Mycobacterium avium in Community and Household Water, Suburban Philadelphia, Pennsylvania, USA, 2010–2012

• Main Authors: Leah Lande, David C. Alexander, Richard J. Wallace, Rebecca Kwait, Elena Iakhiaeva, Myra Williams, Andrew D.S. Cameron, Stephen Olshefsky, Ronit Devon, Ravikiran Vasireddy, Donald D. Peterson, Joseph O. Falkinham
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2019-03-01
• Series: Emerging Infectious Diseases
• Subjects: Nontuberculous mycobacteria; Mycobacterium avium household biofilms; VNTR; Mycobacterium avium water; genome sequencing; Philadelphia
• Online Access: https://wwwnc.cdc.gov/eid/article/25/3/18-0336_article
• ISSN: 1080-6040; 1080-6059

Attention to environmental sources of Mycobacterium avium complex (MAC) infection is a vital component of disease prevention and control. We investigated MAC colonization of household plumbing in suburban Philadelphia, Pennsylvania, USA. We used variable-number tandem-repeat genotyping and whole-genome sequencing with core genome single-nucleotide variant analysis to compare M. avium from household plumbing biofilms with M. avium isolates from patient respiratory specimens. M. avium was recovered from 30 (81.1%) of 37 households, including 19 (90.5%) of 21 M. avium patient households. For 11 (52.4%) of 21 patients with M. avium disease, isolates recovered from their respiratory and household samples were of the same genotype. Within the same community, 18 (85.7%) of 21 M. avium respiratory isolates genotypically matched household plumbing isolates. Six predominant genotypes were recovered across multiple households and respiratory specimens. M. avium colonizing municipal water and household plumbing may be a substantial source of MAC pulmonary infection.