Wastewater-Based Epidemiology (WBE): An Emerging Nexus Between Environment and Human Health

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Biotechnological Innovations for Environmental Bioremediation

Abstract

Water, an integral component of life on earth, is being hampered or exploited to a great extent owing to both natural and anthropogenic activities. The overexploitation of water resulting in the rise in the generation of wastewater not only results in water scarcity but also results in water pollution across. This creates an avenue to focus on technologies to deal with wastewater. Numerous wastewater treatment technologies exist, having the potential to treat wastewater and convert into useful resource. These wastewater treatment plants (WWTPs) serve as reservoirs of providing information on water and environmental health, as well as treat contaminants, especially numerous disease-causing pathogens. The applicability of wastewater as a diagnostic tool referred to as wastewater-based epidemiology (WBE), began in late 1990s when the presence of illicit drugs was detected and correlated with the drug consumption in the associated community. Since then, the technology has been exploited for various purposes such as poliovirus in 2003 and SARS-CoV-2 detection as the recent one. Meanwhile, antimicrobial resistance has been on the rise owing to uncontrolled and unregulated use of antibiotics, especially from environmental sources such as soil, water, and WWTPs. In this line, a pool of 6 Gram-positive and Gram-negative microorganisms referred to as “ESKAPE” have been identified as global priority pathogens by WHO and special emphasis has been given to understanding and control of emerging drug resistance toward them. This chapter therefore focuses on the applicability of WBE in the detection and diagnosis of these pathogens in wastewater. Also, the chapter briefly describes the molecular methods and tools employed for the detection of these resistant microorganisms in the wastewater samples, along with current national and international status of ESKAPE pathogens.

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Bibliography

  • Aarestrup FM, Woolhouse ME (2020) Using sewage for surveillance of antimicrobial resistance. Science 367:630e632. https://doi.org/10.1126/science.aba3432

    Article  CAS  Google Scholar 

  • Achak M, Bakri SA, Chhiti Y, Alaoui FEM, Barka N, Boumya W (2021) SARS-CoV-2 in hospital wastewater during outbreak of COVID-19: a review on detection, survival and disinfection technologies. Sci Total Environ 761:143192. https://doi.org/10.1016/j.scitotenv.2020.143192

    Article  CAS  PubMed  Google Scholar 

  • Ahmed W, Angel N, Edson J, Bibby K, Bivins A, O’Brien JW, Choi PM, Kitajima M, Simpson SL, Li J, Tscharke B, Verhagen R, Smith WJM, Zaugg J, Dierens L, Hugenholtz P, Thomas KV, Mueller JF (2020) First confirmed detection of SARS-CoV-2 in untreated wastewater in Australia: a proof of concept for the wastewater surveillance of COVID-19 in the community. Sci Total Environ 728:138764

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • An XL, Wang JY, Pu Q, Li H, Su JQ (2020) High-throughput diagnosis of human pathogens and fecal contamination in marine recreational water. Environ Res 190:109982. https://doi.org/10.1016/j.envres.2020.109982

    Article  CAS  PubMed  Google Scholar 

  • Arora NK (2019) Earth: 50 years challenge. Environ Sustain 2:1

    Article  Google Scholar 

  • Arora S, Nag A, Sethi J, Rajvanshi J, Saxena S, Shrivastava SK, Gupta AB (2020) Sewage surveillance for the presence of SARS-CoV-2 genome as a useful wastewater based epidemiology (WBE) tracking tool in India. Water Sci Technol 82(12):2823–2836

    Article  CAS  PubMed  Google Scholar 

  • Arora S, Nag A, Kalra A, Sinha V, Meena E, Saxena S et al (2021a) Successful application of wastewater-based epidemiology in prediction and monitoring of the second wave of COVID-19 in India with fragmented sewerage systems-a case study of Jaipur (India). MedRxiv

    Google Scholar 

  • Arora S, Nag A, Rajpal A, Tyagi VK, Tiwari SB, Sethi J et al (2021b) Imprints of lockdown and treatment processes on the wastewater surveillance of SARS-CoV-2: a curious case of fourteen plants in northern India. Water 13(16):2265

