title: Isolation of nontuberculous mycobacteria (NTM) from household water and shower aerosols in patients with pulmonary disease caused by NTM.
abstract: It has been postulated that susceptible individuals may acquire infection with nontuberculous mycobacteria (NTM) from water and aerosol exposure. This study examined household water and shower aerosols of patients with NTM pulmonary disease. The mycobacteria isolated from clinical samples from 20 patients included M. avium (5 patients), M. intracellulare (12 patients), M. abscessus (7 patients), M. gordonae (1 patient), M. lentiflavum (1 patient), M. fortuitum (1 patient), M. peregrinum (1 patient), M. chelonae (1 patient), M. triplex (1 patient), and M. kansasii (1 patient). One-liter water samples and swabs were collected from all taps, and swimming pools or rainwater tanks. Shower aerosols were sampled using Andersen six-stage cascade impactors. For a subgroup of patients, real-time PCR was performed and high-resolution melt profiles were compared to those of ATCC control strains. Pathogenic mycobacteria were isolated from 19 homes. Species identified in the home matched that found in the patient in seven (35%) cases: M. abscessus (3 cases), M. avium (1 case), M. gordonae (1 case), M. lentiflavum (1 case), and M. kansasii (1 case). In an additional patient with M. abscessus infection, this species was isolated from potable water supplying her home. NTM grown from aerosols included M. abscessus (3 homes), M. gordonae (2 homes), M. kansasii (1 home), M. fortuitum complex (4 homes), M. mucogenicum (1 home), and M. wolinskyi (1 home). NTM causing human disease can be isolated from household water and aerosols. The evidence appears strongest for M. avium, M. kansasii, M. lentiflavum, and M. abscessus. Despite a predominance of disease due to M. intracellulare, we found no evidence for acquisition of infection from household water for this species.
authors.affiliation: Gallipoli Medical Research Centre, Greenslopes Private Hospital, Brisbane, Queensland, Australia. R.Thomson@uq.edu.au
authors.forename: Rachel
authors.initials: R
authors.lastname: Thomson
authors.forename: Carla
authors.initials: C
authors.lastname: Tolson
authors.forename: Robyn
authors.initials: R
authors.lastname: Carter
authors.forename: Chris
authors.initials: C
authors.lastname: Coulter
authors.forename: Flavia
authors.initials: F
authors.lastname: Huygens
authors.forename: Megan
authors.initials: M
authors.lastname: Hargreaves
mesh_terms: D000336:Aerosols; D005191:Family Characteristics; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000382:microbiology*; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000302:isolation & purification*; D018410:Pneumonia, Bacterial / Q000382:microbiology*; D014871:Water Microbiology
chemical_list: D000336:Aerosols