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Zulli A, Chan EMG, Shelden B, Duong D, Xu XRS, White BJ, Wolfe MK, Boehm AB. Prospective study of Candida auris nucleic acids in wastewater solids in 190 wastewater treatment plants in the United States suggests widespread occurrence. mBio 2024:e0090824. [PMID: 39041799 DOI: 10.1128/mbio.00908-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/01/2024] [Indexed: 07/24/2024] Open
Abstract
Candida auris 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 C. auris 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, C. auris was detected in the wastewater solids of 65 of them (34.2%) with 1.45% of all samples having detectable levels of C. auris nucleic-acids. Detections varied seasonally, with 2.00% of samples positive in autumn vs 1.01% in winter (P < 0.0001). The frequency of detection in wastewater was significantly associated with states having older populations (P < 0.001), sewersheds containing more hospitals (P < 0.0001), and sewersheds containing more nursing homes (P < 0.001). These associations are in agreement with known C. auris epidemiology. This nationwide study demonstrates the viability of wastewater surveillance for C. auris surveillance and further highlights the value of wastewater surveillance when clinical testing is constrained. IMPORTANCE 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 C. auris in the United States. We further demonstrate that these wastewater detections are consistent with demographic factors relevant to C. auris epidemiology like age and number of hospitals or nursing homes. As C. auris 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.
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Affiliation(s)
- Alessandro Zulli
- Department of Civil and Environmental Engineering, Stanford University, Stanford, California, USA
| | - Elana M G Chan
- Department of Civil and Environmental Engineering, Stanford University, Stanford, California, USA
| | | | - Dorothea Duong
- Verily Life Sciences LLC, South San Francisco, California, USA
| | - Xiang-Ru S Xu
- Verily Life Sciences LLC, South San Francisco, California, USA
| | - Bradley J White
- Verily Life Sciences LLC, South San Francisco, California, USA
| | - Marlene K Wolfe
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Alexandria B Boehm
- Department of Civil and Environmental Engineering, Stanford University, Stanford, California, USA
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2
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Silva I, Miranda IM, Costa-de-Oliveira S. Potential Environmental Reservoirs of Candida auris: A Systematic Review. J Fungi (Basel) 2024; 10:336. [PMID: 38786691 PMCID: PMC11122228 DOI: 10.3390/jof10050336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/28/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Candida auris, a multidrug-resistant yeast, poses significant challenges in healthcare settings worldwide. Understanding its environmental reservoirs is crucial for effective control strategies. This systematic review aimed to review the literature regarding the natural and environmental reservoirs of C. auris. Following the PRISMA guidelines, published studies until October 2023 were searched in three databases: PubMed, Web of Science, and Scopus. Information regarding the origin, sampling procedure, methods for laboratory identification, and antifungal susceptibility was collected and analyzed. Thirty-three studies published between 2016 and 2023 in 15 countries were included and analyzed. C. auris was detected in various environments, including wastewater treatment plants, hospital patient care surfaces, and natural environments such as salt marshes, sand, seawater, estuaries, apples, and dogs. Detection methods varied, with molecular techniques often used alongside culture. Susceptibility profiles revealed resistance patterns. Phylogenetic studies highlight the potential of environmental strains to influence clinical infections. Despite methodological heterogeneity, this review provides valuable information for future research and highlights the need for standardized sampling and detection protocols to mitigate C. auris transmission.
