Global, Environmental, and Occupational Health

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Prior to May 2024, previously known as the Maryland Institute for Applied Environmental Health.

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    Occupational Exposure to Staphylococcus aureus and Enterococcus spp. among Spray Irrigation Workers Using Reclaimed Water
    (MDPI, 2014-04-17) Rosenberg Goldstein, Rachel E.; Micallef, Shirley A.; Gibbs, Shawn G.; He, Xin; George, Ashish; Sapkota, Amir; Joseph, Sam W.; Sapkota, Amy R.
    As reclaimed water use expands, it is important to evaluate potential occupational health risks from exposure to this alternative water source. We compared odds of colonization with methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible S. aureus (MSSA), vancomycin-resistant enterococci (VRE), and vancomycin-susceptible enterococci (VSE) between spray irrigation workers using reclaimed water and office worker controls. Nasal and dermal swabs from 19 spray irrigation workers and 24 office worker controls were collected and analyzed for MRSA, MSSA, VRE, and VSE. Isolates were confirmed using standard biochemical tests and polymerase chain reaction assays. Antimicrobial susceptibility testing was performed by Sensititre® microbroth dilution. Data were analyzed by two-sample proportion, chi-square, Fisher’s exact tests, and logistic regression. No MRSA or VRE were detected in any samples. MSSA was detected in 26% and 29% of spray irrigators and controls, respectively. VSE was detected in 11% and 0% of spray irrigation workers and controls, respectively. The adjusted odds of MSSA, multidrug-resistant MSSA, and either MSSA or VSE colonization were greater among spray irrigation workers, however results were not statistically significant. Future studies with larger sample sizes are needed to further evaluate this relationship.
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    Assessing the Presence of Antibiotic-Resistant Enterococcus in Reclaimed Water Used for Spray Irrigation
    (2013) Carey, Stephanie Ann; Sapkota, Amy R; Turner, Paul; Maryland Institute for Applied Environmental Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Reclaiming wastewater is increasing in the US to combat dwindling freshwater supplies. This water potentially contains pathogenic bacteria; therefore, we evaluated the occurrence, concentration, and antimicrobial susceptibilities of Enterococcus spp.--an important opportunistic pathogen that remains a leading cause of nosocomial infections--in reclaimed water used for spray irrigation (SI). A total of 48 wastewater effluent and SI samples were collected in 2009 and 2010 from the Mid-Atlantic and Midwest regions of the US. Enterococci were isolated using membrane filtration, confirmed using biochemical tests and PCR, and tested for antimicrobial susceptibility using the Sensititre® dilution system. We detected total enterococci and vancomycin-resistant enterococci (VRE) in 68% (27/40) and 8% (3/40), respectively, of all SI samples. VRE and vancomycin-intermediate enterococci (VIE) represented 2% (1/41) and 10% (4/41), respectively, of the total enterococci recovered from all SI sites. Our findings show that SI workers may be exposed to enterococci during spray irrigation activities.
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    EVALUATION OF ANTIBIOTIC-RESISTANT BACTERIA IN TERTIARY TREATED WASTEWATER, RECLAIMED WASTEWATER USED FOR SPRAY IRRIGATION, AND RESULTING OCCUPATIONAL EXPOSURES
    (2010) Goldstein, Rachel Elizabeth Rosenberg; Sapkota, Amy R; Maryland Institute for Applied Environmental Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Occupational exposures to vancomycin-resistant Enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) in reclaimed wastewater used for spray irrigation were evaluated. In 2009, wastewater was collected from a tertiary-treatment facility, and reclaimed wastewater, nasal and dermal swab samples from an irrigation site. Samples were evaluated for MRSA and VRE using standard methods, PCR, and susceptibility testing. MRSA and VRE were isolated from all wastewater samples except effluent. While wastewater MRSA isolates were multidrug resistant (98%), no MRSA was isolated in irrigation water or swabs. VRE was isolated in one irrigation water sample. Fewer irrigation workers were colonized with S. aureus (31%) compared to controls (46%), but they harbored more multidrug resistant S. aureus. This is the first study to 1) evaluate antibiotic-resistant bacteria (ARB) in U.S. reclaimed wastewater and resulting occupational exposures, and 2) detect MRSA in U.S. wastewater. The findings suggested that tertiary wastewater treatment effectively reduced MRSA and VRE.