Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo, 46, 28007, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), C/Doctor Esquerdo, 46, 28007, Madrid, Spain.
Nat Commun. 2024 Mar 28;15(1):2717. doi: 10.1038/s41467-024-46552-w.
Mycobacterium abscessus is an opportunistic, extensively drug-resistant non-tuberculous mycobacterium. Few genomic studies consider its diversity in persistent infections. Our aim was to characterize microevolution/reinfection events in persistent infections. Fifty-three sequential isolates from 14 patients were sequenced to determine SNV-based distances, assign resistance mutations and characterize plasmids. Genomic analysis revealed 12 persistent cases (0-13 differential SNVs), one reinfection (15,956 SNVs) and one very complex case (23 sequential isolates over 192 months), in which a first period of persistence (58 months) involving the same genotype 1 was followed by identification of a genotype 2 (76 SNVs) in 6 additional alternating isolates; additionally, ten transient genotypes (88-243 SNVs) were found. A macrolide resistance mutation was identified from the second isolate. Despite high diversity, the genotypes shared a common phylogenetic ancestor and some coexisted in the same specimens. Genomic analysis is required to access the true intra-patient complexity behind persistent infections involving M. abscessus.
脓肿分枝杆菌是一种机会性、广泛耐药的非结核分枝杆菌。很少有基因组研究考虑其在持续性感染中的多样性。我们的目的是描述持续性感染中的微进化/再感染事件。对 14 名患者的 53 个连续分离株进行测序，以确定基于 SNV 的距离、确定耐药突变并对质粒进行特征分析。基因组分析显示，12 例持续性感染（0-13 个差异 SNV）、1 例再感染（15956 个 SNV）和 1 例非常复杂的感染（192 个月内 23 个连续分离株），其中第一个持续性感染期（58 个月）涉及同一基因型 1，随后在另外 6 个交替分离株中鉴定出基因型 2（76 个 SNV）；此外，还发现了 10 个短暂基因型（88-243 个 SNV）。第二个分离株中发现了一个大环内酯类耐药突变。尽管存在高度多样性，但这些基因型具有共同的系统发育祖先，有些在同一标本中共存。需要进行基因组分析才能了解涉及脓肿分枝杆菌的持续性感染背后的真正患者内复杂性。