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Affiliation(s)
- Isabel Silva
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Isabel M. Miranda
- Cardiovascular R&D Centre UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Sofia Costa-de-Oliveira
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Center for Health Technology and Services Research—CINTESIS@RISE, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
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3
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Garcia-Bustos V. Is Candida auris the first multidrug-resistant fungal zoonosis emerging from climate change? mBio 2024; 15:e0014624. [PMID: 38477572 PMCID: PMC11005414 DOI: 10.1128/mbio.00146-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
The emergence and evolutionary path of Candida auris poses an intriguing scientific enigma. Its isolation from a pet dog's oral cavity in Kansas, reported by White et al. (T. C. White, B. D. Esquivel, E. M. Rouse Salcido, A. M. Schweiker, et al., mBio 15:e03080-23, 2024, https://doi.org/10.1128/mbio.03080-23), carries significant implications. This discovery intensifies concerns about its hypothetical capacity for zoonotic transmission, particularly considering the dog's extensive human contact and the absence of secondary animal/human cases in both animals and humans. The findings challenge established notions of C. auris transmissibility and underscore the need for further investigation into the transmission dynamics, especially zooanthroponotic pathways. It raises concerns about its adaptability in different hosts and environments, highlighting potential role of environmental and animal reservoirs in its dissemination. Critical points include the evolving thermal tolerance and the genetic divergence in the isolate. This case exemplifies the necessity for an integrated One Health approach, combining human, animal, and environmental health perspectives, to unravel the complexities of C. auris's emergence and behavior.
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Affiliation(s)
- Victor Garcia-Bustos
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain
- Instituto Universitario de Sanidad Animal y Seguridad Alimentaria (IUSA), Universidad de Las Palmas de Gran Canaria, Arucas, Spain
- Department of Internal Medicine and Infectious Diseases, University and Polytechnic Hospital La Fe, Valencia, Spain
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Amirali A, Babler KM, Sharkey ME, Beaver CC, Boone MM, Comerford S, Cooper D, Currall BB, Goodman KW, Grills GS, Kobetz E, Kumar N, Laine J, Lamar WE, Mason CE, Reding BD, Roca MA, Ryon K, Schürer SC, Shukla BS, Solle NS, Stevenson M, Tallon JJ, Vidović D, Williams SL, Yin X, Solo-Gabriele HM. Wastewater based surveillance can be used to reduce clinical testing intensity on a university campus. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 918:170452. [PMID: 38296085 PMCID: PMC10923133 DOI: 10.1016/j.scitotenv.2024.170452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/30/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024]
Abstract
Clinical testing has been a vital part of the response to and suppression of the COVID-19 pandemic; however, testing imposes significant burdens on a population. College students had to contend with clinical testing while simultaneously dealing with health risks and the academic pressures brought on by quarantines, changes to virtual platforms, and other disruptions to daily life. The objective of this study was to analyze whether wastewater surveillance can be used to decrease the intensity of clinical testing while maintaining reliable measurements of diseases incidence on campus. Twelve months of human health and wastewater surveillance data for eight residential buildings on a university campus were analyzed to establish how SARS-CoV-2 levels in the wastewater can be used to minimize clinical testing burden on students. Wastewater SARS-CoV-2 levels were used to create multiple scenarios, each with differing levels of testing intensity, which were compared to the actual testing volumes implemented by the university. We found that scenarios in which testing intensity fluctuations matched rise and falls in SARS-CoV-2 wastewater levels had stronger correlations between SARS-CoV-2 levels and recorded clinical positives. In addition to stronger correlations, most scenarios resulted in overall fewer weekly clinical tests performed. We suggest the use of wastewater surveillance to guide COVID-19 testing as it can significantly increase the efficacy of COVID-19 surveillance while reducing the burden placed on college students during a pandemic. Future efforts should be made to integrate wastewater surveillance into clinical testing strategies implemented on college campuses.
