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Journal of Clinical Microbiology, May 2007, p. 1497-1504, Vol. 45, No. 5
0095-1137/07/$08.00+0     doi:10.1128/JCM.02592-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology of Mycobacterium abscessus, with Focus on Cystic Fibrosis

Sahlgrenska University Hospital,¹ Department of Clinical Bacteriology, Göteborg University,² Department of Pulmonary Medicine and Allergology,³ West Swedish CF Centre,⁴ Department of Medical Microbiology and Immunology, Göteborg University, Göteborg, Sweden⁵

Received 27 December 2006/ Returned for modification 6 February 2007/ Accepted 9 March 2007

Mycobacterium abscessus has been isolated increasingly often from the respiratory tracts of cystic fibrosis (CF) patients. It is not known whether these organisms are transmitted from person to person or acquired from environmental sources. Here, colony morphology and pulsed-field gel electrophoresis (PFGE) pattern were examined for 71 isolates of M. abscessus derived from 14 CF patients, three non-CF patients with chronic respiratory M. abscessus infection or colonization, one patient with mastoiditis, and four patients with infected wounds, as well as for six isolates identified as environmental contaminants in various clinical specimens. Contaminants and wound isolates mainly exhibited smooth colony morphology, while a rough colony phenotype was significantly associated with chronic airway colonization (P = 0.014). Rough strains may exhibit increased airway-colonizing capacity, the cause of which remains to be determined. Examination by PFGE of consecutive isolates from the same patient showed that they all represented a single strain, even in cases where both smooth and rough isolates were present. When PFGE patterns were compared, it was shown that 24 patients had unique strains, while four patients harbored strains indistinguishable by PFGE. Two of these were siblings with CF. The other two patients, one of whom had CF, had not had contact with each other or with the siblings. Our results show that most patients colonized by M. abscessus in the airways have unique strains, indicating that these strains derive from the environment and that patient-to-patient transmission rarely occurs.

Published ahead of print on 21 March 2007.

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