Coliphages and Gastrointestinal Illness in Recreational Waters: Pooled Analysis of Six Coastal Beach Cohorts.
Coliphages and Gastrointestinal Illness in Recreational Waters: Pooled Analysis of Six Coastal Beach Cohorts.
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DOI：
10.1097/ede.0000000000000681
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发表时间：
2017-09
期刊：
影响因子：
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通讯作者：
Colford JM Jr
中科院分区：
文献类型：
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作者：
Benjamin-Chung J;Arnold BF;Wade TJ;Schiff K;Griffith JF;Dufour AP;Weisberg SB;Colford JM Jr
文本中提供了补充数字内容。大肠杆菌噬菌体已被提议作为娱乐水域中粪便污染的指示剂，因为它们比粪便指示菌更好地模拟环境和废水处理中病原病毒的持久性。我们估计了大肠杆菌噬菌体与胃肠道疾病之间的关联，并将其与可培养肠球菌的关联进行了比较。我们汇总了六项前瞻性队列研究的数据，这些研究招募了加利福尼亚州、阿拉巴马州和罗德岛州的沿海海滩游客。采集了水样并记录了前往海滩后 10 天内的胃肠道疾病情况。对样品进行了肠球菌、男性特异性和体细胞大肠杆菌噬菌体的检测。我们估计了当人类粪便污染可能存在、不太可能存在以及在所有条件下组合时，在可检测到的大肠杆菌噬菌体的水中游泳与胃肠道疾病之间的关联的累积发生率（CIR）。参考组是未暴露的游泳者。我们定义了连续和基于阈值的暴露（大肠杆菌噬菌体存在/不存在、肠球菌 >35 与 ≤35 CFU/100ml）。在所有条件下，胃肠道疾病与在可检测到大肠杆菌噬菌体或肠球菌的水中游泳之间没有关联。当人类粪便污染可能存在时，大肠杆菌噬菌体和肠球菌与胃肠道疾病增加相关，并且男性特异性大肠杆菌噬菌体水平与疾病之间的关联比肠球菌与疾病之间的关联更强。雄性特异性大肠杆菌噬菌体和体细胞噬菌体之间没有显着差异。体细胞大肠杆菌噬菌体和肠球菌与胃肠道疾病有相似的关联。有一些证据表明，在受人类粪便污染的海水中，与肠球菌相比，男性特异性大肠杆菌噬菌体与疾病的关联性更强。
Supplemental Digital Content is available in the text. Coliphages have been proposed as indicators of fecal contamination in recreational waters because they better mimic the persistence of pathogenic viruses in the environment and wastewater treatment than fecal indicator bacteria. We estimated the association between coliphages and gastrointestinal illness and compared it with the association with culturable enterococci. We pooled data from six prospective cohort studies that enrolled coastal beachgoers in California, Alabama, and Rhode Island. Water samples were collected and gastrointestinal illness within 10 days of the beach visit was recorded. Samples were tested for enterococci and male-specific and somatic coliphages. We estimated cumulative incidence ratios (CIR) for the association between swimming in water with detectable coliphage and gastrointestinal illness when human fecal pollution was likely present, not likely present, and under all conditions combined. The reference group was unexposed swimmers. We defined continuous and threshold-based exposures (coliphage present/absent, enterococci >35 vs. ≤35 CFU/100 ml). Under all conditions combined, there was no association between gastrointestinal illness and swimming in water with detectable coliphage or enterococci. When human fecal pollution was likely present, coliphage and enterococci were associated with increased gastrointestinal illness, and there was an association between male-specific coliphage level and illness that was somewhat stronger than the association between enterococci and illness. There were no substantial differences between male-specific and somatic coliphage. Somatic coliphage and enterococci had similar associations with gastrointestinal illness; there was some evidence that male-specific coliphage had a stronger association with illness than enterococci in marine waters with human fecal contamination.