    Article  CAS  Google Scholar 

  • Benkő R, Gajdács M, Matuz M, Bodó G, Lázár A, Hajdú E, Pető Z (2020) Prevalence and antibiotic resistance of ESKAPE pathogens isolated in the emergency department of a tertiary care teaching hospital in Hungary: a 5-year retrospective survey. Antibiotics 9(9):624

    Article  PubMed Central  CAS  Google Scholar 

  • Bivins A, North D, Ahmad A, Ahmed W, Alm E, Been F et al (2020) Wastewater-based epidemiology: global collaborative to maximize contributions in the fight against COVID-19. Environ Sci Technol 54:7754

    Article  CAS  PubMed  Google Scholar 

  • Blashki G, McMichael T, Karoly DJ (2007) Climate change and primary health care. Aust J Gen Pract 36(12):986

    Google Scholar 

  • Buelow E, Rico A, Gaschet M, Lourenço J, Kennedy SP, Wiest L, Dagot C (2020) Hospital discharges in urban sanitation systems: long-term monitoring of wastewater resistome and microbiota in relationship to their eco-exposome. Water Res X 7:100045

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bustin SA (2009) Why the need for qPCR publication guidelines?-The case for MIQE. Methods 50:217e226. https://doi.org/10.1016/j.ymeth.2009.12.006

    Article  CAS  Google Scholar 

  • Calderón-Franco D, van Loosdrecht MCM, Abeel T, Weissbrodt DG (2021) Freefloating extracellular DNA: systematic profiling of mobile genetic elements and antibiotic resistance from wastewater. Water Res 189:116592. https://doi.org/10.1016/j.watres.2020.116592

    Article  CAS  PubMed  Google Scholar 

  • Cenciarini-Borde C, Courtois S, La Scola B (2009) Nucleic acids as viability markers for bacteria detection using molecular tools. Future Microbiol 4:45e64. https://doi.org/10.2217/17460913.4.1.45

    Article  Google Scholar 

  • Chakraborty P, Pasupuleti M, Shankar MJ, Bharat GK, Krishnasamy S, Dasgupta SC et al (2021) First surveillance of SARS-CoV-2 and organic tracers in community wastewater during post lockdown in Chennai, South India: methods, occurrence and concurrence. Sci Total Environ 778:146252

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Divyashree M, Mani MK, Shama Prakash K, Vijaya Kumar D, Veena Shetty A, Shetty AK, Karunasagar I (2020) Hospital wastewater treatment reduces NDM‐positive bacteria being discharged into water bodies. Water Environ Res 92(4):562–568

    Article  CAS  PubMed  Google Scholar 

  • Du P, Zhang L, Ma Y, Li X, Wang Z, Mao K, Wang X (2020) Occurrence and fate of heavy metals in municipal wastewater in Heilongjiang Province, China: a monthly reconnaissance from 2015 to 2017. Water 12(3):728

    Article  CAS  Google Scholar 

  • Ebomah KE, Okoh AI (2020) An African perspective on the prevalence, fate and effects of carbapenem resistance genes in hospital effluents and wastewater treatment plant (WWTP) final effluents: a critical review. Heliyon 6(5):e03899

    Article  PubMed  PubMed Central  Google Scholar 

  • Flannery J, Keaveney S, Rajko-Nenow P, O’Flaherty V, Doré W (2013) Norovirus and FRNA bacteriophage determined by RT-qPCR and infectious FRNA bacteriophage in wastewater and oysters. Water Res 47:5222e5231. https://doi.org/10.1016/j.watres.2013.06.008

    Article  CAS  Google Scholar 

  • Gandra S, Tseng KK, Arora A, Bhowmik B, Robinson ML, Panigrahi B, Klein EY (2019) The mortality burden of multidrug-resistant pathogens in India: a retrospective, observational study. Clin Infect Dis 69(4):563–570. https://doi.org/10.3389/Fpubh.2019.00172

    Article  PubMed  Google Scholar 

  • Gerner-Smidt P, Besser J, Concepcion-Acevedo J, Folster JP, Huffman J, Joseph LA, Kucerova Z, Nichols MC, Schwensohn CA, Tolar B (2019) Whole genome sequencing: bridging one-health surveillance of foodborne diseases. Front Public Health 7:172

