MSGID: 1:317/3 642f9c66   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    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   
             o Health_&_Medicine   
                   # Today's_Healthcare # Health_Policy #   
                   Public_Health_Education # Diseases_and_Conditions   
             o Plants_&_Animals   
                   # Fungus # Soil_Types # Microbes_and_More # Nature   
       * RELATED_TERMS   
             o Epidemiology o Public_health o Veterinary_medicine o   
             Fungal_keratitis o Medicine o Global_spread_of_H5N1_in_2006   
             o Mumps o Scientific_method   
      
   ==========================================================================   
   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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