Combined use of an immunomagnetic separation method and immunoblotting for the enumeration and isolation of Escherichia coli O157 in wastewaters

Two risk assessments: Evaluating the use of indicator HF183 Bacteroides versus pathogen measurements for modelling recreational illness risks in an urban watershed

The purpose of this study was to evaluate the performance of HF183 Bacteroides for estimating pathogen exposures during recreational water activities. We compared the use of Bacteroides-based exposure assessment to exposure assessment that relied on pathogen measurements. We considered two types of recreational water sites: those impacted by combined sewer overflows (CSOs) and those not impacted by CSOs. Samples from CSO-impacted and non-CSO-impacted urban creeks were analysed by quantitative polymerase chain reaction (qPCR) for HF183 Bacteroides and eight human gastrointestinal pathogens. Exposure assessment was conducted two ways for each type of site (CSO-impacted vs. non-CSO impacted): 1) by estimating pathogen concentrations from HF183 Bacteroides concentrations using published ratios of HF183 to pathogens in sewage and 2) by estimating pathogen concentrations from qPCR measurements. QMRA (quantitative microbial risk assessment) was then conducted for swimming, wading, and fishing exposures. Overall, mean risk estimates varied from 0.27 to 53 illnesses per 1,000 recreators depending on exposure assessment, site, activity, and norovirus dose-response model. HF183-based exposure assessment identified CSO-impacted sites as higher risk, and the recommended HF183 risk-based threshold of 525 genomic copies per 100 mL was generally protective of public health at the CSO-impacted sites but was not as protective at the non-CSO-impacted sites. In the context of our urban watershed, HF183-based exposure assessment over- and under-estimated risk relative to exposure assessment based on pathogen measurements, and the etiology of predicted pathogen-specific illnesses differed significantly. Across all sites, the HF183 model overestimated risk for norovirus, adenovirus, and Campylobacter jejuni, and it underestimated risk for E. coli and Cryptosporidium. To our knowledge, this study is the first to directly compare health risk estimates using HF183 and empirical pathogen measurements from the same waterways. Our work highlights the importance of site-specific hazard identification and exposure assessment to decide whether HF183 is applicable for monitoring risk.

Integrating microbial source tracking with quantitative microbial risk assessment to evaluate site specific risk based thresholds at two South Florida beaches

Quantitative microbial risk assessment (QMRA) can be used to evaluate health risks associated with recreational beach use. This study developed a site-specific risk assessment using a novel approach that combined quantitative PCR-based measurement of microbial source tracking (MST) genetic markers (human, dog, and gull fecal bacteria) with a QMRA analysis of potential pathogen risk. Water samples (n = 24) from two recreational beaches were collected and analyzed for MST markers as part of a broader Beach Exposure And Child Health Study that examined child behavior interactions with the beach environment. We report here the measurements of fecal bacteria MST markers in the environmental DNA extracts of those samples and a QMRA analysis of potential health risks utilizing the results from the MST measurements in the water samples. Human-specific Bacteroides was enumerated by the HF183 Taqman qPCR assay, gull-specific Catellicoccus was enumerated by the Gull2 qPCR assay, and dog-specific Bacteroides was enumerated by the DogBact qPCR assay. Derived reference pathogen doses, calculated from the MST marker concentrations detected in recreational waters, were used to estimate the risk of gastrointestinal illness for both children and adults. Dose-response equations were used to estimate the probability of the risk of infection (Pinf) per a swimming exposure event. Based on the QMRA simulations presented in this study, the GI risk from swimming or playing in water containing a mixture of human and non-human fecal sources appear to be primarily driven by the human fecal source. However, the estimated median GI health risk for both beaches never exceeded the U.S. EPA risk threshold of 32 illnesses per 1,000 recreation events. Our research suggests that utilizing QMRA together with MST can further extend our understanding of potential recreational bather risk by identifying the source contributing the greatest risk in a particular location, therefore informing beach management responses and decision-making.