    Article  PubMed  PubMed Central  Google Scholar 

  • González-Marino I, Rodil R, Barrio I, Cela R, Quintana JB (2017) Wastewater-based ~ epidemiology as a new tool for estimating population exposure to phthalate plasticizers. Environ Sci Technol 51:3902e3910. https://doi.org/10.1021/acs.est.6b05612

    Article  CAS  Google Scholar 

  • Guajardo-Leiva S, Chnaiderman J, Gaggero A, Díez B (2020) Metagenomic insights into the sewage RNA virosphere of a large city. Viruses 12:1050. https://doi.org/10.3390/v12091050

    Article  CAS  PubMed Central  Google Scholar 

  • Hayden RT, Gu Z, Ingersoll J, Abdul-Ali D, Shi L, Pounds S, Caliendo AM (2013) Comparison of droplet digital PCR to real-time PCR for quantitative detection of cytomegalovirus. J Clin Microbiol 51:540e546. https://doi.org/10.1128/JCM.02620-12

    Article  CAS  Google Scholar 

  • Heintz-Buschart A, Wilmes P (2018) Human gut microbiome: function matters. Trends Microbiol 26:563e574. https://doi.org/10.1016/j.tim.2017.11.002

    Article  CAS  Google Scholar 

  • Hiller CX, Hübner U, Fajnorova S, Schwartz T, Drewes JE (2019) Antibiotic microbial resistance (AMR) removal efficiencies by conventional and advanced wastewater treatment processes: a review. Sci Total Environ 685:596–608

    Article  CAS  PubMed  Google Scholar 

  • Houang ET, Chu YW, Leung CM, Chu KY, Berlau J, Ng KC, Cheng AFB (2001) Epidemiology and infection control implications of Acinetobacter spp. in Hong Kong. J Clin Microbiol 39(1):228–234

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hugenholtz P, Tyson GW (2008) Metagenomics. Nature 455:481–483. https://doi.org/10.1038/455481a

    Article  CAS  PubMed  Google Scholar 

  • Jahne MA, Brinkman NE, Keely SP, Zimmerman BD, Wheaton EA, Garland JL (2020) Droplet digital PCR quantification of norovirus and adenovirus in decentralized wastewater and graywater collections: implications for onsite reuse. Water Res 169:115213. https://doi.org/10.1016/j.watres.2019.115213

    Article  CAS  PubMed  Google Scholar 

  • Kang L, Ma S, Chen M, Yang J, Wang Y, Li R, Liu Z (2020) Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: a cross-sectional study. Brain Behav Immun 87:11–17

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lamba M, Graham DW, Ahammad SZ (2017) Hospital wastewater releases of carbapenem-resistance pathogens and genes in urban India. Environ Sci Technol 51(23):13906–13912

    Article  CAS  PubMed  Google Scholar 

  • Lamba M, Gupta S, Shukla R, Graham DW, Sreekrishnan TR, Ahammad SZ (2018) Carbapenem resistance exposures via wastewaters across New Delhi. Environ Int 119:302–308

    Article  CAS  PubMed  Google Scholar 

  • Larsson DJ (2014) Antibiotics in the environment. Ups J Med Sci 119(2):108–112

    Article  PubMed  PubMed Central  Google Scholar 

  • Li B, Webster TJ (2018) Bacteria antibiotic resistance: new challenges and opportunities for implant‐associated orthopedic infections. J Orthop Res 36(1):22–32

    PubMed  Google Scholar 

  • Lira F, Vaz-Moreira I, Tamames J, Manaia CM, Martínez JL (2020) Metagenomic analysis of an urban resistome before and after wastewater treatment. Sci Rep 10(1):1–9

    Article  CAS  Google Scholar 

  • Liu Q, Zhang Y, **g W, Liu S, Zhang D, Sui G (2016) First airborne pathogen direct analysis system. Analyst 141:1637–1640. https://doi.org/10.1039/c5an02367j

    Article  CAS  PubMed  Google Scholar 

  • Ma YX, Wang CY, Li YY, Li J, Wan QQ, Chen JH, Niu LN (2020) Considerations and caveats in combating ESKAPE pathogens against nosocomial infections. Adv Sci 7(1):1901872

