Mycobacterium lentiflavumin Drinking Water Supplies, Australia

Henry M Marshall,Matthew J Torbey,Sharri Minion,Flavia Huygens,Carla Tolson,Megan Hargreaves,Rachel M Thomson,Robyn Carter,Hanna E Sidjabat

doi:10.3201/eid1703.090948

Abstract

Mycobacterium lentiflavum, a slow-growing nontuberculous mycobacterium, is a rare cause of human disease. It has been isolated from environmental samples worldwide. To assess the clinical significance of M. lentiflavum isolates reported to the Queensland Tuberculosis Control Centre, Australia, during 2001-2008, we explored the genotypic similarity and geographic relationship between isolates from humans and potable water in the Brisbane metropolitan area. A total of 47 isolates from 36 patients were reported; 4 patients had clinically significant disease. M. lentiflavum was cultured from 13 of 206 drinking water sites. These sites overlapped geographically with home addresses of the patients who had clinically significant disease. Automated repetitive sequence-based PCR genotyping showed a dominant environmental clone closely related to clinical strains. This finding suggests potable water as a possible source of M. lentiflavum infection in humans.

Highlights

Mycobacterium lentiflavum, a slow-growing nontuberculous mycobacterium, is a rare cause of human disease
Repetitive sequence–based PCR has been used to differentiate mycobacterial strains associated with disease outbreaks in mesotherapy clinics (M. abscessus and M. chelonae) [4] and in patients after surgery (M. fortuitum) [5]
Clinical Isolates Forty-seven isolates of M. lentiflavum were reported from 36 patients (Figure 1; Table 2)

Summary

Introduction

Mycobacterium lentiflavum, a slow-growing nontuberculous mycobacterium, is a rare cause of human disease It has been isolated from environmental samples worldwide. Automated repetitive sequence–based PCR genotyping showed a dominant environmental clone closely related to clinical strains. This finding suggests potable water as a possible source of M. lentiflavum infection in humans. M. lentiflavum is slow growing at 22°C–37°C and has yellow pigmentation, negative tests for Tween 80 hydrolysis, nicotinic acid, nitrate reductase and urease, distinct fatty and mycolic acid patterns, and unique 16S rRNA and 65-kDa heat-shock protein gene sequences It shares phenotypic features with M. avium but is more closely related to M. simiae and M. genavense. An automated rep-PCR system (DiversiLab; bioMérieux, Melbourne, Victoria, Australia) showed high concordance with PFGE results [6] in identifying mycobacterial strain clusters and was faster than PFGE

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