• Kathryn A Harris, Anthony Underwood, Dervla T D Kenna, Anthony Brooks, Ema Kavaliunaite, Georgia Kapatai, Rediat Tewolde, Paul Aurora, and Garth Dixon.
• Department of Microbiology, Virology and Infection Control, Great Ormond Street Hospital NHS Foundation Trust National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London.
• Clin. Infect. Dis. 2015 Apr 1; 60 (7): 1007-16.

BackgroundMycobacterium abscessus has emerged as a major pathogen in cystic fibrosis (CF) patients and has been associated with poor clinical outcomes, particularly following lung transplant. We investigated the acquisition of this bacterium in a cohort of pediatric CF patients.MethodsDemographic and patient location data were used to uncover epidemiological links between patients with genetically related strains of M. abscessus that had been previously typed by variable-number tandem repeat profiling. Whole-genome sequencing was applied to 27 M. abscessus isolates from the 20 patients in this cohort to provide definitive data on the genetic relatedness of strains.ResultsWhole-genome sequencing data demonstrated that M. abscessus isolates from 16 patients were unrelated, differing by at least 34 single-nucleotide polymorphisms (SNPs) from any other isolate, suggesting that independent acquisition events have occurred. Only 2 clusters of very closely related (<25 SNPs) isolates from different patients were seen. The first cluster contained 8 isolates, differing by a maximum of 17 SNPs, from a sibling pair who had intense exposure to each other both inside and outside the hospital. The second cluster contained 3 isolates, differing by a maximum of 24 SNPs, from 2 individuals with no apparent epidemiological links.ConclusionsWe have not demonstrated cross-transmission of M. abscessus within our hospital, except between 1 sibling pair. Alternative routes of acquisition of M. abscessus infection, in particular the environment, require further investigation.© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

32 keywords...

hide…