{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:46:48Z","timestamp":1785433608603,"version":"3.56.0"},"reference-count":50,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100009139","name":"Deutsches Zentrum f\u00fcr Infektionsforschung","doi-asserted-by":"publisher","award":["TI 07.001_001"],"award-info":[{"award-number":["TI 07.001_001"]}],"id":[{"id":"10.13039\/100009139","id-type":"DOI","asserted-by":"publisher"}]},{"name":"BMFTR","award":["01EO2102"],"award-info":[{"award-number":["01EO2102"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,3,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Mycobacterium xenopi<\/jats:italic>\n                      causes non-tuberculous mycobacterial pulmonary disease (NTM-PD) that is difficult to treat. However, data on the genomic population structure, antimicrobial susceptibility, and the clinical significance of this pathogen remain scarce. We analyzed 76 clinical\n                      <jats:italic toggle=\"yes\">M. xenopi<\/jats:italic>\n                      isolates from 70 patients collected between 1995 and 2020 in Frankfurt am Main, Germany. All isolates underwent phenotypic drug susceptibility testing and whole-genome sequencing. Cluster analysis, including isolates from this study and all hitherto available high-quality\n                      <jats:italic toggle=\"yes\">M. xenopi<\/jats:italic>\n                      genome data sets in the Sequence Read Archive (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11), was performed by core genome multilocus sequence typing. In our cohort, only 26.5% of patients met criteria for clinically relevant NTM-PD. Phylogenetic analysis identified three large hospital-associated clusters (\u226410 allelic difference), each involving between 7 and 20 patients and persisting for over 18 years, suggesting prolonged transmission chains or a common environmental source. We also defined three major clades (\u226450 allelic difference), two of which contained isolates from the United Kingdom. Clofazimine and guideline-recommended antimycobacterial agents showed good\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      efficacy, except rifampicin, with 23.6% resistance. This study represents a major expansion of\n                      <jats:italic toggle=\"yes\">M. xenopi<\/jats:italic>\n                      genomic resources and provides insights into the genomic population structure, phenotypic susceptibility, and clinical characteristics of\n                      <jats:italic toggle=\"yes\">M. xenopi<\/jats:italic>\n                      . Guideline-recommended antimycobacterials show good\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      activity, while clofazimine may be a valuable addition to\n                      <jats:italic toggle=\"yes\">M. xenopi<\/jats:italic>\n                      therapy. The identified clusters underscore the need for further investigation into transmission dynamics and globally successful clones.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        <jats:italic toggle=\"yes\">Mycobacterium xenopi<\/jats:italic>\n                        is an increasingly recognized opportunistic lung pathogen that is difficult to treat. Infections often occur in patients with pre-existing health conditions and can present substantial diagnostic and therapeutic challenges. A deeper understanding of its genetic diversity and resistance mechanisms is essential for optimal patient management and for clarifying potential transmission routes. By analyzing 76 whole-genome sequences together with detailed clinical information and phenotypic drug-susceptibility data, this study substantially expands the available genomic repertoire for\n                        <jats:italic toggle=\"yes\">M. xenopi<\/jats:italic>\n                        . While clinical relevance was limited in our cohort, most guideline-recommended antimicrobial agents showed good efficacy\n                        <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                        . The detection of closely related strains might point toward a common environmental source of infection. These findings highlight the need for continued surveillance and provide a comprehensive foundation that supports more accurate monitoring, improved understanding of disease behavior, and future investigations into\n                        <jats:italic toggle=\"yes\">M. xenopi<\/jats:italic>\n                        pathogenicity.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.01511-25","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T13:00:57Z","timestamp":1770642057000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Genomic population structure, antimicrobial susceptibility, and clinical features of\n                    <i>Mycobacterium xenopi<\/i>\n                    isolates, Frankfurt, Germany, 1995\u20132020"],"prefix":"10.1128","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5428-1456","authenticated-orcid":false,"given":"Margo","family":"Diricks","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/036ragn25","id-type":"ROR","asserted-by":"publisher"}],"name":"Molecular and Experimental Mycobacteriology, Research Center Borstel, Leibniz Lung Center","place":["Borstel, Germany"]},{"id":[{"id":"https:\/\/ror.org\/036ragn25","id-type":"ROR","asserted-by":"publisher"}],"name":"National and WHO Supranational Reference Laboratory for Mycobacteria, Research Center Borstel, Leibniz Lung Center","place":["Borstel, Germany"]},{"name":"Leibniz Research Alliance INFECTIONS","place":["Borstel, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Marschall","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04cvxnb49","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Internal 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