Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan.
Microbiol Spectr. 2022 Jun 29;10(3):e0009722. doi: 10.1128/spectrum.00097-22. Epub 2022 May 10.
(M. abscessus) is a highly antimicrobial-resistant pathogen that causes refractory pulmonary disease. Recently, the possibility of M. abscessus cross-transmission among cystic fibrosis (CF) patients has been reported. CF is rare in Asia, but M. abscessus pulmonary disease is common. Therefore, we investigated the possibility of M. abscessus cross-transmission in a Japanese hospital setting. Of 104 M. abscessus isolates, 25 isolates from 24 patients were classified into four clusters based on their variable number of tandem repeat profiles and were subjected to whole-genome sequencing (WGS). The epidemiological linkages among our patients were investigated by integrating the WGS data of previously reported nosocomial outbreak-related M. abscessus clinical isolates in the United Kingdom and the United States. Eight transmissible clusters (TCs) were identified. The United Kingdom and United States isolates were assigned to four clusters (TC1, TC2, TC5, and TC8) and one cluster (TC3), respectively. A total of 12 isolates from our hospital belonged to 4 clusters (TC4, TC5, TC6, and TC7). Epidemiological linkage analysis inferred direct or indirect transmission between patients in our hospital in TC4 and TC5 but not in TC6 and TC7. In TC5, the single nucleotide polymorphism distance between isolates from Japanese and United Kingdom patients was less than 21; however, there was no contact. This study revealed that genetically closely related isolates exist, even in non-CF patients. However, the transmission route remains unclear, and further research is warranted to clarify whether cross-transmission is involved. Although the possibility of (M. abscessus) cross-transmission in cystic fibrosis (CF) patients has often been reported, it is not clear whether similar events have occurred in Asian non-CF patients. Whole-genome sequencing analysis of M. abscessus isolates from Fukujuji Hospital in Japan indicated that genetically closely related M. abscessus isolates exist. In addition, according to epidemiological linkage analysis, some clusters were suspected of direct or indirect transmission between patients within our hospital. However, the transmission route of M. abscessus remains unclear, because interestingly, one cluster showed a single nucleotide polymorphism distance of less than 21 from the United Kingdom isolates, but no epidemiological linkage was identified.
（M. abscessus）是一种高度抗微生物的病原体，可引起难治性肺病。最近，有报道称囊性纤维化（CF）患者之间存在 M. abscessus 交叉传播的可能性。CF 在亚洲很少见，但 M. abscessus 肺病很常见。因此，我们在日本的一家医院调查了 M. abscessus 交叉传播的可能性。在 104 株 M. abscessus 分离株中，根据可变数串联重复序列图谱将 24 名患者的 25 株分离株分为 4 个群集，并进行了全基因组测序（WGS）。通过整合英国和美国先前报道的医院感染暴发相关 M. abscessus 临床分离株的 WGS 数据，研究了我们患者之间的流行病学联系。鉴定出 8 个可传播的集群（TC）。英国和美国分离株分别被分配到 4 个集群（TC1、TC2、TC5 和 TC8）和 1 个集群（TC3）。我们医院的总共 12 株分离株属于 4 个集群（TC4、TC5、TC6 和 TC7）。流行病学关联分析推断，在我们医院的 TC4 和 TC5 中，患者之间存在直接或间接传播，但在 TC6 和 TC7 中不存在。在 TC5 中，日本和英国患者分离株之间的单核苷酸多态性距离小于 21，但没有接触。这项研究表明，即使在非 CF 患者中，也存在遗传上密切相关的分离株。然而，传播途径仍不清楚，需要进一步研究以阐明是否涉及交叉传播。虽然经常报道囊性纤维化（CF）患者中存在（M. abscessus）交叉传播的可能性，但尚不清楚亚洲非 CF 患者是否发生过类似事件。对日本福聚寺医院 M. abscessus 分离株进行全基因组测序分析表明，存在遗传上密切相关的 M. abscessus 分离株。此外，根据流行病学关联分析，一些集群被怀疑在我们医院的患者之间存在直接或间接传播。然而，M. abscessus 的传播途径仍不清楚，因为有趣的是，一个集群与英国分离株的单核苷酸多态性距离小于 21，但没有发现流行病学联系。
