Water Emergency Team (WET): Community-Driven Rapid Response Team to Evaluate Antibiotic-Resistant Bacteria Exposures and Household Environmental Health Risks from Sewer Overflows and Basement Flooding

水应急小组 (WET)：社区驱动的快速响应小组，评估下水道溢出和地下室洪水导致的抗生素耐药细菌暴露和家庭环境健康风险

• 批准号: 10686675
• 负责人: Rachel E Goldstein
• 金额: $ 134.53万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10686675
• 关键词: Address; African American; Aging; Area; Bacterial Antibiotic Resistance; Bacterial Infections; Baltimore; Black American; Cessation of life; Chronic; Cities; Collaborations; Communities; Data; Disease; Emergency Situation; Environmental Health; Escherichia coli; Event; Floods; Frequencies; Government Officials; Health; Health Promotion; Home; Household; Infrastructure; International; Interview; Link; Local Government; Low income; Mental Health; Methods; Minority Groups; Perception; Pilot Projects; Poverty; Precipitation; Protocols documentation; Public Health; Reduce health disparities; Research; Research Priority; Resources; Risk; Sampling; Social Sciences; Source; Strategic Planning; Surface; Surveys; Swab; Techniques; Time; Translating; United States National Institutes of Health; Vancomycin resistant enterococcus; Vancomycin-resistant S. aureus; Water; climate change; community organizations; empowerment; experience; health care settings; improve minority health; infection rate; infection risk; innovation; insight; member; methicillin resistant Staphylococcus aureus; outreach; physical conditioning; prevent; response; sample collection; underserved community

Antibiotic-resistant (AR) bacterial infections are a growing threat causing approximately 35,000-48,000 U.S. deaths per year. The AR bacteria, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin- resistant Enterococci (VRE) are considered serious threats by CDC. Black and African American communities experience disproportionately higher infection rates from AR bacteria, including MRSA (aRR, 2.78; 95% CI, 2.30–3.37) compared to whites. Traditionally associated with healthcare settings, several recent studies have identified environmental sources of AR bacteria, such as wastewater. Due to aging sewer infrastructure and increasing frequency of extreme precipitation from climate change, wastewater sometimes overflows into homes and waterbodies untreated, called sanitary sewer overflow (SSOs). SSOs are a chronic, under-studied public health threat that disproportionately impact low-income and minority populations in many U.S. and international cities. AR bacterial infections have been linked to wastewater exposures, yet no studies have evaluated the risk of these infections from SSOs nor the resultant household basement backups (“backups”). Addressing the risk of AR bacterial infections from these events will have a major impact on preventing disease and promoting health, an NIH research priority, and improving minority health and reducing health disparities, a crosscutting theme in the NIH-wide 2021-2025 Strategic Plan. Our pilot study detected MRSA and E. coli on 30% and 20% of surfaces in Baltimore homes impacted by SSOs or backups, respectively. Yet, a major limitation to our pilot study was that our pre-planned sampling days did not align with recent SSOs or basement backups. We propose to create a community-driven Water Emergency Team (WET) to respond to SSOs and backups in Baltimore, MD homes as they occur. In Baltimore, 63% of residents are Black or African American and 18.9% live in poverty. We will use innovative mixed method approaches to: 1) Develop a rapid-response WET in collaboration with community organizations and local leaders to collect environmental samples from SSOs and backups; 2) Analyze water and surface swab samples for MRSA and VRE, comparing previous traditional techniques with new protocols; 3) Conduct surveys and interviews with Baltimore residents to examine the impact of backups on their physical and mental health, and perceptions of local government; 4) Translate research findings into innovative outreach materials to empower community members and inform local government officials. Rapid responses and reduced time between sample collection and results distribution will enable community members to mitigate contaminated areas and access emergency resources more quickly. New insights on public health risks achieved from this study can be applied widely, as ≥75,000 SSOs occur yearly across the U.S. Community-driven rapid-response exposure assessments combined with social science data can create an effective approach to reducing AR bacteria exposure in underserved communities facing disproportionately higher infection rates.

抗生素耐药（AR）细菌感染是一个日益增长的威胁，造成约35，000 - 48，000美国人死亡。 每年死亡人数。AR细菌，耐甲氧西林金黄色葡萄球菌（MRSA）和万古霉素- 耐药肠球菌（VRE）被CDC认为是严重的威胁。黑人和非裔美国人社区 AR细菌的感染率不成比例地更高，包括MRSA（aRR，2.78; 95% CI， 2.30-3.37）与白人相比。传统上与医疗机构相关，最近的几项研究表明， 确定了AR细菌的环境来源，如废水。由于下水道基础设施老化， 由于气候变化导致极端降水频率增加，废水有时会溢出， 家庭和水体未经处理，称为卫生下水道溢流（SSO）。SSO是一种慢性的、研究不足的 公共卫生威胁，不成比例地影响低收入和少数民族人口在许多美国和 国际城市。AR细菌感染与废水暴露有关，但没有研究 我已经评估了从SSO或由此产生的家庭地下室备份中感染这些病毒的风险 （“备份”）。解决这些事件引起的AR细菌感染风险将对以下方面产生重大影响： 预防疾病和促进健康，NIH的研究重点，改善少数民族的健康和减少 健康差距是NIH范围内2021-2025年战略计划中的一个交叉主题。我们的初步研究发现 MRSA和E.在受到SSO或备份影响的巴尔的摩家庭中， 分别然而，我们的试点研究的一个主要限制是，我们预先计划的采样日与 最近的战略行动或地下室备份我们建议建立一个社区驱动的水应急小组 (WET)响应巴尔的摩（MD）家庭发生的SSO和备份。在巴尔的摩， 居民是黑人或非裔美国人，18.9%的人生活在贫困中。我们将采用创新的混合方法 方法：1）与社区组织和当地组织合作， 领导从SSO和备份收集环境样本; 2）分析水和表面拭子 MRSA和VRE的样本，将以前的传统技术与新方案进行比较; 3）进行 对巴尔的摩居民进行调查和访谈，以检查备份对他们的身体和精神的影响 4）将研究结果转化为创新的宣传材料 赋予社区成员权力，并向当地政府官员通报情况。快速响应，缩短时间 将使社区成员能够减轻受污染的 更快地获取紧急资源。由此获得的关于公共卫生风险的新见解 这项研究可以广泛应用，因为美国每年发生≥ 75，000起SSO。 暴露评估与社会科学数据相结合，可以创造一种有效的方法来减少AR 在服务不足的社区，细菌暴露面临不成比例的高感染率。