@article{van:2022:10.1101/2022.01.07.22268791,
author = {van, Tonder AJ and Ellis, HC and Churchward, CP and Kumar, K and Ramadan, N and Benson, S and Parkhill, J and Moffatt, MF and Loebinger, MR and Cookson, WOC},
doi = {10.1101/2022.01.07.22268791},
title = {<i>Mycobacterium avium</i> complex (MAC) genomics and transmission in a London hospital},
url = {http://dx.doi.org/10.1101/2022.01.07.22268791},
year = {2022}
}

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TY  - JOUR
AB  - <jats:title>Abstract</jats:title><jats:p>Non-tuberculous mycobacteria (NTM) are ubiquitous environmental microorganisms and opportunistic pathogens in individuals with pre-existing lung conditions such as cystic fibrosis (CF) and non-CF bronchiectasis (BX). Whilst recent studies of <jats:italic>Mycobacterium abscessus</jats:italic> have identified transmission within single CF centres as well as nationally and globally, transmission of other NTM species is less well studied. We sequenced 996 Mycobacterium avium complex (MAC) isolates from CF and non-CF patients at the Royal Brompton Hospital (RBH), London. Genomic analysis was used to analyse local transmission. Epidemiological links were identified from patient records. These and previously published genomes were used to characterise global population structures. Analysis of the three predominant MAC species identified putative transmission clusters that contained patients with CF, BX and other lung conditions, although few epidemiological links could be identified. For <jats:italic>M. avium</jats:italic>, lineages were largely limited to single countries, whilst for <jats:italic>M. chimaera</jats:italic>, global transmission clusters previously associated with heater cooler units (HCUs) were found. However, the immediate ancestor of the lineage causing the major HCU-associated outbreak was a lineage already circulating in patients with pre-existing lung conditions. CF and non-CF patients shared transmission chains even in the presence of CF patient-focussed hospital control measures, although the lack of epidemiological links suggested that most transmission is indirect and may involve environmental intermediates or else asymptomatic carriage in the wider population. The major HCU-associated <jats:italic>M. chimaera</jats:italic> lineage being derived from an already circulating lineage, suggests that HCUs, while being responsible for a major global
AU  - van,Tonder AJ
AU  - Ellis,HC
AU  - Churchward,CP
AU  - Kumar,K
AU  - Ramadan,N
AU  - Benson,S
AU  - Parkhill,J
AU  - Moffatt,MF
AU  - Loebinger,MR
AU  - Cookson,WOC
DO  - 10.1101/2022.01.07.22268791
PY  - 2022///
TI  - <i>Mycobacterium avium</i> complex (MAC) genomics and transmission in a London hospital
UR  - http://dx.doi.org/10.1101/2022.01.07.22268791
ER  - 

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