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Affiliation(s)
- Ayaaz Amirali
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
| | - Kristina M Babler
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
| | - Mark E Sharkey
- Department of Medicine, University of Miami Miller School of Medicine, Miami, 33136, FL, USA
| | - Cynthia C Beaver
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Melinda M Boone
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Samuel Comerford
- Department of Medicine, University of Miami Miller School of Medicine, Miami, 33136, FL, USA
| | | | - Benjamin B Currall
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Kenneth W Goodman
- Frost Institute for Data Science & Computing, University of Miami, Coral Gables, FL 33146, USA; Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, 33136, FL, USA
| | - George S Grills
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Erin Kobetz
- Department of Medicine, University of Miami Miller School of Medicine, Miami, 33136, FL, USA
| | - Naresh Kumar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Jennifer Laine
- Environmental Health and Safety, University of Miami, Miami, FL 33136, USA
| | - Walter E Lamar
- Division of Occupational Health, Safety & Compliance, University of Miami Health System, Miami, FL 33136, USA
| | - Christopher E Mason
- Department of Physiology and Biophysics, Weill Cornell Medical College, New York City, NY 10021, USA; The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10021, USA; The WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA
| | - Brian D Reding
- Environmental Health and Safety, University of Miami, Miami, FL 33136, USA
| | - Matthew A Roca
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
| | - Krista Ryon
- Department of Physiology and Biophysics, Weill Cornell Medical College, New York City, NY 10021, USA
| | - Stephan C Schürer
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Molecular & Cellular Pharmacology, University of Miami Miller School of Medicines, Miami, FL 33136, USA; Institute for Data Science & Computing, University of Miami, Coral Gables, FL 33146, USA
| | - Bhavarth S Shukla
- Department of Medicine, University of Miami Miller School of Medicine, Miami, 33136, FL, USA
| | - Natasha Schaefer Solle
- Department of Medicine, University of Miami Miller School of Medicine, Miami, 33136, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Mario Stevenson
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
| | - John J Tallon
- Facilities and Operations, University of Miami, Coral Gables, FL 33146, USA
| | - Dušica Vidović
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
| | - Sion L Williams
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Xue Yin
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
| | - Helena M Solo-Gabriele
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA.
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5
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Zhuang X, Moshi MA, Quinones O, Trenholm RA, Chang CL, Cordes D, Vanderford BJ, Vo V, Gerrity D, Oh EC. Spatial and Temporal Drug Usage Patterns in Wastewater Correlate with Socioeconomic and Demographic Indicators in Southern Nevada. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.02.24302241. [PMID: 38352613 PMCID: PMC10863018 DOI: 10.1101/2024.02.02.24302241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Evaluating drug use within populations in the United States poses significant challenges due to various social, ethical, and legal constraints, often impeding the collection of accurate and timely data. Here, we aimed to overcome these barriers by conducting a comprehensive analysis of drug consumption trends and measuring their association with socioeconomic and demographic factors. From May 2022 to April 2023, we analyzed 208 wastewater samples from eight sampling locations across six wastewater treatment plants in Southern Nevada, covering a population of 2.4 million residents with 50 million annual tourists. Using bi-weekly influent wastewater samples, we employed mass spectrometry to detect 39 analytes, including pharmaceuticals and personal care products (PPCPs) and high risk substances (HRS). Our results revealed a significant increase over time in the level of stimulants such as cocaine (pFDR=1.40×10-10) and opioids, particularly norfentanyl (pFDR =1.66×10-12), while PPCPs exhibited seasonal variation such as peak usage of DEET, an active ingredient in insect repellents, during the summer (pFDR =0.05). Wastewater from socioeconomically disadvantaged or rural areas, as determined by Area Deprivation Index (ADI) and Rural-Urban Commuting Area Codes (RUCA) scores, demonstrated distinct overall usage patterns, such as higher usage/concentration of HRS, including cocaine (p=0.05) and norfentanyl (p=1.64×10-5). Our approach offers a near real-time, comprehensive tool to assess drug consumption and personal care product usage at a community level, linking wastewater patterns to socioeconomic and demographic factors. This approach has the potential to significantly enhance public health monitoring strategies in the United States.
