A new UNLV-led study found that testing wastewater from hospital sewer lines can detect drug-resistant strains of C. auris months before patients begin showing symptoms, offering health officials an earlier warning of potentially deadly outbreaks.
The study, published in Nature Communications, was conducted in collaboration with the Southern Nevada Water Authority, Southern Nevada Health District, Nevada State Public Health Laboratory at the University of Nevada, Reno, and other institutions.
Researchers found that sampling raw wastewater directly from hospital sewer lines instead of municipal treatment plants helped scientists more precisely identify drug-resistant C. auris strains as many as five months before patients showed symptoms.
C. auris is a drug-resistant fungus linked to serious blood, heart, and brain infections in hospital patients. Researchers said the fungus has shown resistance to many commonly used surface disinfectants and all three types of antifungal medicines. More than one in three infected patients die.
Scientists involved in the project said the findings could help hospitals intervene earlier with treatment and outbreak prevention efforts.
“These findings open a new frontier for hospitals, which will no longer have to rely solely on clues in clinical records or case-by-case testing on individuals who are already ill,” said study co-author Edwin Oh, a professor and director of the Center for Water Intelligence and Community Health at UNLV. “Wastewater surveillance provides a non-invasive, facility-scale biopsy of a hospital community. And we can get answers on a daily basis, paving the way for health facilities to save lives by figuring out sooner when pathogens resistant to a standard course of antifungal treatment are present."
The research team said the data collected has already been added to one of the world’s largest C. auris research repositories. Researchers also plan to begin developing new antifungal therapeutics at UNLV with a long-term goal of creating a vaccine.
The study comes as Nevada continues to experience the largest recorded C. auris outbreak in U.S. history since 2022. In 2025, Nevada accounted for 22% of the nation’s nearly 7,200 reported C. auris cases, with 1,605 infections reported to the Centers for Disease Control and Prevention.
Researchers said that equates to 20 times more cases per capita than California, the state with the second-highest number of cases.
