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. 2023 Nov 10:898:165459.
doi: 10.1016/j.scitotenv.2023.165459. Epub 2023 Jul 12.

Detection of the clinically persistent, pathogenic yeast spp. Candida auris from hospital and municipal wastewater in Miami-Dade County, Florida

Kristina Babler  1 , Mark Sharkey  2 , Sebastian Arenas  2 , Ayaaz Amirali  1 , Cynthia Beaver  3 , Samuel Comerford  2 , Kenneth Goodman  4 , George Grills  3 , Michelle Holung  2 , Erin Kobetz  5 , Jennifer Laine  6 , Walter Lamar  7 , Christopher Mason  8 , Darryl Pronty  2 , Brian Reding  6 , Stephan Schürer  9 , Natasha Schaefer Solle  5 , Mario Stevenson  2 , Dusica Vidović  10 , Helena Solo-Gabriele  1 , Bhavarth Shukla  11
Affiliations

Detection of the clinically persistent, pathogenic yeast spp. Candida auris from hospital and municipal wastewater in Miami-Dade County, Florida

Kristina Babler et al. Sci Total Environ. .

Abstract

The use of wastewater-based surveillance (WBS) for detecting pathogens within communities has been growing since the beginning of the COVID-19 pandemic with early efforts investigating severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA in wastewater. Recent efforts have shed light on the utilization of WBS for alternative targets, such as fungal pathogens, like Candida auris, in efforts to expand the technology to assess non-viral targets. The objective of this study was to extend workflows developed for SARS-CoV-2 quantification to evaluate whether C. auris can be recovered from wastewater, inclusive of effluent from a wastewater treatment plant (WWTP) and from a hospital with known numbers of patients colonized with C. auris. Measurements of C. auris in wastewater focused on culture-based methods and quantitative PCR (qPCR). Results showed that C. auris can be cultured from wastewater and that levels detected by qPCR were higher in the hospital wastewater compared to the wastewater from the WWTP, suggesting either dilution or degradation of this pathogenic yeast at downstream collection points. The results from this study illustrate that WBS can extend beyond SARS-CoV-2 monitoring to evaluate additional non-viral pathogenic targets and demonstrates that C. auris isolated from wastewater is competent to replicate in vitro using fungal-specific culture media.

Keywords: C. auris; Candida; SARS-CoV-2; WBS; Wastewater; Wastewater-based surveillance.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1:
Figure 1:
Time series plot of (left axis) daily clinical C. auris data for patients in the hospital as determined by skin swab (shown by blue circles) versus times when patients (n=1 for each vertical line) also tested positive in either urine, sputum or blood samples, and plot (right axis) for C. auris (gc/L) concentrations in wastewater samples.
Figure 2:
Figure 2:
Time series plot of daily clinical data for C. auris and COVID-19 positive cases recorded in the University Hospital and quantified wastewater signal of C. auris and SARS-CoV-2 (gc/L), collected weekly. Gaps in wastewater data provide that no hospital sample was collected on that given date.
Figure 3:
Figure 3:
Colonies of Candida spp. on CHROMAgar from 1 mL of wastewater collected on September 7, 2022, re-filtered after two weeks of hold time at 4 °C, and incubated at 37 °C for 48-hours. The left panel corresponds to the unaltered image. The middle and right panels show magnifications of light blue colonies that were positive for C. auris by qPCR.
See this image and copyright information in PMC

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