Infection by Clonally Related Mycobacterium abscessus Isolates: The Role of Drinking Water

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Thomson, Rachel M
Wheeler, Nicole
Stockwell, Rebecca E
Bryant, Josephine
Taylor, Steven L
Leong, Lex EX
Le, Trieu
Rogers, Geraint B
Carter, Robyn
Sherrard, Laura J
Powell, Harry
Simpson, Graham
Patterson-Fahy, Kirby
Wainwright, Claire E
Floto, R Andres
et al.
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2025
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Abstract

Rationale: Mycobacterium abscessus (MABS) group bacteria cause lethal infections in people with chronic lung diseases. Transmission mechanisms remain poorly understood; the detection of dominant circulating clones (DCCs) has suggested the potential for person-to-person transmission. Objectives: This study aimed to determine the role of drinking water in the transmission of MABS. Methods: A total of 289 isolates were cultured from respiratory samples (n = 231) and drinking water sources (n = 58) across Queensland, Australia. Measurements and Main Results: Whole-genome sequences were analyzed to identify DCCs and determine relatedness. Half of the isolates (n = 144; 49.8%) clustered with previously described DCCs, of which 30 formed a clade within DCC5. Pan-genomic analysis of the water-associated DCC5 clade revealed an enrichment of genes associated with copper resistance. Four instances of plausible epidemiological links were identified between genomically related clinical and water isolates. Conclusions: We provide evidence that drinking water is a reservoir for MABS and may be a vector in the chain of MABS infection.

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American Journal of Respiratory and Critical Care Medicine

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211

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5

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© 2025 by the American Thoracic Society. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).

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Thomson, RM; Wheeler, N; Stockwell, RE; Bryant, J; Taylor, SL; Leong, LEX; Le, T; Rogers, GB; Carter, R; Sherrard, LJ; Powell, H; Simpson, G; Patterson-Fahy, K; Wainwright, CE; Floto, RA; Parkhill, J; Bell, SC, Infection by Clonally Related Mycobacterium abscessus Isolates: The Role of Drinking Water, American Journal of Respiratory and Critical Care Medicine, 2025, 211 (5), pp. 842-853

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