P43
Mycobacterium abscessus genomic diversity and longitudinal analysis of microevolution and reinfection
S Buenestado-Serrano(1) M Martínez-Lirola(2) M Herranz(3) J Martín-Escolano(1) J Esteban(4) P López-Roa(5) D Domingo(6) M J Ruiz-Serrano(1,3) P Muñoz(1,3) L Pérez-Lago(1) D García de Viedma(1,3)
1:Servicio de Microbiología Clínica y Enfermedades Infecciosas, Instituto de Investigación Sanitaria Gregorio Marañón, 28007, Madrid (Spain); 2:Microbiología y Parasitología, Complejo Universitario Hospitalario Torrecárdenas, 04009, Almería (Spain); 3:CIBER Enfermedades Respiratorias (CIBERES), Servicio Madrileño de Salud, Hospital Gregorio Marañón, 28007, Madrid (Spain); 4:Servicio de Microbiología, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Hospital Universitario La Fundación Jiménez Díaz, 28040, Madrid (Spain); 5:Microbiología y Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, 28041, Madrid (Spain); 6:Microbiología, Servicio de Microbiología, Hospital Universitario La Princesa, 28006, Madrid (Spain)
Mycobacterium abscessus is a non-tuberculous mycobacteria, widespread worldwide, characterised by being an opportunistic pathogen and its resistance to a large number of antibiotics. There are still few genomic studies addressing its diversity. Our aim was to characterise M. abscessus from different institutions by whole genome sequencing to evaluate their diversity, inter-patient clusters and microevolution/reinfection events in prolonged persistences. We compiled 39 isolates from 39 patients from 3 hospitals in Madrid and 58 sequential isolates from 15 patients (2-16 isolates per patient, obtained 2 months-11 years apart). Sequences were obtained by using the Nextera XT kit, run in a Miseq instrument and analyzed by a homemade pipeline. The Madrid isolates were distributed in 3 clades (20, 15 and 4 isolates; each one grouping subsp. abscessus, subsp. masiliense and subsp. boletti) with a high intraclade diversity (3-36248 SNPs). Some closer relationships were observed for several patients from the same or different hospitals (3-44 SNPs). Longitudinal intrapatient analysis revealed 7 reinfections (49-19143 SNPs; 3 months-4 years apart) and 11 microevolutions (2-24 SNPs; 2 months-4 years apart). The most complex case (cystic fibrosis; 21 isolates studied) involved 9 sequential reinfections along 11 years, together with a persistent strain transiently detected/underdetected. In summary, genomic analysis of Mycobacterium abscessus allowed us to detect a wide genomic diversity in Madrid, with closer relationships between some isolates, and to reveal an unexpected intrapatient complexity, with involvement of reinfections and microevolution events.
Funding: PI21/01823 (ISCIII); 2021-II-PREDOC-IA-01 (IiSGM); PI21/01738 (ISCIII); ERDF (FEDER) Funds from the European Commission, “A way of making Europe”.