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Patient-to-patient transmission of M. abscessus common in cystic fibrosis
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The transmission of Mycobacterium abscessus is frequent among patients with cystic fibrosis, according to study results published in The Lancet.
“This transmission is indirect and occurs despite rigorous implementation of national infection control policies,” Andres Floto, MD, PhD, of the University of Cambridge in the United Kingdom, told Infectious Disease News. “Our findings suggest that there needs to be an urgent transformation in how we look after patients with cystic fibrosis in the hospital.”
Andres Floto
Floto and colleagues conducted a study in which they performed whole-genome sequencing and antimicrobial susceptibility testing on clinical isolates from patients attending an adult cystic fibrosis clinic. From 2007 to 2011, there were 168 isolates of M. abscessus collected from 31 patients.
There were three different subspecies identified: 13 patients had subspecies abscessus, 15 had subspecies massiliense and two had subspecies bolletii. One was coinfected with subspecies abscessus and massiliense and excluded from the analysis. There were two clustered outbreaks of near-identical isolates of the subspecies massiliense. The similarities suggest patient-to-patient transmission. The subspecies massiliense from the two clusters were found to have a high level of resistance to macrolides.
“Given the work we’ve been doing in the lab on interactions of M. abscessus and macrophages and the rapid rise in cases, we were worried that we might see some transmission events,” Floto said. “We were still surprised to see frequent transmission, given the large body of work showing that patients acquired genetically distinct bugs from the environment.”
Disclosure: Floto reports no relevant financial disclosures.
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