People with Cystic Fibrosis are prone to serious infection in part because they have sticky mucus that can clog up their lungs. In recent years doctors have seen a global increase in the number of infections caused by the antibiotic-resistant bacterial species Mycobacterium abscessus (M. abscessus). M. abscessus is distantly related to the bacterium that causes Tuberculosis and is usually found in water and soil. Until now, experts had thought it could not be passed from person to person.
“There has been worldwide concern about the rising number of M. abscessus infections in people with Cystic Fibrosis and anxiety that spread from person to person might be responsible,” said Dr Andres Floto, Research Director of the Cystic Fibrosis Unit at Papworth Hospital, Principal Investigator at the Cambridge Institute for Medical Research, University of Cambridge and lead author of the research published in The Lancet.
“Our work has allowed us to lead the world in changing hospital infection control: we used state-of-the-art DNA sequencing technology to understand how the infection is being spread, which conventional techniques would have missed.”
“Our results will help to protect patients from this serious infection.”
The team used the latest methods to sequence the genomes of almost 170 isolates of M. abscessus from Cystic Fibrosis patients collected over a five-year period. By looking at the fine detail of the relationships between the bacterial genomes, to produce a ‘family tree’, the research team could determine where it was likely that infection had passed from one patient to another. They showed that, even with nationally recommended infection control measures in place, M. abscessus can spread between patients.
“We are increasingly able to use DNA studies to improve patient care,” says Professor Julian Parkhill, Head of Pathogen Genomics at the Wellcome trust Sanger Institute. “By sequencing the complete genomes of bacteria we can accurately describe where they have emerged from and how they pass from person to person.
“This knowledge means that the clinical teams can develop new health measures to safeguard their patients. Our aim is to develop the best methods to detect and control infection.”
This new information has led to rapid changes in how people with Cystic Fibrosis are cared for in hospital to protect them from this emerging threat.
Publication details
Josephine M. Bryant, Dorothy M. Grogono, Daniel Greaves, Juliet Foweraker, Iain Roddick, Thomas Inns, Mark Reacher, Charles S. Haworth, Martin D. Curran, Simon R. Harris1, Sharon J. Peacock, Julian Parkhill1and R. Andres Floto. (2013) ‘Evidence for transmission of Mycobacterium abscessus between Cystic Fibrosis patients from whole-genome sequencing.
Published in the Lancet online 29 March 2013. doi: 10.1016/S0140-6736(13)60632-7,
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60632-7/abstract
Funding
This work was supported by The Wellcome Trust, Papworth Hospital, NIHR Cambridge Biomedical Research Centre, The UK Health Protection Agency, Medical Research Council, and the UKCRC Translational Infection Research Initiative.
Participating centres
1. Wellcome Trust Sanger Institute, Hinxton, UK
2. Cambridge Institute for Medical Research, University of Cambridge, UK
3. Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, UK
4. Department of Medicine, University of Cambridge, UK
5. Health Protection Agency, Addenbrooke’s Hospital, Cambridge, UK
6. HPA Health Protection Agency East of England Regional Epidemiology Unit, UK
7. HPA, Norfolk, Suffolk & Cambridgeshire Health Protection Unit, UK
8. Field Epidemiology Training Programme (FETP), Health Protection Agency, London, UK
Dr Andres Floto
Andres is the Research Director of the Cambridge Centre for Lung Infection, Papworth Hospital and a Principal Investigator and Wellcome Trust Senior Clinical Fellow at the Cambridge Institute for Medical Research, University of Cambridge. He specialises in the treatment of patients with Cystic Fibrosis (CF), non-CF bronchiectasis, and infections with Nontuberculous Mycobacteria (NTM).
His major research interests lie in understanding the host response to bacterial infection, particularly with NTM, and how to modulate it therapeutically. He is co-chair of the British Thoracic Society NTM guidelines committee, the joint US CF Foundation-European CF Society (ECFS) NTM Guidelines Group and the ECFS working group on NTM.
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For further information please contact:
Don Powell, Media Manager, Wellcome Trust Sanger Institute Hinxton, Cambridge, CB10 1SA, UK
Tel +44 (0)1223 496 928
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Email press.office@sanger.ac.uk
Kate Lancaster, Papworth Hospital
Tel +44 (0)1480 364148
Mobile +44 (0) 07850 918627
Email Kate.lancaster@papworth.nhs.uk
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