Case for Candida auris wastewater surveillance

Date:
April 6, 2023
Source:
University of Nevada, Las Vegas
Summary:
Researchers say tracking methodology in Southern Nevada fungal
outbreak provides blueprint for monitoring and responding to
emerging global public health threat.


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FULL STORY ==========================================================================
A rapid spike in cases of a potentially deadly, drug-resistant fungus
has concerned public health officials across the nation. But a team of
Southern Nevada researchers hope their new study applying wastewater surveillance can help health officials get a step ahead of this emerging
global public health threat.


==========================================================================
The Pathogen Problem Candida auris is a fungus that can cause serious infections, particularly in patients who are immunocompromised, have pre-existing health conditions, are in long-term healthcare settings,
or are undergoing treatment with invasive medical devices such as a
catheter. Infection prevention and control is challenging because the
fungus can grow on both dry and moist surfaces such as furniture, door
handles, clothing, and medical equipment in healthcare facilities. It's
also shown resistance to many commonly used surface disinfectants and
all three types of antifungal medicines. More than 1 in 3 patients
with invasive C. auris infections -- which can affect the blood, heart,
or brain -- dies.

What's more, Nevada -- one of six states with recently high burdens of
C. auris -- last year experienced outbreaks across multiple healthcare facilities and logged the most U.S. cases of the fungal infection. The
Silver State experienced a 16-fold increase from just 24 cases in 2021
to 384 cases in 2022, according to the Centers for Disease Control
and Prevention (CDC). Cases have also been reported in dozens of other countries.

What They Found A research team led by Casey Barber, a UNLV School of
Public Health doctoral student and Southern Nevada Water Authority (SNWA) graduate intern, recently published a study in the journal Environmental Science & Technology that analyzed 10 weeks' worth of wastewater samples
from seven Southern Nevada sewersheds.

The scientists detected the genetic material of C. auris in at least one untreated sewage sample from each Southern Nevada wastewater treatment
facility and nearly 80% of all untreated sewage samples in the study. The sewersheds serving healthcare facilities involved in the outbreak also
showed higher detection frequencies for the fungus. Researchers noted
that no fungus was detected in untreated sewage samples from a wastewater treatment facility in Utah, an area with no known C. auris cases at the
time. The fungus was not detected in the Las Vegas Wash, which contains
treated wastewater effluent, nor in Lake Mead, indicating that there is
no sign that C. auris poses a risk to drinking water.

"These results show that wastewater surveillance may help monitor the
spread of C. auris and could serve as an early warning system for public
health action," Barber said.

Other Takeaways The first human case of C. auris was reported in 2009,
but it's become more prevalent in recent years. The fungus is often
spread via contaminated surfaces or skin-to-skin contact with infected individuals, including with those who are asymptomatic.

Scientists called the Southern Nevada fungus flare-up -- which erupted
in August 2021 and has now affected over 30 healthcare facilities --
one of the largest recent outbreaks of healthcare-associated C. auris in
the U.S. The research team formally launched C. auris-specific monitoring
and data collection in late June 2022, as part of a larger ongoing UNLV wastewater surveillance collaboration with SNWA.

In addition to implications for large-scale C. auris detection and
prevention, researchers said the study is groundbreaking in its progress towards helping establish new procedures for sewage sample processing, preparation, and analysis to look for C. auris.

Wastewater surveillance, they said, may provide a more accurate estimate
of C.

auris prevalence than traditional public health surveillance methods, in
part because traditional methods may not accurately identify C. auris,
leading to delays in targeted intervention measures. The team also
anticipates that their previously established approach to monitoring
COVID-19 levels in wastewater could be applied to watching for mutations
and new strains of C. auris.

"Detection of Candida auris through wastewater surveillance has already prompted expanded screenings in Southern Nevada healthcare facilities in
an effort to prevent larger outbreaks," said SNWA principal research microbiologist Daniel Gerrity. "This demonstrates how wastewater
surveillance can be applied to emerging public health threats beyond
COVID-19."
* RELATED_TOPICS
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# Today's_Healthcare # Health_Policy #
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o Plants_&_Animals
# Fungus # Soil_Types # Microbes_and_More # Nature
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========================================================================== Story Source: Materials provided by
University_of_Nevada,_Las_Vegas. Original written by Keyonna
Summers. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Casey Barber, Katherine Crank, Katerina Papp, Gabriel K. Innes,
Bradley
W. Schmitz, Jorge Chavez, Alessandro Rossi, Daniel
Gerrity. Community- Scale Wastewater Surveillance of Candida auris
during an Ongoing Outbreak in Southern Nevada. Environmental Science
& Technology, 2023; 57 (4): 1755 DOI: 10.1021/acs.est.2c07763 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2023/04/230406152659.htm

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