Authors: Sergio Buenestado-Serrano, Miguel Martínez-Lirola, Marta Herranz-Martín, Jaime Esteban, Antonio Broncano-Lavado, Andrea Molero-Salinas, Amadeo Sanz-Pérez, Jesús Blázquez, Alba Ruedas-López, Carlos Toro, Paula López-Roa, Diego Domingo, Ester Zamarrón, María Jesús Ruiz Serrano, Patricia Muñoz, Laura Pérez-Lago, Darío García de Viedma
Published: 2024-03-28
DOI: 10.1038/s41467-024-46552-w
Source: Full article
AbstractMycobacterium 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.