Stable Mycobacterium avium infections of several Acanthamoeba strains were characterized by increased infection resistance of recent environmental isolates and reduced infectivity in the presence of other bacteria. Exposure of M. avium in coculture with Acanthamoeba castellanii to monochloramine yielded inactivation kinetics markedly similar to those observed for A. castellanii alone.Acanthamoebae are widely distributed in the environment (20) and generally function ecologically as predators of bacteria (23), although numerous types of bacteria resist predation (22). Acanthamoebae are very resistant to a range of disinfectants (5,6,8,28), and bacteria within acanthamoebae are generally afforded extra protection (16). A notable example is the opportunistic pathogen Mycobacterium avium (10), which can survive within Acanthamoeba species trophozoites and cysts (4, 26), resulting in increased resistance to several antimicrobials (22). It has been demonstrated that many Mycobacterium spp. are able to infect the laboratory strain Acanthamoeba polyphaga (1). Acanthamoeba cultures undergo many physiological changes after several passages in the laboratory (15,17,21), although it is not known if prolonged cultivation of Acanthamoeba alters their capacity to be infected by M. avium. This knowledge is important for assessing the environmental relevance of associations between Acanthamoeba and M. avium. Therefore, we studied the infectivity and infection stability of M. avium with several laboratory and environmental Acanthamoeba strains for 28 days under high-nutrient (peptone-yeast extract-glucose [PYG] medium) and low-nutrient (Page's amoeba saline [PAS]) conditions. M. avium infections in different Acanthamoeba strains. Eight Acanthamoeba strains were studied, four of which were recently isolated from the environment (biofilm from a drinking water distribution system, forest soil, and two from marsh sediment) and four "laboratory strains" which had been passaged many times on nutrient-rich medium (see Table S1 in the supplemental material). Fresh isolates (Ͻ2 months) were passaged no more than three times and were determined to be free of endosymbionts and acid-fast stained structures, by the use of methods described previously (13). The strains were classified to genotype according to the 95% sequence similarity threshold for 18S rRNA genes (27) using standard methods (11, 13). All strains were members of sequence type T4 (24), with the exception of Acanthamoeba sp. strain F2B (type T13) and Acanthamoeba hatchetii (type 11) (GenBank accession no. FJ807647 to FJ807651) (see Fig. S1 in the supplemental material). Mycobacterium avium subsp. hominissuis 104 (2) was cultured on Middlebrook 7H9/OADC (oleic acid-albumin-dextrose-catalase) broth (Sigma-Aldrich). M. avium was added to Acanthamoeba monolayers at a multiplicity of infection of 10:1 and treated with amikacin as described previously (4). Cocultures were incubated at 20°C in the dark and were washed and treated weekly with amikacin to minimize the potential for extr...