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Genomic analysis of an Irish population of Mycobacterium abscessus complex collected between 2006 and 2017.

Mycobacterium abscessus complex (MABC) are multidrug resistant nontuberculous mycobacteria and cause opportunistic pulmonary infections in individuals with cystic fibrosis (CF). In this study, genomic analysis of MABC was performed to gain greater insights into the epidemiology of circulating strains in Ireland.Whole genome sequencing (WGS) was performed on 70 MABC isolates that had been referred to the Irish Mycobacteria Reference Laboratory between 2006 and 2017 across nine Irish healthcare centres. MABC comprised of 52 isolates from 27 CF patients and 18 isolates from 10 non-CF patients.WGS identified 57 (81.4%) as M. abscessus subsp. abscessus (MAB), 10 (14.3%) as M. abscessus subsp. massiliense (MMAS) and 3 (4.3%) as M. abscessus subsp. bolletii (MBOL). Forty-nine isolates (94%) from 25 CF patients were identified as MAB whereas 3 (6%) isolates from 2 CF patients were identified as MMAS. Among non-CF patients, 44% (8/18) were identified as MAB, 39% (7/18) as MMAS and 17% (3/18) as MBOL. WGS detected two clusters of closely related MAB that included isolates from different CF centres.There was greater genomic diversity of MABC among non-CF compared to CF patients. Although WGS failed to show direct evidence of patient to patient transmission among CF patients, there was a predominance of two different strains of MAB. Furthermore, some MABC were closely related to global strains suggesting their international spread. Future prospective real-time epidemiological and clinical data along with contemporary MABC sequence analysis may elucidate sources and routes of transmission among patients infected with MABC.