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BMC Public Health

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Open Access 01-12-2022 | Tuberculosis | Research

The source and fate of Mycobacterium tuberculosis complex in wastewater and possible routes of transmission

Authors: Hlengiwe N. Mtetwa, Isaac D. Amoah, Sheena Kumari, Faizal Bux, Poovendhree Reddy

Published in: BMC Public Health | Issue 1/2022

Abstract

Background

The Mycobacterium tuberculosis complex (MTBC) consists of causative agents of both human and animal tuberculosis and is responsible for over 10 million annual infections globally. Infections occur mainly through airborne transmission, however, there are possible indirect transmissions through a faecal-oral route which is poorly reported. This faecal-oral transmission could be through the occurrence of the microbe in environments such as wastewater. This manuscript, therefore, reviews the source and fate of MTBC in the wastewater environment, including the current methods in use and the possible risks of infections.

Results

The reviewed literature indicates that about 20% of patients with pulmonary TB may have extra-pulmonary manifestations such as GITB, resulting in shedding in feaces and urine. This could potentially be the reason for the detection of MTBC in wastewater. MTBC concentrations of up to 5.5 × 10⁵ (±3.9 × 10⁵) copies/L of untreated wastewater have been reported. Studies have indicated that wastewater may provide these bacteria with the required nutrients for their growth and could potentially result in environmental transmission. However, 98.6 (± 2.7) %, removal during wastewater treatment, through physical-chemical decantation (primary treatment) and biofiltration (secondary treatment) has been reported. Despite these reports, several studies observed the presence of MTBC in treated wastewater via both culture-dependent and molecular techniques.

Conclusion

The detection of viable MTBC cells in either treated or untreated wastewater, highlights the potential risks of infection for wastewater workers and communities close to these wastewater treatment plants. The generation of aerosols during wastewater treatment could be the main route of transmission. Additionally, direct exposure to the wastewater containing MTBC could potentially contribute to indirect transmissions which may lead to pulmonary or extra-pulmonary infections. This calls for the implementation of risk reduction measures aimed at protecting the exposed populations.

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Title: The source and fate of Mycobacterium tuberculosis complex in wastewater and possible routes of transmission
Authors: Hlengiwe N. Mtetwa
Isaac D. Amoah
Sheena Kumari
Faizal Bux
Poovendhree Reddy
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Tuberculosis
Mycobacterium Tuberculosis
Tuberculosis
Published in: BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-022-12527-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The source and fate of Mycobacterium tuberculosis complex in wastewater and possible routes of transmission

Abstract

Background

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Results

Conclusion

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