    Article  CAS  Google Scholar 

  • Manaia CM, Macedo G, Fatta-Kassinos D, Nunes OC (2016) Antibiotic resistance in urban aquatic environments: can it be controlled? Appl Microbiol Biotechnol 100(4):1543–1557

    Article  CAS  PubMed  Google Scholar 

  • Medema G, Heijnen L, Elsinga G, Italiaander R, Brouwer A (2020) Presence of SARS-Coronavirus-2 RNA in sewage and correlation with reported COVID-19 prevalence in the early stage of the epidemic in the Netherlands. Environ Sci Technol Lett 7(7):511–516

    Article  CAS  Google Scholar 

  • Navidinia M (2016) The clinical importance of emerging ESKAPE pathogens in nosocomial infections. Arch Adv Biosci 7:43

    Google Scholar 

  • Or Z (2000) Determinants of health outcomes in industrialised countries: a pooled, cross-country, time-series analysis. OECD Econ Stud 30:53–78

    Google Scholar 

  • Podein RJ, Hernke MT (2010) Integrating sustainability and health care. Prim Care: Clin Off Pract 37(1):137–147

    Article  Google Scholar 

  • Popa A, Genger JW, Nicholson MD, Penz T, Schmid D, Aberle SW, Bergthaler A (2020) Genomic epidemiology of superspreading events in Austria reveals mutational dynamics and transmission properties of SARS-CoV-2. Sci Transl Med 12(573):eabe2555

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ragupathi NKD, Bakthavatchalam YD, Mathur P, Pragasam AK, Walia K, Ohri VC, Veeraraghavan B (2019) Plasmid profiles among some ESKAPE pathogens in a tertiary care centre in south India. Indian J Med Res 149(2):222

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ramírez-Castillo FY, Loera-Muro A, Jacques M, Garneau P, Avelar-González FJ, Harel J, Guerrero-Barrera AL (2015) Waterborne pathogens: detection methods and challenges. Pathogens 4:307–334. https://doi.org/10.3390/pathogens4020307

    Article  PubMed  PubMed Central  Google Scholar 

  • Ramsamy Y, Essack SY, Sartorius B, Patel M, Mlisana KP (2018) Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: a five-year retrospective analysis. Afr J Lab Med 7(2):1–8

    Article  CAS  Google Scholar 

  • Raza SA, Qazi W, Khan KA, Salam J (2021) Social isolation and acceptance of the learning management system (LMS) in the time of COVID-19 pandemic: an expansion of the UTAUT model. J Educ Comput Res 59(2):183–208

    Article  Google Scholar 

  • Richardson K, Steffen W, Schellnhuber HJ, Alcamo J, Barker T, Kammen DM et al (2009) Synthesis report. Climate change: global risks, challenges and decisions, Copenhagen, Denmark, 10–12 March, 2009. University of Copenhagen

    Google Scholar 

  • Rousis NI, Gracia-Lor E, Zuccato E, Bade R, Baz-Lomba JA, Castrignanò E, Castiglioni S (2017) Wastewater-based epidemiology to assess pan-European pesticide exposure. Water Res 121:270–279

    Article  CAS  PubMed  Google Scholar 

  • Rudko SP, Ruecker NJ, Ashbolt NJ, Neumann NF, Hanington PC (2017) Enterobius vermicularis as a novel surrogate for the presence of helminth ova in tertiary wastewater treatment plants. Appl Environ Microbiol 83:e00547-00517. https://doi.org/10.1128/AEM.00547-17

    Article  Google Scholar 

  • Santajit S, Indrawattana N (2016) Mechanisms of antimicrobial resistance in ESKAPE pathogens. BioMed Res Int 2016:2475067

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Savin M, Bierbaum G, Hammerl JA, Heinemann C, Parcina M, Sib E, Kreyenschmidt J (2020) Antibiotic-resistant bacteria and antimicrobial residues in wastewater and process water from German pig slaughterhouses and their receiving municipal wastewater treatment plants. Sci Total Environ 727:138788

    Article  CAS  PubMed  Google Scholar 

  • Shekhawat SS, Kulshreshtha NM, Gupta AB (2020) Investigation of chlorine tolerance profile of dominant gram negative bacteria recovered from secondary treated wastewater in Jaipur, India. J Environ Manag 255:109827

