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）细菌感染是日益增长的威胁，导致大约35,000-48,000美国 每年死亡。 Ar细菌，耐甲氧西林金黄色葡萄球菌（MRSA）和万古霉素 - CDC认为抗性肠球菌（VRE）被认为是严重威胁。黑人和非裔美国人社区 来自AR细菌的感染率较高，包括MRSA（ARR，2.78; 95％CI， 2.30–3.37）与白人相比。传统上与医疗机构有关，最近的一些研究已经 鉴定出AR细菌的环境来源，例如废水。由于下水道基础设施的老化和 气候变化的极端降水频率增加，废水有时会溢出 未经处理的房屋和水体，称为卫生下水道溢流（SSO）。 SSO是一个长期研究的 在许多美国和 国际城市。 AR细菌感染已与废水暴露有关，但没有研究 已经评估了来自SSO的感染的风险或由此产生的家庭地下室备份的风险 （“备份”）。解决这些事件中AR细菌感染的风险将对 预防疾病和促进健康，NIH研究的优先事项以及改善少数族裔健康并减少 健康差异，NIH范围的2021-2025战略计划中的横切主题。我们检测到的试点研究 Baltimore房屋中30％和20％的表面上的MRSA和大肠杆菌受SSO或备份影响， 分别。然而，我们的试点研究的主要限制是，我们的预先计划的抽样日与 最近的SSO或地下室备份。我们建议建立一个社区驱动的水紧急团队 （湿）在出现的MD房屋中对巴尔的摩的SSO和备份做出响应。在巴尔的摩，有63％ 居民是黑人或非裔美国人，贫困生活在18.9％。我们将使用创新的混合方法 方法：1）与社区组织和地方合作开发快速响应湿 领导者从SSO和备份中收集环境样本； 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协议进行比较； 3）行为 调查和对巴尔的摩居民的访谈，以检查备份对他们身心的影响 健康和对地方政府的看法； 4）将研究发现转化为创新的外展材料 授权社区成员并通知地方政府官员。快速响应和减少时间 在样本收集和结果分布之间将使社区成员减轻受污染的 区域和访问应急资源更快。从中实现的关于公共卫生风险的新见解 可以广泛应用研究，因为≥75,000SSO在美国社区驱动的快速响应中每年发生 曝光评估与社会科学数据相结合可以创建一种有效的方法来减少AR 面临不成比例的较高感染率的社区中的细菌暴露。