Genomic epidemiology of a national outbreak of post-surgical Mycobacterium abscessus wound infections in Brazil.

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Everall, Izzy 
Nogueira, Christiane Lourenço 
Bryant, Josephine M 
Sánchez-Busó, Leonor 
Chimara, Erica 

An epidemic of post-surgical wound infections, caused by a non-tuberculous mycobacterium, has been on-going in Brazil. It has been unclear whether one or multiple lineages are responsible and whether their wide geographical distribution across Brazil is due to spread from a single point source or is the result of human-mediated transmission. 188 isolates, collected from nine Brazilian states, were whole genome sequenced and analysed using phylogenetic and comparative genomic approaches. The isolates from Brazil formed a single clade, which was estimated to have emerged in 2003. We observed temporal and geographic structure within the lineage that enabled us to infer the movement of sub-lineages across Brazil. The genome size of the Brazilian lineage was reduced relative to most strains in the three subspecies of Mycobacterium abscessus and contained a novel plasmid, pMAB02, in addition to the previously described pMAB01 plasmid. One lineage, which emerged just prior to the initial outbreak, is responsible for the epidemic of post-surgical wound infections in Brazil. Phylogenetic analysis indicates that multiple transmission events led to its spread. The presence of a novel plasmid and the reduced genome size suggest that the lineage has undergone adaptation to the surgical niche.

Genomic epidemiology, Mycobacterium abscessus, nosocomial infections, outbreak, transmission, Adaptation, Biological, Bacterial Typing Techniques, Brazil, Cross Infection, Disease Outbreaks, Disease Transmission, Infectious, Gene Deletion, Genes, Bacterial, Genomics, Humans, Mycobacterium Infections, Nontuberculous, Mycobacterium abscessus, Phenotype, Phylogeny, Plasmids, Surgical Wound Infection, Whole Genome Sequencing
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Microb Genom
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Microbiology Society
Cystic Fibrosis Trust (SRC 002)
Wellcome Trust (107032/Z/15/Z)
Wellcome Trust (110224/Z/15/Z)
Wellcome Trust (107032/B/15/Z)