Early Introductions of Candida Auris Detected by Wastewater Surveillance, Utah, USA, 2022-2023

Overview

Journal Emerg Infect Dis

Specialty Infectious Diseases

Date 2024 Sep 25

PMID 39320163

Authors

Jorge Chavez

Katherine Crank

Casey Barber

Daniel Gerrity

Thomas Iverson

Joshua Mongillo

Angela Weil

Linda Rider

Nathan Lacross

Kelly Oakeson

Alessandro Rossi

Affiliations

Soon will be listed here.

Abstract

Candida auris is considered a nosocomial pathogen of high concern and is currently spreading across the United States. Infection control measures for C. auris focus mainly on healthcare facilities, yet transmission levels may already be significant in the community before outbreaks are detected in healthcare settings. Wastewater-based epidemiology (culture, quantitative PCR, and whole-genome sequencing) can potentially gauge pathogen transmission in the general population and lead to early detection of C. auris before it is detected in clinical cases. To learn more about the sensitivity and limitations of wastewater-based surveillance, we used wastewater-based methods to detect C. auris in a southern Utah jurisdiction with no known clinical cases before and after the documented transfer of colonized patients from bordering Nevada. Our study illustrates the potential of wastewater-based surveillance for being sufficiently sensitive to detect C. auris transmission during the early stages of introduction into a community.

References

Eyre D, Sheppard A, Madder H, Moir I, Moroney R, Quan T . A Candida auris Outbreak and Its Control in an Intensive Care Setting. N Engl J Med. 2018; 379(14):1322-1331. DOI: 10.1056/NEJMoa1714373. View

Penn R, Ward B, Strande L, Maurer M . Review of synthetic human faeces and faecal sludge for sanitation and wastewater research. Water Res. 2018; 132:222-240. DOI: 10.1016/j.watres.2017.12.063. View

Thoma R, Seneghini M, Seiffert S, Vuichard Gysin D, Scanferla G, Haller S . The challenge of preventing and containing outbreaks of multidrug-resistant organisms and Candida auris during the coronavirus disease 2019 pandemic: report of a carbapenem-resistant Acinetobacter baumannii outbreak and a systematic review of the.... Antimicrob Resist Infect Control. 2022; 11(1):12. PMC: 8777447. DOI: 10.1186/s13756-022-01052-8. View

Babler K, Sharkey M, Arenas S, Amirali A, Beaver C, Comerford S . Detection of the clinically persistent, pathogenic yeast spp. Candida auris from hospital and municipal wastewater in Miami-Dade County, Florida. Sci Total Environ. 2023; 898:165459. PMC: 10543605. DOI: 10.1016/j.scitotenv.2023.165459. View

Du H, Bing J, Hu T, Ennis C, Nobile C, Huang G . Candida auris: Epidemiology, biology, antifungal resistance, and virulence. PLoS Pathog. 2020; 16(10):e1008921. PMC: 7581363. DOI: 10.1371/journal.ppat.1008921. View

Lyman M, Forsberg K, Sexton D, Chow N, Lockhart S, Jackson B . Worsening Spread of in the United States, 2019 to 2021. Ann Intern Med. 2023; 176(4):489-495. PMC: 11307313. DOI: 10.7326/M22-3469. View

Ku T, Walraven C, Lee S . : Disinfectants and Implications for Infection Control. Front Microbiol. 2018; 9:726. PMC: 5906573. DOI: 10.3389/fmicb.2018.00726. View

Proctor D, Dangana T, Sexton D, Fukuda C, Yelin R, Stanley M . Integrated genomic, epidemiologic investigation of Candida auris skin colonization in a skilled nursing facility. Nat Med. 2021; 27(8):1401-1409. PMC: 9396956. DOI: 10.1038/s41591-021-01383-w. View

Barber C, Crank K, Papp K, Innes G, Schmitz B, Chavez J . Community-Scale Wastewater Surveillance of during an Ongoing Outbreak in Southern Nevada. Environ Sci Technol. 2023; 57(4):1755-1763. PMC: 9893721. DOI: 10.1021/acs.est.2c07763. View

10.

Jones T, Federspiel N, Chibana H, Dungan J, Kalman S, Magee B . The diploid genome sequence of Candida albicans. Proc Natl Acad Sci U S A. 2004; 101(19):7329-34. PMC: 409918. DOI: 10.1073/pnas.0401648101. View

11.

Rauch W, Brockmann D, Peters I, Larsen T, Gujer W . Combining urine separation with waste design: an analysis using a stochastic model for urine production. Water Res. 2003; 37(3):681-9. DOI: 10.1016/s0043-1354(02)00364-0. View

12.

Rose C, Parker A, Jefferson B, Cartmell E . The Characterization of Feces and Urine: A Review of the Literature to Inform Advanced Treatment Technology. Crit Rev Environ Sci Technol. 2015; 45(17):1827-1879. PMC: 4500995. DOI: 10.1080/10643389.2014.1000761. View

13.

Torres S, Pichowicz A, Torres-Velez F, Song R, Singh N, Lasek-Nesselquist E . Impact of Candida auris Infection in a Neutropenic Murine Model. Antimicrob Agents Chemother. 2019; 64(3). PMC: 7038241. DOI: 10.1128/AAC.01625-19. View

14.

Rossi A, Chavez J, Iverson T, Hergert J, Oakeson K, Lacross N . Candida auris Discovery through Community Wastewater Surveillance during Healthcare Outbreak, Nevada, USA, 2022. Emerg Infect Dis. 2023; 29(2):422-425. PMC: 9881792. DOI: 10.3201/eid2902.221523. View

15.

Lockhart S, Etienne K, Vallabhaneni S, Farooqi J, Chowdhary A, Govender N . Simultaneous Emergence of Multidrug-Resistant Candida auris on 3 Continents Confirmed by Whole-Genome Sequencing and Epidemiological Analyses. Clin Infect Dis. 2016; 64(2):134-140. PMC: 5215215. DOI: 10.1093/cid/ciw691. View

16.

Croxatto A, Dijkstra K, ProdHom G, Greub G . Comparison of Inoculation with the InoqulA and WASP Automated Systems with Manual Inoculation. J Clin Microbiol. 2015; 53(7):2298-307. PMC: 4473203. DOI: 10.1128/JCM.03076-14. View

17.

Huang X, Welsh R, Deming C, Proctor D, Thomas P, Gussin G . Skin Metagenomic Sequence Analysis of Early Candida auris Outbreaks in U.S. Nursing Homes. mSphere. 2021; 6(4):e0028721. PMC: 8386442. DOI: 10.1128/mSphere.00287-21. View

18.

Leach L, Zhu Y, Chaturvedi S . Development and Validation of a Real-Time PCR Assay for Rapid Detection of Candida auris from Surveillance Samples. J Clin Microbiol. 2017; 56(2). PMC: 5786737. DOI: 10.1128/JCM.01223-17. View

19.

Chow N, Gade L, Tsay S, Forsberg K, Greenko J, Southwick K . Multiple introductions and subsequent transmission of multidrug-resistant Candida auris in the USA: a molecular epidemiological survey. Lancet Infect Dis. 2018; 18(12):1377-1384. PMC: 6556114. DOI: 10.1016/S1473-3099(18)30597-8. View

20.

Bagal U, Phan J, Welsh R, Misas E, Wagner D, Gade L . MycoSNP: A Portable Workflow for Performing Whole-Genome Sequencing Analysis of Candida auris. Methods Mol Biol. 2022; 2517:215-228. DOI: 10.1007/978-1-0716-2417-3_17. View