title: Isolation and identification of nontuberculous mycobacteria from hospitalized patients and drinking water samples--examination of their correlation by chemometrics.
abstract: Nontuberculous mycobacteria (NTM) have been found to be widely dispersed in the environment and are being considered potentially pathogenic for humans and animals, while reports of their human to human transmission are absent. Water and aerosols are potential transmission modes of NTM to humans. Hospitalized patients with NTM infections were studied together with drinking water samples from their respective residence areas during 2003-2013. Cluster analysis and factor analysis were used to analyze the data matrix. A total of 367 hospitalized patients living in 30 localities in the Prefecture of Larissa were tested positive for NTM. The most frequently isolated NTM species of the 383 NTM isolates from the clinical specimens were Mycobacterium fortuitum (n = 118, 30.8 %), M. gordonae (n = 87, 22.7 %), M. peregrinum (n = 46, 12.0 %), M. chelonae (n = 11, 2.9 %), M. avium (n = 8, 2.1 %), and M. intracellulare (n = 7, 1.8 %), while 88 (23.0 %) of these isolates were not identified. It is noted that in 8 patients, M. tuberculosis was isolated simultaneously with one NTM, in 15 patients, together with two types of NTM, while in 1 patient, it was found at the same time as three different NTM. In addition, 3360 drinking water samples were collected from 30 localities and analyzed during 2010 to 2013; they were found 11.2 % NTM positive. Cluster analysis and factor analysis results confirm that NTM strains are correlated to each other in both isolated samples from patients and drinking water, while the strength of their correlation varied from weak to moderate (e.g., factor loadings ranged from 0.69 to 0.74 when all data are considered). These results provide indications that drinking water could be linked with NTM cases in humans.
authors.affiliation: Department of Respiratory Medicine, Medical School, University of Thessaly, Larissa, Greece. h.dovriki@gmail.com.
authors.forename: Eleni
authors.identifier: http://orcid.org/0000-0001-5573-1562
authors.initials: E
authors.lastname: Dovriki
authors.affiliation: Department of Respiratory Medicine, Medical School, University of Thessaly, Larissa, Greece.
authors.forename: Irini
authors.initials: I
authors.lastname: Gerogianni
authors.affiliation: Department of Microbiology, Medical School, University of Larissa, Larissa, Greece.
authors.forename: Efi
authors.initials: E
authors.lastname: Petinaki
authors.affiliation: Department of Hygiene and Epidemiology, School of Medicine, University of Thessaly, Larissa, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Hadjichristodoulou
authors.affiliation: Department of Medical Laboratories, Technological Education Institution of Thessaly, Larissa, Greece.
authors.forename: Agelos
authors.initials: A
authors.lastname: Papaioannou
authors.affiliation: Department of Respiratory Medicine, Medical School, University of Thessaly, Larissa, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Gourgoulianis
mesh_terms: D000336:Aerosols; D000818:Animals; D060766:Drinking Water / Q000382:microbiology*; D004777:Environment; D004784:Environmental Monitoring; D005260:Female; D006761:Hospitals; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000254:growth & development* / Q000302:isolation & purification
chemical_list: D000336:Aerosols; D060766:Drinking Water
keywords: Cluster analysis; Drinking water; Factor analysis; Greece; Hospitalized patients; Nontuberculous mycobacteria