Prevalence of nontuberculous mycobacteria in potable water

Abstract

Objectives: Nontuberculous mycobacteria (NTM) is an emerging respiratory infection in people with CF with one species, Mycobacterium abscessus complex (MABSC), causing significant concern. Over 25% of MABSC strains in people with CF have unique genotypes, with acquisition possibly through contact with environmental sources such as potable water. This study is investigating the presence of NTM (including MABSC) in potable water of The Prince Charles Hospital (TPCH) and homes in Queensland, Australia. Methods: For hospital water, showers and sink tap water was collected from 2 respiratory wards at TPCH across 5 time points (2014-2017). Home water was separated into 4 groups: people with CF and 1) active MABSC respiratory infection (<2 years since positive sputum culture), 2) past MABSC respiratory infection (>2 years since positive sputum culture) or 3) never infected with NTM and 4) homes of people with no lung disease. The water samples were processed and incubated for 8 weeks. DNA was extracted from presumptive NTM isolates and sent for whole genome sequencing. Results: Thewater sampling recovered 254 presumptive NTM isolates with sequencing completed for 231 isolates. Fifty-two isolates from the hospital water were identified as Mycobacterium kansasii (n = 25), MABSC (n = 10), Mycobacterium llatzerense (n = 8), Mycobacterium cosmeticum (n = 2), Mycobacterium avium (n = 1) and unidentified mycobacteria (n = 6). One hundred and seventy-nine isolates from the homewaterwere identified as M. kansasii (n = 45), MABSC (n = 32), M. llatzerense (n = 24), M. fortuitum (n = 7) and unidentified mycobacteria (n = 71). Conclusion: Pathogenic NTM species are detected in the hospital and homewater samples. Of the isolates recovered from the hospital and home water samples,19% and 18%were identified as MABSC, respectively. Further analysis of the dataset will compare the MABSCwater isolates to CF MABSC respiratory isolates to determine if water is a possible initial acquisition source of infection in the CF population.L6229307852018-07-12 <br />