Contamination Scenario Matters when Using Viral and Bacterial Human-Associated Genetic Markers as Indicators of a Health Risk in Untreated Sewage-Impacted Recreational Waters

Fecal pollution at beaches can pose a health risk to recreators. Quantitative microbial risk assessment (QMRA) is a tool to evaluate the use of candidate fecal indicators to signify a health risk from enteric pathogens in sewage-impacted waters. We extend the QMRA approach to model mixtures of sewage at different ages using genetic marker concentrations for human-associated crAssphage, Bacteroides spp., and polyomavirus in sewage samples from 49 wastewater facilities across the contiguous United States. Risk-based threshold (RBT) estimates varied across different mixture and sewage age scenarios. Fresh sewage RBT estimates were not always protective when aged sewage was present, and aged sewage RBT estimates often fell below the marker lower limit of quantification. Conservative RBT estimates of 9.3 × 10² and 9.1 × 10³ (copies/100 mL) for HF183/BacR287 and CPQ_056, respectively, were predicted when fresh sewage was greater (by volume) than aged at the time of measurement. Conversely, genetic markers may not be effective indicators when aged sewage contributes the majority of pathogens, relative to fresh contamination, but minimal marker levels. Results highlight the utility of QMRA that incorporates pollutant age and mixture scenarios, the potential advantages of a crAssphage fecal indicator, and the potential influence of site-specific factors on estimating RBT values.

Risk-based water quality thresholds for coliphages in surface waters: effect of temperature and contamination aging

Coliphages, viruses that infect Escherichia coli, have been used for decades to assess surface water quality yet there is no guideline for interpreting their concentrations. The present study uses a quantitative microbial risk assessment (QMRA) framework to derive risk-based surface water quality thresholds for somatic and F+ or male-specific coliphages. The risk-based threshold is the concentration at which the risk of gastro-intestinal illness is simulated to be 32/1000. The framework specifically investigates a simplified hazard scenario where recreational swimmers come into contact with water contaminated with untreated sewage containing coliphages and enteric pathogens. The framework considers exposure to sewage of diverse ages and thus accounts for the decay of coliphages and pathogens over time. As decay rate constants depend on temperature, the model considers the effect of temperature on the risk-based threshold. When exposure to fresh, unaged sewage contamination occurs, the risk-based water quality threshold for somatic and F+ coliphages is 60 PFU per 100 mL and 30 PFU per 100 mL, respectively, and temperature independent. The risk-based threshold decreases as the contamination ages because, on average, coliphages decay more quickly than norovirus, the pathogen that contributes the most to risk. The decrease in the risk-based threshold with contaminant age is equal to the difference in the first order decay rate constants of coliphages and norovirus. Since coliphage decay rate constants are larger at 25 °C than at 15 °C, and norovirus decay rate constants are a weak function of temperature, risk-based thresholds decrease more quickly with age at 25 °C than at 15 °C. For the common case where the age of contamination is unknown, the risk-based threshold for both coliphages is between ∼1 PFU per 100 mL and ∼10 PFU per 100 mL, depending on model assumptions. Future work can apply this QMRA framework for identifying risk-based thresholds for coliphages from different hazards (treated wastewater or animal feces) or from mixtures of contamination of different ages and sources.

Validation and verification of LAMP, ISO, and VIDAS UP methods for detection of Escherichia coli O157:H7 in different food matrices

Escherichia coli O157:H7 is one of the most important food-borne pathogens to threaten public health. Cultural methods are used as a gold standard while they are laborious and time-consuming. Loop-mediated isothermal amplification (LAMP) method is an alternative method that became widely used for the detection of food-borne pathogens. The aim of this study was to evaluate the specificity and sensitivity of LAMP method for detection of E. coli O157:H7, also to compare detection performances with VIDAS UP and ISO (International Organization for Standardization) methods in different food matrices (beef meat, minced lamb meat, milk, cheese, apple puree, and soybean sprouts). E. coli O157:H7 were spiked in three different levels (high 4.58; medium 2.32; low 0.30 log₁₀ CFU/g-ml) to food matrices. Although there were no significant differences in terms of the specificity and sensitivity values among the three methods (p ≥ .05), it was determined that the highest specificity and sensitivity values obtained from the LAMP method. Sensitivity and specificity values of LAMP method were found as 0.997 and 0.988, for the ISO method were 0.989 and 0.971, and for the VIDAS UP method were 0.980 and 0.963, respectively. In milk samples, sensitivity and specificity values of the VIDAS UP method were significantly lower than LAMP and ISO methods (p < .05). However, there were no significant differences found for the other food matrices among the three methods (p > .05). It can be summarized from this study that specificity and sensitivity values of the LAMP method are equal or higher and less time-consuming than ISO and VIDAS UP methods. In conclusion, using a simple, fast, and inexpensive detection method, such as LAMP, especially in endemic regions or in an outbreak to control spreading of pathogens, is very important for public health.

