Rapid Identification of Pathogens from Water and Wastewater

Diarrheal disease is the top infectious threat to U.S. military readiness, ranking first among 57 threats in the 2019 Military Infectious Disease Threat Prioritization Panel. From 2010 to 2019, gastroenteritis and diarrheal illnesses accounted for 98.8% of acute gastrointestinal infections among active-duty personnel, with incidence rates exceeding 4,135 per 100,000 person-years. Over half of these infections are caused by bacterial pathogens, and rising antimicrobial resistance (AMR) complicates treatment, increasing prolonged illness, treatment failure, and operational incapacitation. Contaminated ground, surface, and wastewater are primary transmission vectors, yet deployed forces lack rapid diagnostics for bacterial pathogens and AMR markers. Current DHA-endorsed bio-surveillance remains centralized and slow, leaving warfighters vulnerable to preventable outbreaks. To address this capability gap, GoDx, Inc. developed GAMR, a rapid (~60-minute) point-of-care diagnostic platform validated for stool-based detection of diarrheal pathogens and AMR markers. GAMR’s core innovation leverages proprietary antibody-mediated bacterial isolation to remove environmental contaminants prior to nucleic acid amplification, delivering >95% sensitivity and specificity at clinically relevant loads (4,000–12,000 CFU/mL). The compact, rugged (6×7 in., ~4.5 lbs) system, with battery or wall power, meets DHA requirements for austere deployments. Currently achieving DoD Technology Readiness Level (TRL5) for stool matrices, GoDx proposes adapting GAMR for environmental water surveillance under this Direct-to-Phase II effort. The project encompasses six integrated objectives: (1) develop a portable water-sample concentration module; (2) optimize antibody-mediated pathogen isolation in varied water matrices; (3) integrate and automate nucleic acid amplification/detection; (4) validate pathogen detection performance across surface, ground, and wastewater; (5) demonstrate direct AMR marker detection from environmental isolates; and (6) complete ruggedization and field-validation testing in operationally relevant environments. The resulting sample-to-answer system will weigh less than 25 lbs and deliver actionable results within three hours of collection. This adaptation directly supports DHA’s mission to safeguard force health by enabling real-time environmental bio-surveillance at the tactical edge. By empowering medical and environmental personnel to detect, quantify, and respond to pathogen and resistance threats rapidly, GAMR will reduce infection incidence, optimize antimicrobial stewardship, and preserve operational tempo. The platform’s modular architecture integrates with existing DHA water-quality monitoring frameworks and feeds critical data into DHA’s epidemiological surveillance systems, enhancing situational awareness, decision-making, and strategic response. It is cost-effective to field and delivers measurable ROI reducing medevacs preserving readiness.