Microevolution, reinfection and highly complex genomic diversity in patients with sequential isolates of Mycobacterium abscessus.
Sergio Buenestado-SerranoMiguel Martínez-LirolaMarta Herranz-MartínJaime Esteban MorenoAntonio Broncano-LavadoAndrea Molero-SalinasAmadeo Sanz-PérezJesús BlázquezAlba Ruedas-LópezCarlos ToroPaula López-RoaDiego DomingoEster ZamarrónMaría Jesús Ruiz SerranoPatricia MuñozLaura Pérez-LagoDarío García de ViedmaPublished in: Nature communications (2024)
Mycobacterium abscessus is an opportunistic, extensively drug-resistant non-tuberculous mycobacterium. Few genomic studies consider its diversity in persistent infections. Our aim was to characterize microevolution/reinfection events in persistent infections. Fifty-three sequential isolates from 14 patients were sequenced to determine SNV-based distances, assign resistance mutations and characterize plasmids. Genomic analysis revealed 12 persistent cases (0-13 differential SNVs), one reinfection (15,956 SNVs) and one very complex case (23 sequential isolates over 192 months), in which a first period of persistence (58 months) involving the same genotype 1 was followed by identification of a genotype 2 (76 SNVs) in 6 additional alternating isolates; additionally, ten transient genotypes (88-243 SNVs) were found. A macrolide resistance mutation was identified from the second isolate. Despite high diversity, the genotypes shared a common phylogenetic ancestor and some coexisted in the same specimens. Genomic analysis is required to access the true intra-patient complexity behind persistent infections involving M. abscessus.
Keyphrases
- drug resistant
- multidrug resistant
- mycobacterium tuberculosis
- end stage renal disease
- acinetobacter baumannii
- ejection fraction
- genetic diversity
- chronic kidney disease
- newly diagnosed
- escherichia coli
- copy number
- prognostic factors
- peritoneal dialysis
- brain injury
- pseudomonas aeruginosa
- genome wide
- fine needle aspiration