Department of Civil and Environmental Engineering, Stanford University, Stanford, California, USA.
Verily Life Sciences LLC, South San Francisco, California, USA.
mBio. 2024 Aug 14;15(8):e0090824. doi: 10.1128/mbio.00908-24. Epub 2024 Jul 23.
is an emerging, multidrug-resistant fungal pathogen that poses a significant public health threat in healthcare settings. Despite yearly clinical cases rapidly increasing from 77 to 8,131 in the last decade, surveillance data on its distribution and prevalence remain limited. We implemented a novel assay for detection on a nationwide scale prospectively from September 2023 to March 2024, analyzing a total of 13,842 samples from 190 wastewater treatment plants across 41 U.S. states. Assays were extensively validated through comparison to other known assays and internal controls. Of these 190 wastewater treatment plants, was detected in the wastewater solids of 65 of them (34.2%) with 1.45% of all samples having detectable levels of nucleic-acids. Detections varied seasonally, with 2.00% of samples positive in autumn vs 1.01% in winter ( < 0.0001). The frequency of detection in wastewater was significantly associated with states having older populations ( < 0.001), sewersheds containing more hospitals ( < 0.0001), and sewersheds containing more nursing homes ( < 0.001). These associations are in agreement with known epidemiology. This nationwide study demonstrates the viability of wastewater surveillance for surveillance and further highlights the value of wastewater surveillance when clinical testing is constrained.
This study highlights the viability of wastewater surveillance when dealing with emerging pathogens. By leveraging an existing framework of wastewater surveillance, we reveal the widespread presence of in the United States. We further demonstrate that these wastewater detections are consistent with demographic factors relevant to epidemiology like age and number of hospitals or nursing homes. As and other pathogens continue to emerge, the low-cost and rapid nature of wastewater surveillance will provide public health officials with the information necessary to enact targeted prevention and control strategies.
这是一种新兴的、多药耐药真菌病原体，在医疗保健环境中对公共健康构成重大威胁。尽管在过去十年中，每年的临床病例从 77 例迅速增加到 8131 例，但关于其分布和流行率的监测数据仍然有限。我们从 2023 年 9 月到 2024 年 3 月在全国范围内实施了一种新的检测方法，对来自美国 41 个州的 190 个污水处理厂的 13842 个样本进行了前瞻性分析。通过与其他已知检测方法和内部对照的比较，对检测方法进行了广泛的验证。在这 190 个污水处理厂中，有 65 个（34.2%）的污水处理厂固体中检测到了 ，1.45%的所有样本中都检测到了 核酸。检测结果呈季节性变化，秋季样本阳性率为 2.00%，冬季为 1.01%（<0.0001）。污水中的检测频率与老年人口较多的州（<0.001）、含有更多医院的污水流域（<0.0001）和含有更多养老院的污水流域（<0.001）显著相关。这些关联与已知的流行病学一致。这项全国性研究表明，在处理新兴病原体时，污水监测是可行的，并进一步强调了在临床检测受到限制时，污水监测的价值。
这项研究强调了在处理新兴病原体时，污水监测的可行性。通过利用现有的污水监测框架，我们揭示了 在美国的广泛存在。我们进一步证明，这些污水检测结果与 流行病学相关的人口统计学因素（如年龄和医院或养老院数量）一致。随着 和其他病原体的不断出现，污水监测的低成本和快速性将为公共卫生官员提供必要的信息，以制定有针对性的预防和控制策略。