Can We Swim Yet? Systematic Review, Meta-Analysis, and Risk Assessment of Aging Sewage in Surface Waters

This study investigated the risk of gastrointestinal illness associated with swimming in surface waters with aged sewage contamination. First, a systematic review compiled 333 first order decay rate constants ( k) for human norovirus and its surrogates feline calicivirus and murine norovirus, Salmonella, Campylobacter, Escherichia coli O157:H7, Giardia, and Cryptosporidium, and human-associated indicators in surface water. A meta-analysis investigated effects of sunlight, temperature, and water matrix on k. There was a relatively large number of k for bacterial pathogens and some human-associated indicators ( n > 40), fewer for protozoans ( n = 14-22), and few for human norovirus and its Caliciviridae surrogates ( n = 2-4). Average k ranked: Campylobacter > human-associated markers > Salmonella> E. coli O157:H7 > norovirus and its surrogates > Giardia > Cryptosporidium. Compiled k values were used in a quantitative microbial risk assessment (QMRA) to simulate gastrointestinal illness risk associated with swimming in water with aged sewage contamination. The QMRA used human-associated fecal indicator HF183 as an index for the amount of sewage present and thereby provided insight into how risk relates to HF183 concentrations in surface water. Because exposure to norovirus contributed the majority of risk, and HF183 k is greater than norovirus k, the risk associated with exposure to a fixed HF183 concentration increases with the age of contamination. Swimmer exposure to sewage after it has aged ∼3 days results in median risks less than 30/1000. A risk-based water quality threshold for HF183 in surface waters that takes into account uncertainty in contamination age is derived to be 4100 copies/100 mL.

Estimating the probability of illness due to swimming in recreational water with a mixture of human- and gull-associated microbial source tracking markers

Beaches often receive fecal contamination from more than one source. Human sources include untreated sewage as well as treated wastewater effluent, and animal sources include wildlife such as gulls. Different contamination sources are expected to pose different health risks to swimmers. Genetic microbial source tracking (MST) markers can be used to detect bacteria that are associated with different animal sources, but the health risks associated with a mixture of MST markers are unknown. This study presents a method for predicting these health risks, using human- and gull-associated markers as an example. Quantitative Microbial Risk Assessment (QMRA) is conducted with MST markers as indicators. We find that risks associated with exposure to a specific concentration of a human-associated MST marker (HF) are greater if the HF source is untreated sewage rather than treated wastewater effluent. We also provide a risk-based threshold of HF from untreated sewage at a beach, to stay below a predicted illness risk of 3 per 100 swimmers, that is a function of gull-associated MST marker (CAT) concentration.

Evaluation of the dry and wet weather recreational health risks in a semi-enclosed marine embayment in Southern California

For many coastal regions around the world, recreational beach water quality is assessed using fecal indicator bacteria (FIB). However, the utility of FIB as indicators of recreational water illness (RWI) risk has been questioned, particularly in coastal settings with no obvious sources of human sewage. In this study we employed a source-apportionment quantitative microbial risk assessment (SA-QMRA) to assess RWI risk at a popular semi-enclosed recreational beach in Southern California (Baby Beach, City of Dana Point) with no obvious point sources of human sewage. Our SA-QMRA results suggest that, during dry weather, the median RWI risk at this beach is below the U.S. EPA recreational water quality criteria (RWQC) of 36 illness cases per 1000 bathers. During wet weather, the median RWI risk predicted by SA-QMRA depends on the assumed level of human waste associated with stormwater; the RWI risk is below the EPA RWQC illness risk benchmark 100% of the time provided that <2% of the FIB in stormwater are of human origin. However, these QMRA outcomes contrast strongly with the EPA RWQC for 30-day geometric mean of enterococci bacteria. Our results suggest that SA-QMRA is a useful framework for estimating robust RWI risk that takes into account local information about possible human and non-human sources of FIB.

Detection and prevalence of verotoxin-producing Escherichia coli O157 and non-O157 serotypes in a Canadian watershed

Verotoxin-producing Escherichia coli (VTEC) strains are the cause of food-borne and waterborne illnesses around the world. Traditionally, surveillance of the human population as well as the environment has focused on the detection of E. coli O157:H7. Recently, increasing recognition of non-O157 VTEC strains as human pathogens and the German O104:H4 food-borne outbreak have illustrated the importance of considering the broader group of VTEC organisms from a public health perspective. This study presents the results of a comparison of three methods for the detection of VTEC in surface water, highlighting the efficacy of a direct VT immunoblotting method without broth enrichment for detection and isolation of O157 and non-O157 VTEC strains. The direct immunoblot method eliminates the need for an enrichment step or the use of immunomagnetic separation. This method was developed after 4 years of detecting low frequencies (1%) of E. coli O157:H7 in surface water in a Canadian watershed, situated within one of the FoodNet Canada integrated surveillance sites. By the direct immunoblot method, VTEC prevalence estimates ranged from 11 to 35% for this watershed, and E. coli O157:H7 prevalence increased to 4% (due to improved method sensitivity). This direct testing method provides an efficient means to enhance our understanding of the prevalence and types of VTEC in the environment. This study employed a rapid evidence assessment (REA) approach to frame the watershed findings with watershed E. coli O157:H7 prevalences reported in the literature since 1990 and the knowledge gap with respect to VTEC detection in surface waters.

