Skilled nursing facility wastewater surveillance: a SARS-CoV-2 and antimicrobial resistance detection pilot study
The purpose of this study was to determine the feasibility of facility-level wastewater surveillance in the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in skilled nursing facility (SNF) wastewater using three concentration methods, as well as a proof-of-concept for antimicrobial resistance (AR) genes/organisms detection. Wastewater effluent samples were collected from an SNF over an 8-week period. Wastewater was concentrated using electronegative membrane filtration (enMF), polyethylene glycol precipitation, and Nanotrap<sup>®</sup> magnetic virus particles (NP). Quantification of the genome copy concentration from SARS-CoV-2 and bovine respiratory syncytial virus (BRSV), a SARS-CoV-2 surrogate spiked into all samples, was performed with droplet digital polymerase chain reaction (ddPCR). Wastewater sample aliquots were also enriched in microbiological culture media and screened for organisms with AR phenotypes on selective and differential agars. Multiplex real-time PCR was used to detect a broad array of carbapenem resistance genes. SARS-CoV-2 was detected and quantified from a single enMF-concentrated wastewater sample. The highest concentration of BRSV came from enMF-concentrated samples. <i>Klebsiella</i>, <i>Enterobacter</i>, <i>Citrobacter</i>, and <i>Escherichia coli</i> exhibiting AR phenotypes were successfully detected using culture-dependent approaches. Culture-independent, multiplex PCR indicated that bla<sub><i>KPC</i></sub> was the main carbapenemase gene detected in wastewater samples. Facility-level wastewater surveillance could be a useful strategy for SNFs.
Authors
- Peter W. Cook (ORCID: https://orcid.org/0000-0002-2058-5646)
- Johnetta Moore (ORCID: https://orcid.org/0000-0003-4794-0377)
- Suxiang Tong (ORCID: https://orcid.org/0000-0001-8439-8826)
- Amanda K. Lyons (ORCID: https://orcid.org/0000-0003-4312-2481)
- Christine Ganim (ORCID: https://orcid.org/0000-0002-2005-9355)
- Angela Coulliette-Salmond (ORCID: https://orcid.org/0000-0003-0435-7595)
- Magdalena Medrzycki (ORCID: https://orcid.org/0000-0001-6800-0283)
- Leila Kartforosh (ORCID: https://orcid.org/0000-0003-2219-7652)
- Paige Gable (ORCID: https://orcid.org/0000-0002-3223-7569)
- Adam C. Retchless (ORCID: https://orcid.org/0000-0001-7185-591X)
- Maria Burgos-Garay (ORCID: https://orcid.org/0000-0002-7525-4262)
- Lauren Franco
- Maroya Spalding Walters (ORCID: https://orcid.org/0000-0002-1090-7621)
- Bayeh Abera (ORCID: https://orcid.org/0000-0002-2559-6635)
- Carrie Sanders (ORCID: https://orcid.org/0000-0002-4904-9484)
- Rodney M. Donlan (ORCID: https://orcid.org/0000-0002-0990-3340)
- Christoph Adler (ORCID: https://orcid.org/0000-0002-2879-3837)
- Lakshmi Malapati (ORCID: https://orcid.org/0000-0003-1272-7496)
- Ariel J. Santiago (ORCID: https://orcid.org/0000-0002-2847-7439)
- Judith Noble‐Wang (ORCID: https://orcid.org/0000-0001-5090-5025)
- Yan Li (ORCID: https://orcid.org/0000-0002-1567-9365)
- Jing Zhang (ORCID: https://orcid.org/0000-0003-2966-9149)
- Sophie Jones (ORCID: https://orcid.org/0000-0003-0350-2578)
- Ying Tao (ORCID: https://orcid.org/0009-0005-0199-0661)
- Susanna Lenz (ORCID: https://orcid.org/0009-0007-6660-4076)
- Mariya Campbell (ORCID: https://orcid.org/0000-0001-6235-9404)
- Yimu Cahela
Institutions
- Oak Ridge Associated Universities (US)
- Centers for Disease Control and Prevention (US)
- National Center for Immunization and Respiratory Diseases (US)
- United States Public Health Service (US)
- National Center for Emerging and Zoonotic Infectious Diseases (US)
- Epidemic Intelligence Service (US)
- Oak Ridge Institute for Science and Education
Publication Details
- Journal
- Journal of Water and Health
- Published
- 2025-05-09
- DOI
- https://doi.org/10.2166/wh.2025.374
- Citations
- 4
- Primary Topic
- SARS-CoV-2 detection and testing
- Type
- article
- Field-Weighted Citation Impact
- 5.58