Barrett Leah R, Beasy Paris, Palacios Delgado Yussi M, Boyce John D, Leder Karin, McCarthy David T, Henry Rebekah
Department of Civil Engineering, Monash University, Melbourne, Victoria, Australia.
Biomedicine Discovery Institute, Department of Microbiology, Melbourne, Victoria, Australia.
Crit Rev Environ Sci Technol. 2025 Feb 6;55(7):447-464. doi: 10.1080/10643389.2025.2455031. eCollection 2025.
Human fecal waste is a global health risk associated with diarrheal diseases, responsible for approximately 1.2 million deaths annually. Microbial Source Tracking (MST) is a molecular method that evaluates environmental sources of fecal contamination, aiding quantification of this contamination and associated health risks. However, reported variations in global human gut microbiomes and geographic performance of human-specific fecal markers suggest that current MST targets may not have broad applicability across populations. This systematic review quantified the performance of human-specific fecal markers to identify those suitable for use across various geographic regions. We evaluated data from primary research articles, published before 18 October 2023, identified through PubMed, Scopus, and Web of Science using PRISMA guidelines. 103 studies published between 1995 and 2023, spanning 34 countries, 6 continents, and 4 climate zones met inclusion criteria, with quantifiable performance metrics (sensitivity, specificity or accuracy) and a geographic testing location. Extracted data was analyzed to establish marker performance across geographic locations, climate zones, and development status. Over 80% were conducted in High-Income Countries (HICs) and >50% in temperate zones, primarily in the USA (43%), Australia (24%), and Spain (19%). was the most commonly tested ( = 45 studies). However, no target consistently demonstrated sensitivity, specificity, and/or accuracy >80% across different settings. Consequently, a decision tree is presented supporting selection of appropriate human-specific markers for regional-specific baseline studies. This provides critical information to support new MST research, particularly in Low- and Middle-Income Countries (LMICs), assisting with informed decision and method selection for assessing risks of faecal derived pathogens.
人类粪便废物是一种与腹泻病相关的全球健康风险，每年导致约120万人死亡。微生物源追踪（MST）是一种评估粪便污染环境来源的分子方法，有助于量化这种污染及相关健康风险。然而，全球人类肠道微生物群的报告差异以及人类特异性粪便标志物的地理性能表明，当前的MST目标可能在不同人群中没有广泛的适用性。本系统综述量化了人类特异性粪便标志物的性能，以确定那些适用于不同地理区域的标志物。我们评估了通过PubMed、Scopus和Web of Science使用PRISMA指南识别的2023年10月18日前发表的原始研究文章中的数据。1995年至2023年间发表的103项研究，涵盖34个国家、6个大洲和4个气候区，符合纳入标准，具有可量化的性能指标（敏感性、特异性或准确性）和地理测试地点。对提取的数据进行分析，以确定标志物在不同地理位置、气候区和发展状况下的性能。超过80%的研究在高收入国家（HICs）进行，超过50%在温带地区进行，主要在美国（43%）、澳大利亚（24%）和西班牙（19%）。 是最常测试的（ = 45项研究）。然而，没有一个目标在不同环境中始终表现出敏感性、特异性和/或准确性>80%。因此，提出了一个决策树，支持为区域特异性基线研究选择合适的人类特异性标志物。这提供了关键信息，以支持新的MST研究，特别是在低收入和中等收入国家（LMICs），协助在评估粪便源性病原体风险时做出明智的决策和方法选择。