Feasibility of methods based on nucleic acid amplification techniques to fulfil the requirements for microbiological analysis of water quality

Molecular methods based on nucleic acid recognition and amplification are valuable tools to complement and support water management decisions. At present, these decisions are mostly supported by the principle of end-point monitoring for indicators and a small number of selected measured by traditional methods. Nucleic acid methods show enormous potential for identifying isolates from conventional culture methods, providing data on cultivable and noncultivable micro-organisms, informing on the presence of pathogens in waters, determining the causes of waterborne outbreaks, and, in some cases, detecting emerging pathogens. However, some features of water microbiology affect the performance of nucleic acid-based molecular techniques and thus challenge their suitability for routine water quality control. These features include the variable composition of target water samples, the generally low numbers of target micro-organisms, the variable water quality required for different uses and the physiological status or condition of such micro-organisms. The standardization of these molecular techniques is also an important challenge for its routine use in terms of accuracy (trueness and precision) and robustness (reproducibility and reliability during normal usage). Most of national and international water regulations recommend the application of standard methods, and any new technique must be validated respect to established methods and procedures. Moreover, molecular methods show a high cost-effectiveness value that limits its practicability on some microbial water analyses. However, new molecular techniques could contribute with new information or at least to supplement the limitation of traditional culture-based methods. Undoubtedly, challenges for these nucleic acid-based methods need to be identified and solved to improve their feasibility for routine microbial water monitoring.

Estimated human health risks from exposure to recreational waters impacted by human and non-human sources of faecal contamination

This work was conducted to determine whether estimated risks following exposure to recreational waters impacted by gull, chicken, pig, or cattle faecal contamination are substantially different than those associated with waters impacted by human sources such as treated wastewater. Previously published Quantitative Microbial Risk Assessment (QMRA) methods were employed and extended to meet these objectives. Health outcomes used in the analyses were infection from reference waterborne pathogens via ingestion during recreation and subsequent gastrointestinal (GI) illness. Illness risks from these pathogens were calculated for exposure to faecally contaminated recreational water at the U.S. regulatory limits of 35 cfu 100 mL(-1) enterococci and 126 cfu 100 mL(-1)Escherichia coli. The probabilities of GI illness were calculated using pathogen dose-response relationships from the literature and Monte Carlo simulations. Three scenarios were simulated, representing a range of feasible interpretations of the available data. The primary findings are that: 1) GI illness risks associated with exposure to recreational waters impacted by fresh cattle faeces may not be substantially different from waters impacted by human sources; and 2) the risks associated with exposure to recreational waters impacted by fresh gull, chicken, or pig faeces appear substantially lower than waters impacted by human sources. These results suggest that careful consideration may be needed in the future for the management of recreational waters not impacted by human sources.

Phage-mediated Shiga toxin 2 gene transfer in food and water

Shiga toxin (stx) transduction in various food matrices has been evaluated with lysogens of Stx phages. stx transduction events were observed for many phages under appropriate conditions. Transduction did not occur at low pH and low temperatures. A total of 10(3) to 10(4) CFU ml(-1) was the minimal amount of donor and recipient strains necessary to generate transductants.

Genotypic and phenotypic diversity among induced, stx2-carrying bacteriophages from environmental Escherichia coli strains

Shiga toxin 2 (stx(2)) gene-carrying bacteriophages have been shown to convert Escherichia coli strains to Shiga toxin-producing Escherichia coli (STEC). In this study, 79 E. coli strains belonging to 35 serotypes isolated from wastewaters of both human and animal origin were examined for the presence of stx(2)-carrying bacteriophages in their genomes. The lytic cycle of the bacteriophages was induced by mitomycin, and the bacteriophage fraction was isolated and used for morphological and genetic characterization. The induced bacteriophages showed morphological diversity, as well as restriction fragment length polymorphism variation, in the different strains belonging to different serotypes. The ability to infect new hosts was highly variable, although most of the induced phages infected Shigella sonnei host strain 866. In summary, in spite of carrying either the same or different stx(2) variants and in spite of the fact that they were isolated from strains belonging to the same or different serotypes, the induced bacteriophages were highly variable. The high level of diversity and the great infectious capacity of these phages could enhance the spread of the stx(2) gene and variants of this gene among different bacterial populations in environments to which humans may be exposed.