    Article  CAS  Google Scholar 

  • Shekhawat SS, Gupta AB, Kulshreshtha NM, Prakash R (2021) UV disinfection studies on chlorine tolerant bacteria recovered from treated sewage. J Environ Chem Eng 9(3):105253

    Article  CAS  Google Scholar 

  • Sulej-Suchomska AM, Klupczynska A, Dereziński P, Matysiak J, Przybyłowski P, Kokot ZJ (2020) Urban wastewater analysis as an effective tool for monitoring illegal drugs, including new psychoactive substances, in the Eastern European region. Sci Rep 10(1):1–12

    Article  CAS  Google Scholar 

  • Tacconelli E, Carrara E, Savoldi A, Harbarth S, Mendelson M, Monnet DL, Zorzet A (2018) Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. Lancet Infect Dis 18(3):318–327

    Article  PubMed  Google Scholar 

  • Tomita N, Mori Y, Kanda H, Notomi T (2008) Loop-mediated isothermal amplification (LAMP) of gene sequences and simple visual detection of products. Nat Protoc 3:877e882. https://doi.org/10.1038/nprot.2008.57

    Article  CAS  Google Scholar 

  • Tringe SG, Rubin EM (2005) Metagenomics: DNA sequencing of environmental samples. Nat Rev Genet 6:805e814. https://doi.org/10.1038/nrg1709

    Article  CAS  Google Scholar 

  • Vaz-Moreira I, Nunes OC, Manaia CM (2014) Bacterial diversity and antibiotic resistance in water habitats: searching the links with the human microbiome. FEMS Microbiol Rev 38(4):761–778

    Article  CAS  PubMed  Google Scholar 

  • World Health Organization (2015) Global antimicrobial resistance surveillance system (GLASS). WHO, Geneva. https://www.who.int/glass/en/

    Google Scholar 

  • World Health Organization (2020) GLASS whole-genome sequencing for surveillance of antimicrobial resistance. WHO, Geneva. https://apps.who.int/iris/handle/10665/334354

    Google Scholar 

  • Xagoraraki I, O’Brien E (2020) Wastewater-based epidemiology for early detection of viral outbreaks. In: Women in water quality. Springer, Cham, pp 75–97

    Chapter  Google Scholar 

  • Xu M, Fu H, Chen D, Shao Z, Zhu J, Alali WQ, Chen L (2019) Simple visualized detection method of virulence-associated genes of Vibrio cholerae by loop mediated isothermal amplification. Front Microbiol 10:2899

    Article  PubMed  PubMed Central  Google Scholar 

  • Yadav S, Kapley A (2021) Antibiotic resistance: global health crisis and metagenomics. Biotechnol Rep 29:e00604

    Article  CAS  Google Scholar 

  • Yang S, Carlson K (2004) Routine monitoring of antibiotics in water and wastewater with a radioimmunoassay technique. Water Res 38(14–15):3155–3166

    Article  CAS  PubMed  Google Scholar 

  • Yuan H, Chao Y, Li S, Tang MYH, Huang Y, Che Y, Wong AST, Zhang T, Shum HC (2018) Picoinjection-enabled multitarget loop-mediated isothermal amplification for detection of foodborne pathogens. Anal Chem 90:13173–13177. https://doi.org/10.1021/acs.analchem.8b03673

    Article  CAS  PubMed  Google Scholar 

  • Zuccato E, Chiabrando C, Castiglioni S, Calamari D, Bagnati R, Schiarea S, Fanelli R (2005) Cocaine in surface waters: a new evidence-based tool to monitor community drug abuse. Environ Health 4(1):1–7

    Article  Google Scholar 

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Kalra, A., Mathur, A., Pamnani, T., Arora, S. (2022). Wastewater-Based Epidemiology (WBE): An Emerging Nexus Between Environment and Human Health. In: Arora, S., Kumar, A., Ogita, S., Yau, Y.Y. (eds) Biotechnological Innovations for Environmental Bioremediation. Springer, Singapore. https://doi.org/10.1007/978-981-16-9001-3_29

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