Mycobacterium avium complex (MAC) genomics and transmission in a London hospital

Non-tuberculous mycobacteria (NTM) are ubiquitous environmental microorganisms and opportunistic pathogens in individuals with pre-existing lung conditions such as cystic fibrosis (CF) and non-CF bronchiectasis (BX). Whilst recent studies of Mycobacterium abscessus have identified transmission within single CF centres as well as nationally and globally, transmission of other NTM species is less well studied. We sequenced 1000 Mycobacterium avium complex (MAC) isolates from CF and non-CF patients at the Royal Brompton Hospital (RBH), London. Epidemiological links were identified from patient records. Previously published genomes were used to characterise global population structures. Analysis of the three most predominant MAC species identified putative transmission clusters that contained patients with CF, BX and other lung conditions, although few epidemiological links could be identified. For M. avium, lineages were largely limited to single countries, whilst for M. chimaera, global transmission clusters previously associated with heater cooler units (HCUs) were found. However, the origin of the major HCU-associated outbreak was a lineage already circulating in patients with pre-existing lung conditions. CF and non-CF patients share transmission chains even in the presence of CF patient-focussed hospital control measures, although the lack of epidemiological links suggests that most transmission is indirect and may be due to environmental foci or else asymptomatic carriage in the wider population. The major HCU-associated M. chimaera lineage being derived from an already circulating lineage, suggests that HCUs are not the sole vector nor the ultimate source of this lineage. Future studies should include sampling of environmental reservoirs and potential asymptomatic carriers.

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FULMINANT RESPIRATORY FAILURE IN MULTI-DRUG RESISTANT MYCOBACTERIUM ABSCESSUS COMPLEX WITH MYCOBACTERIUM AVIUM COMPLEX CO-INFECTION

CHEST Journal ◽

10.1016/j.chest.2020.08.442 ◽

2020 ◽

Vol 158 (4) ◽

pp. A459-A460

Author(s):

Divya Mounisha Thimmareddygari ◽

Susanne Ajao ◽

Rutwik Patel ◽

Richard Miller ◽

Jihad Slim

Keyword(s):

Respiratory Failure ◽

Mycobacterium Avium ◽

Mycobacterium Avium Complex ◽

Mycobacterium Abscessus ◽

Drug Resistant ◽

Mycobacterium Abscessus Complex

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Comparison of the Surgical Lung Histopathologic Features of Patients with Pulmonary Disease Due to Mycobacterium Avium Complex Versus Mycobacterium Abscessus Complex

10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a2532 ◽

2019 ◽

Author(s):

E.D. Chan ◽

K.J. Potts ◽

C. Cool ◽

M. Althoff ◽

S.D. Groshong ◽

...

Keyword(s):

Pulmonary Disease ◽

Mycobacterium Avium ◽

Mycobacterium Avium Complex ◽

Mycobacterium Abscessus ◽

Complex Versus ◽

Mycobacterium Abscessus Complex ◽

Histopathologic Features

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The presence of opportunistic pathogens, Legionella spp., L. pneumophila and Mycobacterium avium complex, in South Australian reuse water distribution pipelines

Journal of Water and Health ◽

10.2166/wh.2014.317 ◽

2014 ◽

Vol 13 (2) ◽

pp. 553-561 ◽

Cited By ~ 7

Author(s):

H. Whiley ◽

A. Keegan ◽

H. Fallowfield ◽

R. Bentham

Keyword(s):

Mycobacterium Avium ◽

Water Reuse ◽

Water Distribution ◽

Mycobacterium Avium Complex ◽

Human Pathogens ◽

Opportunistic Pathogens ◽

Potential Health ◽

Reuse Water ◽

Chlorine Residual ◽

Polymerase Chain

Water reuse has become increasingly important for sustainable water management. Currently, its application is primarily constrained by the potential health risks. Presently there is limited knowledge regarding the presence and fate of opportunistic pathogens along reuse water distribution pipelines. In this study opportunistic human pathogens Legionella spp., L. pneumophila and Mycobacterium avium complex were detected using real-time polymerase chain reaction along two South Australian reuse water distribution pipelines at maximum concentrations of 105, 103 and 105 copies/mL, respectively. During the summer period of sampling the concentration of all three organisms significantly increased (P < 0.05) along the pipeline, suggesting multiplication and hence viability. No seasonality in the decrease in chlorine residual along the pipelines was observed. This suggests that the combination of reduced chlorine residual and increased water temperature promoted the presence of these opportunistic pathogens.

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Nontuberculous Mycobacteria

Seminars in Respiratory and Critical Care Medicine ◽

10.1055/s-0041-1730997 ◽

2021 ◽

Vol 42 (04) ◽

pp. 567-586

Author(s):

Shera Tan ◽

Shannon Kasperbauer

Keyword(s):

Risk Factor ◽

Pulmonary Disease ◽

Mycobacterium Avium ◽

Mycobacterium Avium Complex ◽

Nontuberculous Mycobacteria ◽

Mycobacterium Abscessus ◽

Pulmonary Infections ◽

Human Pathogens ◽

Common Manifestation

AbstractNontuberculous mycobacteria (NTM) are ubiquitous in the environment and 193 species of NTM have been discovered thus far. NTM species vary in virulence from benign environmental organisms to difficult-to-treat human pathogens. Pulmonary infections remain the most common manifestation of NTM disease in humans and bronchiectasis continues to be a major risk factor for NTM pulmonary disease (NTM PD). This article will provide a useful introduction and framework for clinicians involved in the management of bronchiectasis and NTM. It includes an overview of the epidemiology, pathogenesis, diagnosis, and management of NTM PD. We will address the challenges faced in the diagnosis of NTM PD and the importance of subspeciation in guiding treatment and follow-up, especially in Mycobacterium abscessus infections. The treatment of both Mycobacterium avium complex and M. abscessus, the two most common NTM species known to cause disease, will be discussed in detail. Elements of the recent ATS/ERS/ESCMID/IDSA NTM guidelines published in 2020 will also be reviewed.

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