病原体靶点），并将该方法应用于2020年2月至10月在佐治亚州亚特兰大市四个污水处理厂采集的浓缩废水样本。在服务约200万人的排水区域，我们检测到了广泛的靶点，包括许多我们预期在废水中发现的靶点（例如产肠毒素的大肠杆菌，在29个样本中有97%以稳定浓度存在）以及意外靶点，包括类圆线虫（一种在美国很少观察到的人体线虫）。其他值得注意的检测结果包括严重急性呼吸综合征冠状病毒2（SARS-CoV-2），但也有一些废水监测中通常不包括的病原体靶点，如嗜肺军团菌属、空肠弯曲菌、星状病毒、诺如病毒和札如病毒。我们的数据表明，该方法在扩大废水中肠道病原体监测范围方面具有广泛的效用，有可能应用于各种环境，在这些环境中粪便废物流中的病原体定量可用于公共卫生监测和选择控制感染的措施。
