title: Absence of Mycobacterium intracellulare and presence of Mycobacterium chimaera in household water and biofilm samples of patients in the United States with Mycobacterium avium complex respiratory disease.
abstract: Recent studies have shown that respiratory isolates from pulmonary disease patients and household water/biofilm isolates of Mycobacterium avium could be matched by DNA fingerprinting. To determine if this is true for Mycobacterium intracellulare, household water sources for 36 patients with Mycobacterium avium complex (MAC) lung disease were evaluated. MAC household water isolates from three published studies that included 37 additional MAC respiratory disease patients were also evaluated. Species identification was done initially using nonsequencing methods with confirmation by internal transcribed spacer (ITS) and/or partial 16S rRNA gene sequencing. M. intracellulare was identified by nonsequencing methods in 54 respiratory cultures and 41 household water/biofilm samples. By ITS sequencing, 49 (90.7%) respiratory isolates were M. intracellulare and 4 (7.4%) were Mycobacterium chimaera. In contrast, 30 (73%) household water samples were M. chimaera, 8 (20%) were other MAC X species (i.e., isolates positive with a MAC probe but negative with species-specific M. avium and M. intracellulare probes), and 3 (7%) were M. avium; none were M. intracellulare. In comparison, M. avium was recovered from 141 water/biofilm samples. These results indicate that M. intracellulare lung disease in the United States is acquired from environmental sources other than household water. Nonsequencing methods for identification of nontuberculous mycobacteria (including those of the MAC) might fail to distinguish closely related species (such as M. intracellulare and M. chimaera). This is the first report of M. chimaera recovery from household water. The study underscores the importance of taxonomy and distinguishing the many species and subspecies of the MAC.
authors.affiliation: Mycobacteria/Nocardia Research Laboratory, The University of Texas Health Science Center at Tyler, Tyler, Texas, USA. richard.wallace@uthct.edu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wallace
authors.forename: Elena
authors.initials: E
authors.lastname: Iakhiaeva
authors.forename: Myra D
authors.initials: MD
authors.lastname: Williams
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Brown-Elliott
authors.forename: Sruthi
authors.initials: S
authors.lastname: Vasireddy
authors.forename: Ravikiran
authors.initials: R
authors.lastname: Vasireddy
authors.forename: Leah
authors.initials: L
authors.lastname: Lande
authors.forename: Donald D
authors.initials: DD
authors.lastname: Peterson
authors.forename: Janet
authors.initials: J
authors.lastname: Sawicki
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kwait
authors.forename: Wellington S
authors.initials: WS
authors.lastname: Tichenor
authors.forename: Christine
authors.initials: C
authors.lastname: Turenne
authors.forename: Joseph O
authors.initials: JO
authors.lastname: Falkinham
mesh_terms: D018441:Biofilms; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D005191:Family Characteristics; D006801:Humans; D015269:Mycobacterium avium Complex / Q000145:classification* / Q000302:isolation & purification*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA; D014397:Tuberculosis, Pulmonary / Q000382:microbiology*; D014871:Water Microbiology
chemical_list: D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer; D012336:RNA, Ribosomal, 16S
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