Identification of Mycobacterium porcinum in patients with cystic Fibrosis: Pathogen or contaminant?

Autor: Christopher J. Nemastil, Stella Antonara, Grace R. Paul, Amy Leber, Michael T. Brady, Stephanie Stack-Simone, Alexander L. Greninger, Kimberly J. Novak
Rok vydání: 2019
Předmět:
0301 basic medicine
Pulmonary and Respiratory Medicine
Adult
Male
medicine.medical_specialty
Adolescent
Cystic Fibrosis
medicine.medical_treatment
Cystic Fibrosis Transmembrane Conductance Regulator
Mycobacterium Infections
Nontuberculous
Cystic fibrosis
Pulmonary function testing
03 medical and health sciences
0302 clinical medicine
Internal medicine
Genotype
medicine
Lung transplantation
Humans
Mycobacteriaceae
Equipment and Supplies
Hospital
biology
Whole Genome Sequencing
business.industry
Sputum
biology.organism_classification
medicine.disease
United States
Respiratory Function Tests
Hospitalization
030104 developmental biology
030228 respiratory system
Mycobacterium porcinum
Pediatrics
Perinatology and Child Health
Equipment Contamination
Nontuberculous mycobacteria
Female
medicine.symptom
business
Mycobacterium
Zdroj: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society. 19(4)
ISSN: 1873-5010
Popis: Background Mycobacterium porcinum is a non-tuberculous mycobacterium (NTM) identified in potable water. The identification and clinical impact of M. porcinum in patients with cystic fibrosis (CF) has not been described. In our institution, M. porcinum was isolated exclusively during hospitalization in a cluster of patients with CF. Methods Patients with CF who were hospitalized between September 2016 and September 2018 and could expectorate sputum were included, and samples were processed per institutional guidelines. Post-hospitalization and one-year clinical outcomes on those who isolated M. porcinum in respiratory cultures were reviewed. Whole genome sequencing was performed on M. porcinum isolates obtained from patients and environmental sources to identify source of acquisition. Results Review of 14 CF patients with 16 M. porcinum isolates revealed rapid time to culture positivity within 0.8 (0.04–8.0) days after admission. M. porcinum was isolated in teenagers and adults irrespective of baseline pulmonary function, body mass index, or CF genotype. Whole genome sequencing suggested all isolates belong to the same M. porcinum strain and confirmed the source of acquisition to the ice machine. Review of patients’ clinical course, including three patients who underwent lung transplantation, suggested a pseudo-outbreak with minimal clinical impact. Conclusions NTM, including M. porcinum, are ubiquitous in potable water and institutional water reservoirs. Our findings suggest M. porcinum is a transient colonizer rather than a pathogen. Challenges exist in discerning the role of NTM as a contributor of pulmonary morbidity in patients with CF, and adherence to established guidelines regarding NTM related pulmonary disease remains important.
Databáze: OpenAIRE
Externí odkaz: