Contribution of hospitals to the occurrence of enteric protists in urban wastewater
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PROTOZOOLOGY - ORIGINAL PAPER
Contribution of hospitals to the occurrence of enteric protists in urban wastewater Wen Jiang 1 & Dawn M. Roellig 2 & Na Li 3 & Lin Wang 1 & Yaqiong Guo 3 & Yaoyu Feng 1,3
&
Lihua Xiao 3
Received: 15 June 2020 / Accepted: 27 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract We assessed the potential contribution of hospitals to contaminations of wastewater by enteric protists, including Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi in raw wastewater. Wastewater samples were collected from storage tanks in two hospitals and one associated wastewater treatment plant in Shanghai, China, from March to November 2009. Enteric pathogens were detected and identified using PCR and DNA sequencing techniques. Among a total of 164 samples analyzed, 31 (18.9%), 45 (27.4%), and 122 (74.4%) were positive for Cryptosporidium spp., G. duodenalis, and E. bieneusi, respectively. Altogether, three Cryptosporidium species, four G. duodenalis assemblages, and 12 E. bieneusi genotypes were detected. Cryptosporidium hominis, G. duodenalis sub-assemblage AII, and E. bieneusi genotype D were the dominant ones in wastewater from both hospitals and the wastewater treatment plant. A similar distribution in genotypes of enteric pathogens was seen between samples from hospitals and the wastewater treatment plant, suggesting that humans are one of the major sources for these pathogens and hospitals are important contributors of enteric parasites in urban wastewater. Data from this study might be useful in the formulation of preventive measures against environmental contamination of waterborne pathogens. Keywords Enteric protists . Waterborne transmission . Urban wastewater . Hospital . Environmental contamination
Introduction Enteric protists such as Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are important causes of diarrhea in humans (Xiao and Feng 2017). As they maintain their lifecycle using the fecal-oral route, waterborne transmission is important in disease epidemiology (Thompson and Ash 2016). Existing data suggest that the waterborne outbreaks of cryptosporidiosis affect 3–5% of the world population, while giardiasis Handling Editor: Una Ryan * Yaoyu Feng [email protected] 1
School of Resources and Environmental Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, China
2
Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
3
Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agriculture University, Guangzhou 510642, China
outbreaks affect over 10% (Huang and White 2006; Efstratiou et al. 2017). Therefore, the presence of these pathogens in the environment is a major public health issue (Razzolini et al. 2020). In China, the new drinking water quality standard mandates the monitoring of Cryptosporidium oocysts and Giardia cysts in drinking water (Qu et al. 2012).
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