{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:52:50Z","timestamp":1791568370139,"version":"4.3.4"},"reference-count":44,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Sergey Brin Family Foundation"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["mBio"],"published-print":{"date-parts":[[2024,8,14]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Candida auris<\/jats:italic>\n                      is an emerging, multidrug-resistant fungal pathogen that poses a significant public health threat in healthcare settings. Despite yearly clinical cases rapidly increasing from 77 to 8,131 in the last decade, surveillance data on its distribution and prevalence remain limited. We implemented a novel assay for\n                      <jats:italic toggle=\"yes\">C. auris<\/jats:italic>\n                      detection on a nationwide scale prospectively from September 2023 to March 2024, analyzing a total of 13,842 samples from 190 wastewater treatment plants across 41 U.S. states. Assays were extensively validated through comparison to other known assays and internal controls. Of these 190 wastewater treatment plants,\n                      <jats:italic toggle=\"yes\">C. auris<\/jats:italic>\n                      was detected in the wastewater solids of 65 of them (34.2%) with 1.45% of all samples having detectable levels of\n                      <jats:italic toggle=\"yes\">C. auris<\/jats:italic>\n                      nucleic-acids. Detections varied seasonally, with 2.00% of samples positive in autumn vs 1.01% in winter (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). The frequency of detection in wastewater was significantly associated with states having older populations (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), sewersheds containing more hospitals (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001), and sewersheds containing more nursing homes (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). These associations are in agreement with known\n                      <jats:italic toggle=\"yes\">C. auris<\/jats:italic>\n                      epidemiology. This nationwide study demonstrates the viability of wastewater surveillance for\n                      <jats:italic toggle=\"yes\">C. auris<\/jats:italic>\n                      surveillance and further highlights the value of wastewater surveillance when clinical testing is constrained.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      This study highlights the viability of wastewater surveillance when dealing with emerging pathogens. By leveraging an existing framework of wastewater surveillance, we reveal the widespread presence of\n                      <jats:italic toggle=\"yes\">C. auris<\/jats:italic>\n                      in the United States. We further demonstrate that these wastewater detections are consistent with demographic factors relevant to\n                      <jats:italic toggle=\"yes\">C. auris<\/jats:italic>\n                      epidemiology like age and number of hospitals or nursing homes. As\n                      <jats:italic toggle=\"yes\">C. auris<\/jats:italic>\n                      and other pathogens continue to emerge, the low-cost and rapid nature of wastewater surveillance will provide public health officials with the information necessary to enact targeted prevention and control strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/mbio.00908-24","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T09:11:32Z","timestamp":1721725892000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":26,"title":["Prospective study of\n                    <i>Candida auris<\/i>\n                    nucleic acids in wastewater solids in 190 wastewater treatment plants in the United States suggests widespread occurrence"],"prefix":"10.1128","volume":"15","author":[{"given":"Alessandro","family":"Zulli","sequence":"first","affiliation":[{"name":"Department of Civil and Environmental Engineering, Stanford University","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elana M. G.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, Stanford University","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridgette","family":"Shelden","sequence":"additional","affiliation":[{"name":"Verily Life Sciences LLC","place":["South San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothea","family":"Duong","sequence":"additional","affiliation":[{"name":"Verily Life Sciences LLC","place":["South San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Ru S.","family":"Xu","sequence":"additional","affiliation":[{"name":"Verily Life Sciences LLC","place":["South San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley J.","family":"White","sequence":"additional","affiliation":[{"name":"Verily Life Sciences LLC","place":["South San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene K.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8162-5090","authenticated-orcid":true,"given":"Alexandria B.","family":"Boehm","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, Stanford University","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","unstructured":"Ageing and health. 2022. 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