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Science. 2016 Nov 11;354(6313):751-757. doi: 10.1126/science.aaf8156.

Emergence and spread of a human-transmissible multidrug-resistant nontuberculous mycobacterium.

Author information

1
Wellcome Trust Sanger Institute, Hinxton, UK.
2
University of Cambridge Department of Medicine, MRC-Laboratory of Molecular Biology, Cambridge, UK.
3
Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, UK.
4
EMBL European Bioinformatics Institute, Hinxton, UK.
5
Mycobacteria Research Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins CO, USA.
6
University of North Carolina School of Medicine, NC, USA.
7
QIMR Berghofer Medical Research Institute, Brisbane, Australia.
8
School of Medicine, The University of Queensland, Australia.
9
The Prince Charles Hospital, Brisbane, Australia.
10
Gallipoli Medical Research Centre, University of Queensland, Brisbane, Australia.
11
Lady Cilento Children's Hospital, Brisbane.
12
Queensland Mycobacterial Reference Laboratory, Brisbane, Australia.
13
Centre for Experimental Medicine, Queen's University Belfast, UK.
14
School of Chemistry and Biomolecular sciences, The University of Queensland, Australia.
15
Queensland University of Technology, Brisbane, Australia.
16
International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Australia.
17
School of Public Health, The University of Queensland, Brisbane, Australia.
18
Child Health Research Centre, The University of Queensland, Brisbane, Australia.
19
Royal Brompton and Harefield NHS Foundation Trust, UK.
20
Scottish Mycobacteria Reference Laboratory, UK.
21
Wales Centre for Mycobacteria, UK.
22
The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK.
23
Oxford University Hospitals NHS Foundation Trust, UK.
24
Nottingham University Hospitals NHS Trust, UK.
25
University Hospital of South Manchester NHS Foundation Trust, UK.
26
Aberdeen Royal Infirmary, NHS Grampian, Scotland, UK.
27
The Leeds Teaching Hospitals NHS Trust, UK.
28
Birmingham Children's Hospital NHS Foundation Trust, UK.
29
Alder Hey Children's NHS Foundation Trust, UK.
30
Sheffield Teaching Hospitals NHS Foundation Trust, UK.
31
The Royal Liverpool and Broadgreen University Hospitals NHS Trust, UK.
32
University Hospital Southampton NHS Foundation Trust, UK.
33
Department of Infectious Diseases, Aarhus University Hospital, Denmark.
34
Department of Infectious Medicine, Institute of Biomedicine, University of Gothenburg, Sweden.
35
Copenhagen Cystic Fibrosis Center, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
36
International reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark.
37
Gartnavel Hospital, Glasgow, NHS Greater Glasgow and Clyde, Scotland, UK.
38
Barts Health NHS Trust, London, UK.
39
University Hospitals of Leicester NHS Trust, UK.
40
Heart of England NHS Foundation Trust, Birmingham, UK.
41
St Vincent's University Hospital, Dublin, Ireland.
42
King's College Hospital NHS Foundation Trust, London, UK.
43
Western General Hospital, NHS Lothian, Scotland, UK.
44
Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
45
Liverpool Heart and Chest Hospital NHS Foundation Trust, UK.
46
Sheffield Children's NHS Foundation Trust, UK.
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Contributed equally

Abstract

Lung infections with Mycobacterium abscessus, a species of multidrug-resistant nontuberculous mycobacteria, are emerging as an important global threat to individuals with cystic fibrosis (CF), in whom M. abscessus accelerates inflammatory lung damage, leading to increased morbidity and mortality. Previously, M. abscessus was thought to be independently acquired by susceptible individuals from the environment. However, using whole-genome analysis of a global collection of clinical isolates, we show that the majority of M. abscessus infections are acquired through transmission, potentially via fomites and aerosols, of recently emerged dominant circulating clones that have spread globally. We demonstrate that these clones are associated with worse clinical outcomes, show increased virulence in cell-based and mouse infection models, and thus represent an urgent international infection challenge.

PMID:
27846606
PMCID:
PMC5142603
DOI:
10.1126/science.aaf8156
[Indexed for MEDLINE]
Free PMC Article

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