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bioRxiv · 10.64898/2025.12.14.694051

Evaluation of Detection Methods for Wastewater Surveillance of Antimicrobial-Resistant Bacteria from Healthcare Facilities

Warren, E.·VanDerslice, J.·Benson, L. S.·Brazelton, W. J.·Tanner, W.·Lyons, A. K.·Whitehill, F.·Coulliette-Salmond, A.·Fusco, S.·Weidhaas, J.
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Abstract

Carbapenem resistance is an urgent public health threat. Wastewater surveillance could support antimicrobial resistance monitoring at long-term care facilities (LTCFs). Feasibility of wastewater sampling (via composite or passive sampler, and sewer biofilm swabs) for carbapenemase genes (blaKPC, blaVIM, blaOXA-48-like, blaNDM, and blaIMP) detected by qPCR or GeneXpert(R) Carba-R from a LTCF was assessed over 16 months and compared to clinical infections. blaKPC, blaOXA-48-like, and blaVIM were routinely detected in composite wastewater samples (6.4{+/-}0.8 log10 gene copy (GC)/ml (100% of 61 samples), 5.5{+/-}0.8 (98%), and 5.9{+/-}1.3 (34%), respectively), passive samples (8.2{+/-}0.5 log10 GC/g (31% of 55), 6.6{+/-}0.5 (96%), and 6.6{+/-}0.7 (31%)) and sewer biofilm (6.0{+/-}0.7 log10 GC/cm2 of pipe (100% of 17), 5.0{+/-}0.7 (100%), and 5.8{+/-}2.7 (24%)). Resistomes of wastewater and sewer biofilms differed, but both contained blaKPC, blaVIM, and blaIMP. Passive sampling may be a suitable alternative to composite sampling. Wastewater surveillance is a promising addition to carbapenemase monitoring.

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Warren, E., VanDerslice, J., Benson, L. S., Brazelton, W. J., Tanner, W., Lyons, A. K., Whitehill, F., Coulliette-Salmond, A., Fusco, S., Weidhaas, J.. 2025-12-15. Evaluation of Detection Methods for Wastewater Surveillance of Antimicrobial-Resistant Bacteria from Healthcare Facilities. https://doi.org/10.64898/2025.12.14.694051

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