Immunomagnetic separation combined with real-time reverse transcriptase PCR assays for detection of norovirus in contaminated food

We developed an immunomagnetic separation (IMS) technique combined with real-time TaqMan reverse transcriptase PCR (RT-PCR), which allowed detection of norovirus at a level as low as 3 to 7 RT-PCR units from artificially contaminated strawberries. The inoculum recovery rate ranged from 14 to 30%. The data demonstrate that IMS combined with real-time RT-PCR will be useful as a rapid and sensitive method for detecting food-borne microbial contaminants.

Occurrence of Escherichia coli O157:H7 and other enterohemorrhagic Escherichia coli in the environment

Enterohemorrhagic Escherichia coli (EHEC) (O157 and other serotypes) are zoonotic pathogens linked with severe human illnesses. The main virulence factors of EHEC are the Shiga toxins, among others. Most of the genes coding for these toxins are bacteriophage-encoded. Although ruminants are recognized as their main natural reservoir, water has also been documented as a way of transmission of EHEC. E. coli O157:H7 and other EHEC may contaminate waters (recreational, drinking or irrigation waters) through feces from humans and other animals. Indeed, the occurrence of EHEC carrying the stx2 gene in raw municipal sewage and animal wastewater from several origins has been widely documented. However, the evaluation of the persistence of naturally occurring EHEC in the environment is still difficult due to methodological problems. Methods proposed for the detection and isolation of stx-encoding bacteria, ranging from the classic culture-based methods to molecular approaches, and their application in the environment, are discussed here. Most virulence factors associated with these strains are linked to either plasmids or phages, and consequently they are likely to be subject to horizontal gene transfer between species or serotypes. Moreover, the presence of infectious stx-phages isolated as free particles in the environment and their high persistence in water systems suggest that they may contribute to the spread of stx genes, as they are directly involved in the emergence of new pathogenic strains, which might have important health consequences.

Impact of microbial diversity on rapid detection of enterohemorrhagic Escherichia coli in surface waters

Enterohemorrhagic Escherichia coli (EHEC) are a physiologically, immunologically and genetically diverse collection of strains that pose a serious water-borne threat to human health. Consequently, immunological and PCR assays have been developed for the rapid, sensitive detection of presumptive EHEC. However, the ability of these assays to consistently detect presumptive EHEC while excluding closely related non-EHEC strains has not been documented. We conducted a 30-month monitoring study of a major metropolitan watershed. Surface water samples were analyzed using an immunological assay for E. coli O157 (the predominant strain worldwide) and a multiplex PCR assay for the virulence genes stx(1), stx(2) and eae. The mean frequency of water samples positive for the presence of E. coli O157, stx(1) or stx(2) genes, or the eae gene was 50%, 26% and 96%, respectively. Quantitative analysis of selected enriched water samples indicated that even in samples positive for E. coli O157 cells, stx(1)/stx(2) genes, and the eae gene, the concentrations were rarely comparable. Seventeen E. coli O157 strains were isolated, however, none were EHEC. These data indicate the presence of multiple strains similar to EHEC but less pathogenic. These findings have important ramifications for the rapid detection of presumptive EHEC; namely, that current immunological or PCR assays cannot reliably identify water-borne EHEC strains.

Hydrologic modeling of pathogen fate and transport

A watershed-scale fate and transport model has been developed for Escherichia coli and several waterborne pathogens: Cryptosporidiumspp., Giardiaspp., Campylobacter spp, and E. coli O157:H7. The objectives were to determine the primary sources of pathogenic contamination in a watershed used for drinking water supply and to gain a greater understanding of the factors that most influence their survival and transport. To predict the levels of indicator bacteria and pathogens in surface water, an existing hydrologic model, WATFLOOD, was augmented for pathogen transport and tested on a watershed in Southwestern Ontario, Canada. The pathogen model considered transport as a result of overland flow, subsurface flow to tile drainage systems, and in-stream routing. The model predicted that most microorganisms entering the stream from land-based sources enter the stream from tile drainage systems rather than overland transport. Although the model predicted overland transport to be rare, when it occurred, it corresponded to the highest observed and modeled microbial concentrations. Furthermore, rapid increases in measured E. coli concentrations during storm events suggested that the resuspension of microorganisms from stream sediments may be of equal or greater importance than land-based sources of pathogens.