TB or not TB: emerging mycobacteriaceae detected in a human patient, tree shrews, and soil

Abstract

This study investigated the extrapulmonary pathogenesis of a novel Mycobacteroides abscessus subsp. massiliense strain in a young adult, manifesting as a chronic cutaneous infection. Epidemiological investigation proposed pathogen transmission via contaminated Java apple fruit, likely facilitated by tree shrews. The strain, identified through next-generation sequencing, demonstrated resistance to 76.7% of tested antibiotics, and potential heteroresistance among the M. abscessus subsp. massiliense subpopulations were suggested. Mycobacteroides abscessus complex (MAC) is a group of non-tuberculous mycobacteria, typically associated with soil and water, and poses significant clinical challenges due to its resistance to conventional treatments and its similarity to Mycobacterium tuberculosis. The findings underscore the necessity for further genetic studies to confirm heteroresistant subpopulations and address the complexities of MAC infections.