Infection by Clonally Related Mycobacterium abscessus Isolates: The Role of Drinking Water

Rachel M Thomson^{1

2}, Nicole Wheeler^{3

4}, Rebecca E Stockwell^{5

6}, Josephine Bryant⁷, Steven L Taylor^{8

9}, Lex E X Leong¹⁰, Trieu Le⁷, Geraint B Rogers^{8

9}, Robyn Carter¹, Laura J Sherrard^{5

11}, Harry Powell¹², Graham Simpson¹³, Kirby Patterson-Fahy¹, Claire E Wainwright^{14

15}, R Andres Floto^{16

17}, Julian Parkhill¹⁸, Scott C Bell^{2

14

19}

Affiliations

¹ Greenslopes Clinical School, Gallipoli Medical Research, The University of Queensland, Greenslopes, Queensland, Australia.
² Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia.
³ Wellcome Sanger Institute, Cambridge, United Kingdom.
⁴ Institute of Microbiology and Infection, University of Birmingham, Birmingham, United Kingdom.
⁵ Lung Bacteria Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
⁶ Child Health Research Centre, The University of Queensland, Herston, Queensland, Australia.
⁷ Wellcome Sanger Institute, Genome Campus, Hinxton, United Kingdom.
⁸ Microbiome and Host Health Program, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia.
⁹ College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
¹⁰ Public Health and Epidemiology, SA Pathology, Adelaide, South Australia, Australia.
¹¹ School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom.
¹² The University of Queensland, Greenslopes Clinical School, Gallipoli Medical Research, Greenslopes, Queensland, Australia.
¹³ Respiratory Medicine, Cairns Base Hospital, Cairns, Queensland, Australia.
¹⁴ Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
¹⁵ Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia.
¹⁶ Molecular Immunity Unit, University of Cambridge Department of Medicine MRC-Laboratory of Molecular Biology, Cambridge, United Kingdom.
¹⁷ Cambridge Centre for Lung Infection, Royal Papworth Hospital, Cambridge, United Kingdom.
¹⁸ Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom; and.
¹⁹ Translational Research Institute, Woolloongabba, Queensland, Australia.

PMID: 40072241
PMCID: PMC12091025 (available on 2026-05-01)
DOI: 10.1164/rccm.202409-1824OC

Infection by Clonally Related Mycobacterium abscessus Isolates: The Role of Drinking Water

Rachel M Thomson et al. Am J Respir Crit Care Med. 2025 May.

. 2025 May;211(5):842-853.

doi: 10.1164/rccm.202409-1824OC.

Authors

Affiliations

¹ Greenslopes Clinical School, Gallipoli Medical Research, The University of Queensland, Greenslopes, Queensland, Australia.
² Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia.
³ Wellcome Sanger Institute, Cambridge, United Kingdom.
⁴ Institute of Microbiology and Infection, University of Birmingham, Birmingham, United Kingdom.
⁵ Lung Bacteria Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
⁶ Child Health Research Centre, The University of Queensland, Herston, Queensland, Australia.
⁷ Wellcome Sanger Institute, Genome Campus, Hinxton, United Kingdom.
⁸ Microbiome and Host Health Program, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia.
⁹ College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
¹⁰ Public Health and Epidemiology, SA Pathology, Adelaide, South Australia, Australia.
¹¹ School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom.
¹² The University of Queensland, Greenslopes Clinical School, Gallipoli Medical Research, Greenslopes, Queensland, Australia.
¹³ Respiratory Medicine, Cairns Base Hospital, Cairns, Queensland, Australia.
¹⁴ Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
¹⁵ Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia.
¹⁶ Molecular Immunity Unit, University of Cambridge Department of Medicine MRC-Laboratory of Molecular Biology, Cambridge, United Kingdom.
¹⁷ Cambridge Centre for Lung Infection, Royal Papworth Hospital, Cambridge, United Kingdom.
¹⁸ Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom; and.
¹⁹ Translational Research Institute, Woolloongabba, Queensland, Australia.

PMID: 40072241
PMCID: PMC12091025 (available on 2026-05-01)
DOI: 10.1164/rccm.202409-1824OC

Abstract

Rationale: Mycobacterium abscessus (MABS) group bacteria cause lethal infections in people with chronic lung diseases. Transmission mechanisms remain poorly understood; the detection of dominant circulating clones (DCCs) has suggested the potential for person-to-person transmission. Objectives: This study aimed to determine the role of drinking water in the transmission of MABS. Methods: A total of 289 isolates were cultured from respiratory samples (n = 231) and drinking water sources (n = 58) across Queensland, Australia. Measurements and Main Results: Whole-genome sequences were analyzed to identify DCCs and determine relatedness. Half of the isolates (n = 144; 49.8%) clustered with previously described DCCs, of which 30 formed a clade within DCC5. Pan-genomic analysis of the water-associated DCC5 clade revealed an enrichment of genes associated with copper resistance. Four instances of plausible epidemiological links were identified between genomically related clinical and water isolates. Conclusions: We provide evidence that drinking water is a reservoir for MABS and may be a vector in the chain of MABS infection.

Keywords: Mycobacterium abscessus; bronchiectasis; cystic fibrosis; drinking water; environmental transmission.

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Comment in

doi: 10.1164/rccm.202503-0579ED

References

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Infection by Clonally Related Mycobacterium abscessus Isolates: The Role of Drinking Water

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Infection by Clonally Related Mycobacterium abscessus Isolates: The Role of Drinking Water

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