A multicenter study investigating SARS-CoV-2 in tertiary-care hospital wastewater. viral burden correlates with increasing hospitalized cases as well as hospital-associated transmissions and outbreaks

被引：67

作者：

Acosta, Nicole ^{[1
]}

Bautista, Maria A. ^{[2
]}

Hollman, Jordan ^{[3
,4
]}

McCalder, Janine ^{[1
,2
]}

Beaudet, Alexander Buchner ^{[2
]}

Man, Lawrence ^{[2
]}

Waddell, Barbara J. ^{[1
]}

Chen, Jianwei ^{[2
]}

Li, Carmen ^{[2
]}

Kuzma, Darina ^{[5
]}

Bhatnagar, Srijak ^{[2
]}

Leal, Jenine ^{[1
,6
,7
,10
]}

Meddings, Jon ^{[8
]}

Hu, Jia ^{[7
,9
,10
]}

Cabaj, Jason L. ^{[7
,10
]}

Ruecker, Norma J. ^{[11
]}

Naugler, Christopher ^{[7
,12
]}

Pillai, Dylan R. ^{[1
,12
,14
]}

Achari, Gopal ^{[4
]}

Ryan, M. Cathryn ^{[3
]}

Conly, John M. ^{[1
,6
,8
,10
,12
,13
]}

Frankowski, Kevin ^{[5
]}

Hubert, Casey R. J. ^{[2
]}

Parkins, Michael D. ^{[1
,8
,13
]}

机构：

[1] Univ Calgary, Dept Microbiol Immunol & Infect Dis, 3330 Hosp Dr NW, Calgary, AB, Canada

[2] Univ Calgary, Dept Biol Sci, 3330 Hosp Dr NW, Calgary, AB, Canada

[3] Univ Calgary, Dept Geosci, 2500 Univ Dr NW, Calgary, AB, Canada

[4] Univ Calgary, Dept Civil Engn, 2500 Univ Dr NW, Calgary, AB, Canada

[5] Univ Calgary, Adv Canadian Wastewater Assets, 3131 210 Ave SE, Calgary, AB, Canada

[6] Alberta Hlth Serv, Infect Prevent & Control, 1403 29th St NW, Calgary, AB, Canada

[7] Univ Calgary, Dept Community Hlth Sci, 3280 Hosp Dr NW, Calgary, AB, Canada

[8] Univ Calgary, Cumming Sch Med, Dept Med, 3330 Hosp Dr NW, Calgary, AB, Canada

[9] Alberta Hlth Serv, Prov Populat & Publ Hlth, 3030 Hosp Dr NW, Calgary, AB, Canada

[10] Univ Calgary, OBrien Inst Publ Hlth, 3280 Hosp Dr NW, Calgary, AB, Canada

[11] Water Qual Serv, City Calgary, 625 25 Ave SE, Calgary, AB, Canada

[12] Univ Calgary, Dept Pathol & Lab Med, 3330 Hosp Dr NW, Calgary, AB, Canada

[13] Univ Calgary, Snyder Inst Chron Dis, 3330 Hosp Dr NW, Calgary, AB, Canada

[14] Alberta Hlth Serv, Alberta Precis Labs, 3535 Res Rd NW, Calgary, AB, Canada

来源：

WATER RESEARCH | 2021年 / 201卷

关键词：

COVID-19; Sewage; Wastewater; Wastewater-based epidemiology; Hospital-acquired; UNITED-STATES;

D O I：

10.1016/j.watres.2021.117369

中图分类号：

X [环境科学、安全科学];

学科分类号：

08 ; 0830 ;

摘要：

SARS-CoV-2 has been detected in wastewater and its abundance correlated with community COVID-19 cases, hospitalizations and deaths. We sought to use wastewater-based detection of SARS-CoV-2 to assess the epidemiology of SARS-CoV-2 in hospitals. Between August and December 2020, twice-weekly wastewater samples from three tertiary-care hospitals (totaling > 2100 dedicated inpatient beds) were collected. Hospital-1 and Hospital-2 could be captured with a single sampling point whereas Hospital-3 required three separate monitoring sites. Wastewater samples were concentrated and cleaned using the 4S-silica column method and assessed for SARS-CoV-2 gene-targets (N1, N2 and E) and controls using RT-qPCR. Wastewater SARS-CoV-2 as measured by quantification cycle (Cq), genome copies and genomes normalized to the fecal biomarker PMMoV were compared to the total daily number of patients hospitalized with active COVID-19, confirmed cases of hospitalacquired infection, and the occurrence of unit-specific outbreaks. Of 165 wastewater samples collected, 159 (96%) were assayable. The N1-gene from SARS-CoV-2 was detected in 64.1% of samples, N2 in 49.7% and E in 10%. N1 and N2 in wastewater increased over time both in terms of the amount of detectable virus and the proportion of samples that were positive, consistent with increasing hospitalizations at those sites with single monitoring points (Pearson's r = 0.679, P < 0.0001, Pearson's r = 0.799, P < 0.0001, respectively). Despite increasing hospitalizations through the study period, nosocomial-acquired cases of COVID-19 (Pearson's r = 0.389, P < 0.001) and unit-specific outbreaks were discernable with significant increases in detectable SARSCoV-2 N1-RNA (median 112 copies/ml) versus outbreak-free periods (0 copies/ml; P < 0.0001). Wastewater based monitoring of SARS-CoV-2 represents a promising tool for SARS-CoV-2 passive surveillance and case identification, containment, and mitigation in acute-care medical facilities.

引用

页数：10

共 49 条

[1] Detection of SARS-CoV-2 RNA in commercial passenger aircraft and cruise ship wastewater: a surveillance tool for assessing the presence of COVID-19 infected travellers [J].

