Genomic epidemiology of a national outbreak of post-surgical Mycobacterium abscessus wound infections in Brazil

Journal article

An epidemic of post-surgical wound infections, caused by a non-tuberculous mycobacterium, has been on-going in Brazil. It has been unclear whether one or multiple lineages are responsible and whether their wide geographical distribution across Brazil is due to spread from a single point source or is the result of human-mediated transmission. 188 isolates, collected from nine Brazilian states, were whole genome sequenced and analysed using phylogenetic and comparative genomic approaches. The isolates from Brazil formed a single clade, which was estimated to have emerged in 2003. We observed temporal and geographic structure within the lineage that enabled us to infer the movement of sub-lineages across Brazil. The genome size of the Brazilian lineage was reduced relative to most strains in the three subspecies of Mycobacterium abscessus and contained a novel plasmid, pMAB02, in addition to the previously described pMAB01 plasmid. One lineage, which emerged just prior to the initial outbreak, is responsible for the epidemic of post-surgical wound infections in Brazil. Phylogenetic analysis indicates that multiple transmission events led to its spread. The presence of a novel plasmid and the reduced genome size suggest that the lineage has undergone adaptation to the surgical niche.

Authors: Everall, I; Nogueira, CL; Bryant, JM; Sánchez-Busó, L; Chimara, E

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Microbiology Society
• Journal: Microbial Genomics
• Volume: 3
• Issue: 5
• Article number: e000111
• Publication date: 2017-05-03
• Acceptance date: 2017-03-28
• DOI: 10.1099/mgen.0.000111
• ISSN: 2057-5858
• Pmid: 28884021
• Language: English
• Keywords: FFR; transmission; genomic epidemiology; outbreak; nosocomial infections; mycobacterium abscessus