Abstract

Three recently sequenced strains isolated from patients during an outbreak of Mycobacterium abscessus subsp. massiliense infections at a cystic fibrosis center in the United States were compared with 6 strains from an outbreak at a cystic fibrosis center in the United Kingdom and worldwide strains. Strains from the 2 cystic fibrosis outbreaks showed high-level relatedness with each other and major-level relatedness with strains that caused soft tissue infections during an epidemic in Brazil. We identified unique single-nucleotide polymorphisms in cystic fibrosis and soft tissue outbreak strains, separate single-nucleotide polymorphisms only in cystic fibrosis outbreak strains, and unique genomic traits for each subset of isolates. Our findings highlight the necessity of identifying M. abscessus to the subspecies level and screening all cystic fibrosis isolates for relatedness to these outbreak strains. We propose 2 diagnostic strategies that use partial sequencing of rpoB and secA1 genes and a multilocus sequence typing protocol.

Highlights

  • Three recently sequenced strains isolated from patients during an outbreak of Mycobacterium abscessus subsp. massiliense infections at a cystic fibrosis center in the United States were compared with 6 strains from an outbreak at a cystic fibrosis center in the United Kingdom and worldwide strains

  • Reports from the United States, France, and Israel have shown that the M. abscessus group accounts for a major proportion of Nontuberculous mycobacteria (NTM) infections in patients with cystic fibrosis; prevalence rates range from 16% to 48% [1,2,3]

  • The Seattle and Papworth cystic fibrosis outbreak strains showed some relatedness to strains CRM-0020 and GO-06 derived strains isolated during an epidemic of soft tissue infections in Brazil [32] and the M. abscessus subsp. massiliense M18 strain from Malaysia [10]

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Summary

Introduction

Three recently sequenced strains isolated from patients during an outbreak of Mycobacterium abscessus subsp. massiliense infections at a cystic fibrosis center in the United States were compared with 6 strains from an outbreak at a cystic fibrosis center in the United Kingdom and worldwide strains. Three recently sequenced strains isolated from patients during an outbreak of Mycobacterium abscessus subsp. Recent study, whole-genome sequencing and epidemiologic analysis provided strong support for patient-to-patient transmission in 2 clustered outbreaks of M. abscessus subsp. Massiliense Strains fibrosis outbreak, including the index strain, and compared them with representative strains from the Papworth cystic fibrosis outbreak, as well as with available strains from the United Kingdom, the United States, Brazil, South Korea, France, and Malaysia (Table 1).

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