Ahmed, Warish ;

Bertsch, Paul M. ;

Angel, Nicola ;

Bibby, Kyle ;

Bivins, Aaron ;

Dierens, Leanne ;

Edson, Janette ;

Ehret, John ;

Gyawali, Pradip ;

Hamilton, Kerry A. ;

Hosegood, Ian ;

Hugenholtz, Philip ;

Jiang, Guangming ;

Kitajima, Masaaki ;

Sichani, Homa T. ;

Shi, Jiahua ;

Shimko, Katja M. ;

Simpson, Stuart L. ;

Smith, Wendy J. M. ;

Symonds, Erin M. ;

Thomas, Kevin, V ;

Verhagen, Rory ;

Zaugg, Julian ;

Mueller, Jochen F. .

JOURNAL OF TRAVEL MEDICINE, 2020, 27 (05)

[2] First con firmed detection of SARS-CoV-2 in untreated wastewater in Australia: A proof of concept for the wastewater surveillance of COVID-19 in the community [J].

Ahmed, Warish ;

Angel, Nicola ;

Edson, Janette ;

Bibby, Kyle ;

Bivins, Aaron ;

O'Brien, Jake W. ;

Choi, Phil M. ;

Kitajima, Masaaki ;

Simpson, Stuart L. ;

Li, Jiaying ;

Tscharke, Ben ;

Verhagen, Rory ;

Smith, Wendy J. M. ;

Zaugg, Julian ;

Dierens, Leanne ;

Hugenholtz, Philip ;

Thomas, Kevin, V ;

Mueller, Jochen F. .

SCIENCE OF THE TOTAL ENVIRONMENT, 2020, 728

[3]

Alberta-Health-Services, 2020, CONT DROPL PREC

[4] Analytical methodologies for the detection of SARS-CoV-2 in wastewater: Protocols and future perspectives [J].

Alygizakis, Nikiforos ;

Markou, Athina N. ;

Rousis, Nikolaos, I ;

Galani, Aikaterini ;

Avgeris, Margaritis ;

Adamopoulos, Panagiotis G. ;

Scorilas, Andreas ;

Lianidou, Evi S. ;

Paraskevis, Dimitrios ;

Tsiodras, Sotirios ;

Tsakris, Athanassios ;

Dimopoulos, Meletios-Athanasios ;

Thomaidis, Nikolaos S. .

TRAC-TRENDS IN ANALYTICAL CHEMISTRY, 2021, 134 (134)

[5] Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility [J].

Arons, M. M. ;

Hatfield, K. M. ;

Reddy, S. C. ;

Kimball, A. ;

James, A. ;

Jacobs, J. R. ;

Taylor, J. ;

Spicer, K. ;

Bardossy, A. C. ;

Oakley, L. P. ;

Tanwar, S. ;

Dyal, J. W. ;

Harney, J. ;

Chisty, Z. ;

Bell, J. M. ;

Methner, M. ;

Paul, P. ;

Carlson, C. M. ;

McLaughlin, H. P. ;

Thornburg, N. ;

Tong, S. ;

Tamin, A. ;

Tao, Y. ;

Uehara, A. ;

Harcourt, J. ;

Clark, S. ;

Brostrom-Smith, C. ;

Page, L. C. ;

Kay, M. ;

Lewis, J. ;

Montgomery, P. ;

Stone, N. D. ;

Clark, T. A. ;

Honein, M. A. ;

Duchin, J. S. ;

Jernigan, J. A. .

NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (22) :2081-2090

[6] Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020 [J].

Backer, Jantien A. ;

Klinkenberg, Don ;

Wallinga, Jacco .

EUROSURVEILLANCE, 2020, 25 (05) :10-15

[7]

Bennet J.a.A.M, 2019, WOMEN POOP SOMETIME

[8] Nosocomial COVID-19 infection: examining the risk of mortality. The COPE-Nosocomial Study (COVID in Older PEople) [J].

Carter, B. ;

Collins, J. T. ;

Barlow-Pay, F. ;

Rickard, F. ;

Bruce, E. ;

Verduri, A. ;

Quinn, T. J. ;

Mitchell, E. ;

Price, A. ;

Vilches-Moraga, A. ;

Stechman, M. J. ;

Short, R. ;

Einarsson, A. ;

Braude, P. ;

Moug, S. ;

Myint, P. K. ;

Hewitt, J. ;

Pearce, L. ;

McCarthy, K. .

JOURNAL OF HOSPITAL INFECTION, 2020, 106 (02) :376-384

[9] SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis [J].

Cevik, Muge ;

Tate, Matthew ;

Lloyd, Ollie ;

Maraolo, Alberto Enrico ;

Schafers, Jenna ;

Ho, Antonia .

LANCET MICROBE, 2021, 2 (01) :E13-E22

[10] Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis [J].

Cheung, Ka Shing ;

Hung, Ivan F. N. ;

Chan, Pierre P. Y. ;

Lung, K. C. ;

Tso, Eugene ;

Liu, Raymond ;

Ng, Y. Y. ;

Chu, Man Y. ;

Chung, Tom W. H. ;

Tam, Anthony Raymond ;

Yip, Cyril C. Y. ;

Leung, Kit-Hang ;

Fung, Agnes Yim-Fong ;

Zhang, Ricky R. ;

Lin, Yansheng ;

Cheng, Ho Ming ;

Zhang, Anna J. X. ;

To, Kelvin K. W. ;

Chan, Kwok-H ;

Yuen, Kwok-Y ;

Leung, Wai K. .

GASTROENTEROLOGY, 2020, 159 (01) :81-95

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