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Published on: October 21, 2010
Wastewater surveillance of Candida auris in Baltimore
Daniel A Nwaubani1, Rakshya Baral1, Tamunobelema Solomon1
1Center of Research Excellence in Wastewater based Epidemiology, Morgan State University, Baltimore, MD, 21251, USA.
Abstract:
Candida auris (C. auris), an opportunistic fungus causing disease, poses a growing global health concern due to its significant mortality rate, resistance to antifungal treatment, and ability to persist in healthcare settings. Over a span of 47 weeks, untreated wastewater samples were regularly gathered from two wastewater treatment plants (referred to as WWTP-A and WWTP-B) in Baltimore, from July 27, 2022, to June 23, 2023. Throughout the study period, 110 primary influent (PI) samples were collected from both WWTP-A and WWTP-B. A quantitative polymerase chain reaction (qPCR) method was used to analyze C. auris captured on filters (0.45 μm) from these samples. Positive C. auris detection (11.81%) occurred in the influent samples, with a higher frequency of detection in WWTP-B. Influent wastewater concentrations ranged from 1.2 to 7.9 log10 gene copies per liter (gc/L). Interestingly, seasonal analysis showed that C. auris presence in wastewater was more pronounced during the spring season, indicating a sustained existence of the pathogen as seasons changed. Integration of wastewater surveillance and clinical data reveals temporal correlations in C. auris dynamics. The resulting Pearson correlation coefficient of 0.27 reveals a weak positive correlation between the number of new C. auris cases in Baltimore and the quantity of detected gene copies in wastewater. This study marks the first instance of detecting C. auris in Baltimore's wastewater. The results emphasize that wastewater monitoring could serve as an additional early warning tool for anticipating and managing future outbreaks of C. auris.
Insights
Candida auris was detected in Baltimore wastewater, with higher levels in spring. Wastewater surveillance can help predict and manage future outbreaks of this concerning fungal pathogen.
Area of Science:
- Environmental microbiology
- Public health surveillance
- Mycology
Background:
- Candida auris is an emerging global health threat due to its high mortality, antifungal resistance, and persistence in healthcare environments.
- Wastewater surveillance offers a potential method for monitoring public health threats.
Purpose of the Study:
- To investigate the presence and prevalence of Candida auris in Baltimore wastewater.
- To assess the correlation between wastewater detection and clinical cases of C. auris.
- To evaluate wastewater monitoring as an early warning system for C. auris.
Main Methods:
- Collection of 110 primary influent samples from two wastewater treatment plants (WWTP-A and WWTP-B) over 47 weeks.
- Quantitative polymerase chain reaction (qPCR) analysis of C. auris in filtered wastewater samples.
- Statistical analysis including Pearson correlation to compare wastewater data with clinical case counts.
Main Results:
- Candida auris was detected in 11.81% of influent samples, with higher detection rates in WWTP-B.
- Wastewater concentrations ranged from 1.2 to 7.9 log10 gene copies per liter.
- A weak positive correlation (r=0.27) was observed between wastewater C. auris levels and clinical cases.
- Increased C. auris presence was noted during the spring season.
Conclusions:
- This is the first report of Candida auris detection in Baltimore wastewater.
- Wastewater surveillance can provide valuable insights into C. auris prevalence and dynamics.
- Wastewater monitoring serves as a complementary tool for early detection and management of C. auris outbreaks.
