A new UNLV-led wastewater surveillance study brings scientists one step closer to a global race to detect and stop the proliferation of potentially deadly drug-resistant bacteria that puts hospitalized patients at risk of serious blood, heart and brain infections.
candida auris It poses an ongoing challenge to Nevada’s health care facilities. By 2025, the Silver States alone will account for 22% of the approximately 7,200 states in the United States. C.ear Number of cases – 1,605 cases reported to the Centers for Disease Control and Prevention, higher than California’s approximately 1,550 cases and Texas’ 830 cases. Adjusted for population, Nevada has 20 times more cases per capita than its coastal neighbors.
A UNLV-led study published in 2023 was the first to prove the effectiveness of using sewer monitoring to detect. C.ear Found in untreated wastewater drawn from sewage treatment plants. Now, the university is building on that basic research with online-first research in collaboration with the Southern Nevada Water District, the Southern Nevada Health District, Auburn University, the Nevada Public Health Institute at the University of Nevada, Reno, and several local wastewater agencies. nature communications.
A new paper reveals sampling untreated wastewater in locations close to the water source, such as sewer pipes that feed directly to hospitals, nursing homes, and long-term care facilities. C.ear Scientists can detect drug-resistant pathogen strains five months before patients start showing symptoms, as cases tend to be the epicenter and pose the greatest public health risk.
These discoveries break new ground for hospitals, which no longer need to rely solely on clues in clinical records or case-by-case testing of individuals who are already sick. ”
Edwin Oh, study co-author, professor, and director of the UNLV Center for Water Intelligence and Community Health
“Wastewater surveillance provides a non-invasive, facility-wide biopsy of the hospital community, giving us answers every day and paving the way for healthcare facilities to save lives by understanding earlier when pathogens are present that are resistant to standard antifungal treatment courses,” Oh continued. “Complementing surveillance with laboratory tests can detect drug-resistant pathogens months in advance, giving clinicians time to change course before a full-blown outbreak occurs.”
C.earalso known as Candida aurisa fungus that can cause serious wound, bloodstream, and organ infections, especially in immunocompromised patients, patients with pre-existing health conditions, patients in long-term care settings, or patients receiving treatment with invasive medical devices such as catheters. C.ear Although not a risk to drinking water systems, infection prevention and control in healthcare facilities is difficult because the fungus can grow on both dry and moist surfaces, such as furniture, door handles, clothing, and medical equipment. It has also shown resistance to many commonly used surface disinfectants and all three types of antifungal drugs. More than 1 in 3 patients have invasive disease C.ear Death from infection.
Nevada holds record for largest scale ever C.ear This outbreak has been occurring for the first time in U.S. history since 2022, and scientists say efforts to eradicate the fungus are critical.
their nature communications The study compared untreated wastewater drawn from a downtown municipal wastewater treatment plant with higher-resolution samples from sewer lines serving three major hospitals in Southern Nevada from 2021 to 2024. And they called the results “remarkable.” From wastewater sampled directly from hospital sewage, C.ear Concentrations are nearly 100 times higher than at community-scale wastewater treatment plants, with a detection rate of 95% versus 18%.
The study also revealed unexpected biological insights into how fungi adapt to drug pressure. Resistant strains showed signs of metabolic rewiring and new stress response mechanisms that may point to new therapeutic targets.
“Since 2020, wastewater monitoring has proven invaluable in understanding community transmission of diseases such as COVID-19 and influenza,” said study co-author Daniel Gerrity, principal investigator at the Southern Nevada Water Authority. “These new results highlight the benefits of bringing this new public health tool closer to health care facilities, which could lead health professionals to more effective treatment options for patients.”
The research team has used data to build one of the world’s largest research facilities. C.ear Repository. And the next step is to combine genomic and molecular tools to begin developing new antifungal treatments and perhaps vaccines to fight off these drug-resistant pathogens.
“In many cases, a patient’s own illness is the first signal that drug-resistant bacteria has entered the facility, and by then it may already be widespread,” said study co-lead author Ching Lan (Rainey) Zhang, a neuroscience doctoral student at UNLV. “Wastewater surveillance changes that timeline and gives healthcare workers, patients, and their families a head start that didn’t exist before. New antifungal treatments and vaccines remain long-term goals, but the genomic repository built from this research lays the foundation. Meanwhile, wastewater intelligence gives us the ability to act now.”
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University of Nevada Las Vegas
Reference magazines:
Chan, C.-L. Others. (2026). Wastewater intelligence predicts the emergence of clinically relevant and drug-resistant C. auris in healthcare facilities. nature communications. DOI: 10.1038/s41467-026-71960-5. https://www.nature.com/articles/s41467-026-71960-5
