Olawoye Idowu B, Waglechner Nicholas, McIntosh Fiona, Akochy Pierre-Marie, Cloutier Nancy, Grandjean Lapierre Simon, Tannir Bouchra, Greenaway Christina, Matouk Elias, Poirier Louise, Levesque Roger C, Boyle Brian, Quach Caroline, Soualhine Hafid, Batt Jane, Behr Marcel A, Lee Robyn S, Guthrie Jennifer L
Department of Microbiology and Immunology, University of Western Ontario, London, Canada.
Department of Microbiology, Sinai Health, Toronto, Canada.
J Infect Dis. 2025 Feb 20;231(2):e396-e406. doi: 10.1093/infdis/jiae407.
Mycobacterium abscessus complex (MABC), an opportunistic nontuberculous mycobacteria, can lead to poor clinical outcomes in pulmonary infections. Conflicting data exist on person-to-person transmission of MABC within and across health care facilities. To investigate further, a comprehensive retrospective study across 5 health care institutions on the Island of Montréal was undertaken.
We analyzed the genomes of 221 MABC isolates obtained from 115 individuals (2010-2018) to identify possible links. Genetic similarity, defined as ≤25 single-nucleotide polymorphisms (SNPs), was investigated through a blinded epidemiological inquiry.
Bioinformatics analyses identified 28 sequence types, including globally observed dominant circulating clones (DCCs). Further analysis revealed 210 isolate pairs within the SNP threshold. Among these pairs, there was 1 possible laboratory contamination where isolates from different patients processed in the same laboratory differed by only 2 SNPs. There were 37 isolate pairs from patients who had provided specimens from the same hospital; however, epidemiological analysis found no evidence of health care-associated person-to-person transmission between these patients. Additionally, pangenome analysis showed higher discriminatory power than core genome analysis for examining genomic similarity.
Genomics alone is insufficient to establish MABC transmission, particularly considering the genetic similarity and wide distribution of DCCs, although pangenome analysis has the potential to add further insight. Our findings indicate that MABC infections in Montréal are unlikely attributable to health care-associated person-to-person transmission.
脓肿分枝杆菌复合群（MABC）是一种机会性非结核分枝杆菌，可导致肺部感染的临床预后不良。关于MABC在医疗机构内部和之间的人际传播，存在相互矛盾的数据。为了进一步调查，我们对蒙特利尔岛上的5家医疗机构进行了一项全面的回顾性研究。
我们分析了从115名个体（2010 - 2018年）获得的221株MABC分离株的基因组，以确定可能的联系。通过盲法流行病学调查研究了定义为≤25个单核苷酸多态性（SNP）的遗传相似性。
生物信息学分析确定了28种序列类型，包括全球观察到的优势循环克隆（DCC）。进一步分析揭示了在SNP阈值内的210对分离株。在这些对中，有1对可能是实验室污染，即在同一实验室处理的不同患者的分离株仅相差2个SNP。有37对分离株来自在同一家医院提供标本的患者；然而，流行病学分析没有发现这些患者之间存在与医疗保健相关的人际传播的证据。此外，泛基因组分析在检查基因组相似性方面显示出比核心基因组分析更高的鉴别力。
仅基因组学不足以确定MABC的传播，特别是考虑到DCC的遗传相似性和广泛分布，尽管泛基因组分析有可能提供进一步的见解。我们的研究结果表明，蒙特利尔的MABC感染不太可能归因于与医疗保健相关的人际传播。
