Whole-genome sequencing and epidemiological analysis do not provide evidence for cross-transmission of mycobacterium abscessus in a cohort of pediatric cystic fibrosis patients

Kathryn A. Harris*, Anthony Underwood, Dervla T.D. Kenna, Anthony Brooks, Ema Kavaliunaite, Georgia Kapatai, Rediat Tewolde, Paul Aurora, Garth Dixon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Citations (Scopus)

Abstract

Background. Mycobacterium 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. Methods. Demographic 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. Results. Whole-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. Conclusions. We 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.

Original languageEnglish
Pages (from-to)1007-1016
Number of pages10
JournalClinical Infectious Diseases
Volume60
Issue number7
DOIs
Publication statusPublished - 1 Apr 2015

Bibliographical note

Funding Information:
Financial support. This study was supported by the National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children National Health Service Foundation Trust and University College London. Potential conflicts of interest. All authors: No reported conflicts.

Publisher Copyright:
© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

Keywords

  • Mycobacterium abscessus
  • VNTR
  • cross-transmission
  • cystic fibrosis
  • whole-genome sequencing

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