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Affiliation(s)
- Xiaowei Zhuang
- Laboratory of Neurogenetics and Precision Medicine, College of Sciences, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
- Neuroscience Interdisciplinary Ph.D. program, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV
| | - Michael A. Moshi
- Laboratory of Neurogenetics and Precision Medicine, College of Sciences, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
- Neuroscience Interdisciplinary Ph.D. program, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
| | - Oscar Quinones
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas NV, 89193, USA
| | - Rebecca A. Trenholm
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas NV, 89193, USA
| | - Ching-Lan Chang
- Laboratory of Neurogenetics and Precision Medicine, College of Sciences, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
- Neuroscience Interdisciplinary Ph.D. program, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
| | - Dietmar Cordes
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV
| | - Brett J. Vanderford
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas NV, 89193, USA
| | - Van Vo
- Laboratory of Neurogenetics and Precision Medicine, College of Sciences, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
| | - Daniel Gerrity
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas NV, 89193, USA
| | - Edwin C. Oh
- Laboratory of Neurogenetics and Precision Medicine, College of Sciences, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
- Neuroscience Interdisciplinary Ph.D. program, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
- Department of Brain Health, Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV 89154
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6
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Gerrity D, Crank K, Oh EC, Quinones O, Trenholm RA, Vanderford BJ. Wastewater surveillance of high risk substances in Southern Nevada: Sucralose normalization to translate data for potential public health action. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 908:168369. [PMID: 37951274 DOI: 10.1016/j.scitotenv.2023.168369] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/13/2023]
Abstract
The COVID-19 pandemic highlighted the value of wastewater surveillance in providing unbiased assessments of incidence/prevalence for infectious disease targets, ultimately leading to the development of local, state, and national programs across the United States. To address the growing epidemic of drug abuse, there have been calls to extend these programs to high risk substances (HRS) and metabolites, while leveraging the experience gained during the pandemic and from ongoing efforts in other countries. This study further advances the science of wastewater surveillance for HRS by (1) highlighting analytical and sewer transport considerations, (2) proposing sucralose normalization to adjust for varying human urine/fecal load and confounded population estimates (e.g., high tourism areas), and (3) characterizing temporal and geographic trends in HRS use. This one-year study across eight sewersheds in Southern Nevada (208 total samples) monitored concentrations of 17 pharmaceuticals and personal care products (PPCPs) and 22 HRS and metabolites, including natural, semi-synthetic, and synthetic opioids. The data indicated a ∼200 % increase in heroin and methamphetamine use since 2010, a stark increase in fentanyl consumption beginning in October 2022, and statistically significant differences in HRS consumption patterns between sewersheds and on certain dates. Notably, the latter outcome highlights the potential for wastewater surveillance data to be strategically translated into public health action to reduce and/or more rapidly respond to overdoses.
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Affiliation(s)
- Daniel Gerrity
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States.
| | - Katherine Crank
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States
| | - Edwin C Oh
- Laboratory of Neurogenetics and Precision Medicine, Nevada Institute of Personalized Medicine, Department of Internal Medicine, UNLV School of Medicine, University of Nevada, Las Vegas, Las Vegas, NV 89154, United States
| | - Oscar Quinones
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States
| | - Rebecca A Trenholm
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States
| | - Brett J Vanderford
- Applied Research and Development Center, Southern Nevada Water Authority, P.O. Box 99954, Las Vegas, NV 89193, United States
