Cross-transmission Is Not the Source of New Mycobacterium abscessus Infections in a Multicenter Cohort of Cystic Fibrosis Patients
Por:
Doyle, RM, Rubio, M, Dixon, G, Hartley, J, Klein, N, Coll, P, Harris, KA
Publicada:
1 may 2020
Resumen:
Background: Mycobacterium abscessus is an extensively drug-resistant pathogen that causes pulmonary disease, particularly in cystic fibrosis (CF) patients. Identifying direct patient-to-patient transmission of M. abscessus is critically important in directing an infection control policy for the management of risk in CF patients. A variety of clinical labs have used molecular epidemiology to investigate transmission. However, there is still conflicting evidence as to how M. abscessus is acquired and whether cross-transmission occurs. Recently, labs have applied whole-genome sequencing (WGS) to investigate this further and, in this study, we investigated whether WGS can reliably identify cross-transmission in M. abscessus.
Methods: We retrospectively sequenced the whole genomes of 145 M. abscessus isolates from 62 patients, seen at 4 hospitals in 2 countries over 16 years.
Results: We have shown that a comparison of a fixed number of core single nucleotide variants alone cannot be used to infer cross-transmission in M. abscessus but does provide enough information to replace multiple existing molecular assays. We detected 1 episode of possible direct patient-to-patient transmission in a sibling pair. We found that patients acquired unique M. abscessus strains even after spending considerable time on the same wards with other M. abscessus-positive patients.
Conclusions: This novel analysis has demonstrated that the majority of patients in this study have not acquired M. abscessus through direct patient-to-patient transmission or a common reservoir. Tracking transmission using WGS will only realize its full potential with proper environmental screening, as well as patient sampling.
Filiaciones:
Doyle, RM:
Great Ormond St Hosp Natl Hlth Serv Fdn Trust, Dept Microbiol Virol & Infect Control, London, England
Natl Hlth Serv Fdn Trust, Great Ormond St Hosp Children, Natl Inst Hlth Res, Biomed Res Ctr, London, England
UCL, London, England
Rubio, M:
Univ Autonoma Barcelona, Dept Genet & Microbiol, Bellaterra, Spain
Dixon, G:
Great Ormond St Hosp Natl Hlth Serv Fdn Trust, Dept Microbiol Virol & Infect Control, London, England
Natl Hlth Serv Fdn Trust, Great Ormond St Hosp Children, Natl Inst Hlth Res, Biomed Res Ctr, London, England
UCL, London, England
Hartley, J:
Great Ormond St Hosp Natl Hlth Serv Fdn Trust, Dept Microbiol Virol & Infect Control, London, England
Natl Hlth Serv Fdn Trust, Great Ormond St Hosp Children, Natl Inst Hlth Res, Biomed Res Ctr, London, England
UCL, London, England
Klein, N:
Natl Hlth Serv Fdn Trust, Great Ormond St Hosp Children, Natl Inst Hlth Res, Biomed Res Ctr, London, England
UCL, London, England
UCL, Great Ormond St Inst Child Hlth, London, England
Coll, P:
Univ Autonoma Barcelona, Dept Genet & Microbiol, Bellaterra, Spain
Hosp Santa Creu & Sant Pau, Fundacio Gestio, Serv Microbiol, Barcelona, Spain
Harris, KA:
Great Ormond St Hosp Natl Hlth Serv Fdn Trust, Dept Microbiol Virol & Infect Control, London, England
Natl Hlth Serv Fdn Trust, Great Ormond St Hosp Children, Natl Inst Hlth Res, Biomed Res Ctr, London, England
UCL, London, England
Green Accepted, Green Published, Hybrid Gold
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