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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.

Original publication

DOI

10.1126/science.aaf8156

Type

Journal article

Journal

Science

Volume

354

Pages

751 - 757

Keywords

Animals, Communicable Diseases, Emerging, Cystic Fibrosis, Drug Resistance, Multiple, Bacterial, Genome, Bacterial, Genomics, Humans, Incidence, Lung, Mice, Mice, SCID, Mycobacterium Infections, Nontuberculous, Nontuberculous Mycobacteria, Phylogeny, Pneumonia, Bacterial, Polymorphism, Single Nucleotide, Sequence Analysis, DNA