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7
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Babler KM, Sharkey ME, Amirali A, Boone MM, Comerford S, Currall BB, Grills GS, Laine J, Mason CE, Reding B, Schürer S, Stevenson M, Vidović D, Williams SL, Solo-Gabriele HM. Expanding a Wastewater-Based Surveillance Methodology for DNA Isolation from a Workflow Optimized for SARS-CoV-2 RNA Quantification. J Biomol Tech 2023; 34:3fc1f5fe.dfa8d906. [PMID: 38268997 PMCID: PMC10805363 DOI: 10.7171/3fc1f5fe.dfa8d906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Wastewater-based surveillance (WBS) is a noninvasive, epidemiological strategy for assessing the spread of COVID-19 in communities. This strategy was based upon wastewater RNA measurements of the viral target, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The utility of WBS for assessing the spread of COVID-19 has motivated research to measure targets beyond SARS-CoV-2, including pathogens containing DNA. The objective of this study was to establish the necessary steps for isolating DNA from wastewater by modifying a long-standing RNA-specific extraction workflow optimized for SARS-CoV-2 detection. Modifications were made to the sample concentration process and included an evaluation of bead bashing prior to the extraction of either DNA or RNA. Results showed that bead bashing reduced detection of RNA from wastewater but improved recovery of DNA as assessed by quantitative polymerase chain reaction (qPCR). Bead bashing is therefore not recommended for the quantification of RNA viruses using qPCR. Whereas for Mycobacterium bacterial DNA isolation, bead bashing was necessary for improving qPCR quantification. Overall, we recommend 2 separate workflows, one for RNA viruses that does not include bead bashing and one for other microbes that use bead bashing for DNA isolation. The experimentation done here shows that current-standing WBS program methodologies optimized for SARS-CoV-2 need to be modified and reoptimized to allow for alternative pathogens to be readily detected and monitored, expanding its utility as a tool for public health assessment.
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Affiliation(s)
- Kristina M. Babler
- Department of ChemicalEnvironmental and Materials
EngineeringUniversity of MiamiCoral GablesFlorida33124USA
| | - Mark E. Sharkey
- Department of MedicineUniversity of Miami Miller School
of MedicineMiamiFlorida33136USA
| | - Ayaaz Amirali
- Department of ChemicalEnvironmental and Materials
EngineeringUniversity of MiamiCoral GablesFlorida33124USA
| | - Melinda M. Boone
- Sylvester Comprehensive Cancer CenterUniversity of Miami
Miller School of MedicineMiamiFlorida33136USA
| | - Samuel Comerford
- Department of MedicineUniversity of Miami Miller School
of MedicineMiamiFlorida33136USA
| | - Benjamin B. Currall
- Sylvester Comprehensive Cancer CenterUniversity of Miami
Miller School of MedicineMiamiFlorida33136USA
| | - George S. Grills
- Sylvester Comprehensive Cancer CenterUniversity of Miami
Miller School of MedicineMiamiFlorida33136USA
| | - Jennifer Laine
- Environmental Health and SafetyUniversity of MiamiMiamiFlorida33136USA
| | - Christopher E. Mason
- Department of Physiology and BiophysicsWeill Cornell
MedicineNew YorkNew York10065USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Al-Saud
Institute for Computational BiomedicineWeill Cornell MedicineNew
YorkNew York10065USA
- The WorldQuant Initiative for Quantitative PredictionWeill Cornell MedicineNew YorkNew YorkUSA 10065USA
| | - Brian Reding
- Environmental Health and SafetyUniversity of MiamiMiamiFlorida33136USA
| | - Stephan Schürer
- Sylvester Comprehensive Cancer CenterUniversity of Miami
Miller School of MedicineMiamiFlorida33136USA
- Department of Molecular and Cellular PharmacologyUniversity of Miami Miller School of MedicineMiamiFlorida33136USA
- Institute for Data Science & Computing, University of
MiamiCoral GablesFlorida33146USA
| | - Mario Stevenson
- Department of MedicineUniversity of Miami Miller School
of MedicineMiamiFlorida33136USA
| | - Dušica Vidović
- Department of Molecular and Cellular PharmacologyUniversity of Miami Miller School of MedicineMiamiFlorida33136USA
| | - Sion L. Williams
- Sylvester Comprehensive Cancer CenterUniversity of Miami
Miller School of MedicineMiamiFlorida33136USA
| | - Helena M. Solo-Gabriele
- Department of ChemicalEnvironmental and Materials
EngineeringUniversity of MiamiCoral GablesFlorida33124USA
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