Abstract
BackgroundNontuberculous mycobacterium (NTM) species are ubiquitous microorganisms. NTM pulmonary disease (NTM-PD) is thought to be caused not by human-to-human transmission but by independent environmental acquisition. However, recent studies using next-generation sequencing (NGS) have reported trans-continental spread of Mycobacterium abscessus among patients with cystic fibrosis.ResultsWe investigated NTM genomes through NGS to examine transmission patterns in three pairs of co-habiting patients with NTM-PD who were suspected of patient-to-patient transmission. Three pairs of patients with NTM-PD co-habiting for at least 15 years were enrolled: a mother and a daughter with M. avium-PD, a couple with M. intracellulare-PD, and a second couple, one of whom was infected with M. intracellulare and the other of whom was infected with M. abscessus. Whole genome sequencing was performed using patients’ NTM isolates as well as environmental specimens. Genetic distances were estimated based on single nucleotide polymorphisms (SNPs). By comparison with the genetic distances among 78 publicly available NTM genomes, NTM isolates derived from the two pairs of patients infected with the same NTM species were not closely related to each other. In phylogenetic analysis, the NTM isolates from patients with M. avium-PD clustered with isolates from different environmental sources.ConclusionsIn conclusion, considering the genetic distances between NTM strains, the likelihood of patient-to-patient transmission in pairs of co-habiting NTM-PD patients without overt immune deficiency is minimal.
Highlights
Nontuberculous mycobacterium (NTM) species are ubiquitous microorganisms
Harris and colleagues reported no evidence of patient-to-patient transmission in their cohort of pediatric cystic fibrosis patients [10], next-generation sequencing (NGS) studies of NTM transmission have raised concerns that NTM might be transmitted among immunosuppressed individuals and among immunocompetent ones
We investigated the genomes of NTM isolates derived from the patients and environmental samples in their houses to understand the source of infection using whole genome sequencing (WGS)
Summary
Nontuberculous mycobacterium (NTM) species are ubiquitous microorganisms. NTM pulmonary disease (NTM-PD) is thought to be caused not by human-to-human transmission but by independent environmental acquisition. Bryant and colleagues collected Mycobacterium abscessus isolates from patients with cystic fibrosis, performed WGS, and analysed phylogenetic relationships among these isolates. Harris and colleagues reported no evidence of patient-to-patient transmission in their cohort of pediatric cystic fibrosis patients [10], NGS studies of NTM transmission have raised concerns that NTM might be transmitted among immunosuppressed individuals and among immunocompetent ones. This would be especially important for hospital infection control, since isolation practices for NTM-PD patients without cystic fibrosis are not as strict as those for pulmonary tuberculosis patients generally
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