Evidence map›Paper›PMID 41864437›Full record

ArticleThe Journal of hospital infection2026

Implementation of wastewater-based epidemiology in a Northern California acute care hospital: a pilot study, June-July 2024.

G Rodriguez-Nava, A Zulli, M P Grieshop, E P Viana-Cardenas, S Jong, E Miranti, M Jiang, A Ayala, M Sampson, A S Bhatt and 2 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of hospital infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

12 authors.

G Rodriguez-NavaDivision of Infectious Diseases & Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: Guillermo.RodriguezNava@dhha.org.
A ZulliDepartment of Civil and Environmental Engineering, Stanford University, Stanford, CA, USA.
M P GrieshopStanford University School of Medicine, Stanford, CA, USA; Stanford Medical Scientist Training Program, Stanford, CA, USA.
E P Viana-CardenasDivision of Infectious Diseases & Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
S JongDepartment of Civil and Environmental Engineering, Stanford University, Stanford, CA, USA.
E MirantiDivision of Infectious Diseases & Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
M JiangDepartment of Civil and Environmental Engineering, Stanford University, Stanford, CA, USA.
A AyalaDivision of Infectious Diseases & Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
M SampsonDivision of Infectious Diseases & Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
A S BhattDepartment of Medicine (Division of Haematology) and Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA.
A B BoehmDepartment of Civil and Environmental Engineering, Stanford University, Stanford, CA, USA.
J L SalinasDivision of Infectious Diseases & Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.

Funding

Stanford Center for Clinical and Translational Research and EducationUM1TR004921 · NCATS · STANFORD UNIVERSITY · PI MANISHA DESAI, DEAN W FELSHER · 2024 to 2026
$30.1M
NCATS NIH HHS UM1 TR004921
6 · The paper itself

Abstract

aimThe aim of this study was to evaluate the feasibility and performance of wastewater-based healthcare epidemiology for monitoring respiratory viruses and antimicrobial resistance genes.

methodsWe conducted a pilot study at an 800-bed academic quaternary care hospital in Northern California. Composite wastewater samples were collected weekly over three timepoints (June-July 2024) from the main hospital outflow. Droplet digital polymerase chain reaction was performed to quantify nucleic acids from respiratory viruses (SARS-CoV-2, influenza A, and respiratory syncytial virus) and antimicrobial resistant genes (ARGs; mecA, vanA, KPC, NDM, OXA-48, and VIM). Viral levels were compared with hospital testing data and community wastewater trends. Antimicrobial resistance genes were compared with contemporaneous clinical cultures.

findingsSampling was logistically feasible but constrained by equipment size and placement limitations. Viral nucleic acid levels in hospital wastewater broadly reflected hospital testing results and community wastewater trends. By contrast, ARG levels showed limited alignment with clinical culture data. mecA levels were low despite an elevated number of methicillin-resistant Staphylococcus aureus cultures, while vanA and carbapenemase genes were abundant, including during weeks with no corresponding clinical cases.

conclusionsWastewater-based healthcare epidemiology captured trends in hospital respiratory virus testing but showed limited concordance with culture-based detection of resistant bacteria. While not suited for case detection of resistant pathogens, it may serve as a system-level tool to assess the hospital resistome, antimicrobial pressures, and potential environmental transmission risks.

Indexed as

WastewaterWastewater-Based Epidemiological MonitoringCaliforniaHospitalsHumansInfluenza A virusPilot ProjectsRespiratory Syncytial VirusesSARS-CoV-2WastewaterAntimicrobial resistanceWastewater

Identifiers

PMID41864437
PMCPMC13091305

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.