首页|Two-step wastewater surveillance reveals co-circulation of respiratory pathogens during the 2023-2024 influenza season in a low-resource setting

Two-step wastewater surveillance reveals co-circulation of respiratory pathogens during the 2023-2024 influenza season in a low-resource setting

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  • NETL
  • NSTL
  • Higher Education Press
Clinical surveillance for respiratory pathogens has traditionally been challenging in low-resource settings, such as Western China. A low-cost wastewater monitoring network offers an alternative solution. To explore this, we first compared the sensitivity of a MeltArray-based qPCR assay, which detects 25 respiratory pathogens, with singleplex qPCR using both mock and real wastewater samples. We then employed this MeltArray assay to detect these respiratory pathogens in wastewater from a low-income region in Xi'an city from September 2023 to January 2024. Following this, qPCR and MLST were employed to quantify the dynamics of positive respiratory pathogens and confirm their genotypes. Results showed unusual surges in sewage influenza A virus (IAV) and adenovirus levels starting in October 2023, persisting until late December. Additionally, influenza B virus (IBV) outbreaks were identified beginning in late December. These findings matched the positivity rates reported by a sentinel hospital. For coronaviruses, HCoV-229E/OC43 were consistently detected in wastewater, while SARS-CoV-2 was occasionally found. The qPCR assays revealed continuous increases in sewage Mycoplasma pneumoniae and Hemophilus influenzae concentrations since September, both peaking in October. Genotyping confirmed the circulation of specific bacterial genotypes in the region. Therefore, to the best of our knowledge, this study is possibly the first to evaluate the efficacy of qPCR assays for wastewater monitoring of respiratory bacterial pathogens. Thus, these findings provide significant insights into the co-circulation of various respiratory pathogens during the autumn and winter of 2023, thereby suggesting that wastewater surveillance could be a powerful tool for the early warning of respiratory diseases.

Respiratory bacterial pathogensWastewater surveillanceMeltArrayMycoplasma pneumoniae

Hui Li、Haifeng Li、Xin Du、Zhenyu Liu、Fenglan He、Xinyan Du、Zengguo Wang、Chunlong Zhu、Songzhe Fu

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The Collaboration Unit for State Key Laboratory of Infectious Disease Prevention and Control, Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China

Key Laboratory of Resource Biology and Biotechnology in Western China (Ministry of Education), School of Medicine, Northwest University, Xi'an 710069, China

Department of Clinical Laboratory, Xi'an Children's Hospital, Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an 710003, China

Clinical Laboratory, The Third Hospital of Nanchang, Nanchang 330009, China

The Collaboration Unit for State Key Laboratory of Infectious Disease Prevention and Control, Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang 330038, China||Key Laboratory of Resource Biology and Biotechnology in Western China (Ministry of Education), School of Medicine, Northwest University, Xi'an 710069, China

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2025

10.1007/s11783-025-1981-z

Frontiers of environmental science & engineering

Frontiers of environmental science & engineering

ISSN：2095-2201
年,卷(期)：2025.19(5)
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