Paper Title
COMMUNITY-SCALE MONITORING OF INFECTIOUS PATHOGENS AND ANTIBIOTIC RESISTANCE GENES IN WASTEWATER

Abstract
Monitoring infectious pathogens and antibiotic resistance genes in the environment can help us to understand their prevalence and movement in different habitats. Furthermore, environmental surveillance of pathogens can provide early warnings of outbreaks. The current investigation presents findings from an extensive longitudinal initiative aimed at monitoring the presence of SARS-CoV-2, norovirus, hepatitis A virus, and beta-lactam resistance (bla) genes in wastewater samples collected from a wastewater treatment facility duringthe COVID-19 surge in Gyeonggi province, South Korea. Real-time digital PCR analyses demonstrated the presence of all butblaNDM gene and hepatitis A virus in the influent wastewater samples. SARS-CoV-2 N1 gene was detected in all influent specimens with an average log-transformed concentration of >5. A high relative prevalence of norovirus in influent and presence in effluent only during the colder winter season exhibited seasonal variability of the pathogen in wastewater.Beta-lactamases with extended-spectrum (blaTEM, blaCTX), extremely extended-spectrum carbapenemase (blaKPC), and plasmid-mediated AmpC (blaDHA, blaACC, blaFOX) were detected in wastewater.The bla genes exhibited significant correlations (r), with the most pronounced correlation for the blaKPC - blaFOX pair, followed by blaTEM - blaCTX, and blaTEM - blaDHA. Their strong positive associations can be attributed to the simultaneous expression of carbapenemase and increased expression levels of ESBL and AmpC β-lactamases.A strong positive association (r=0.80) of the SARS-CoV-2 RNA with the prevalence of COVID-19 cases showed a promising role of community-scale monitoring of pathogens to provide considerable early signals of infection dynamics.