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Transmission mechanisms remain poorly understood; the detection of dominant circulating clones (DCCs) has suggested the potential for person-to-person transmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to determine the role of drinking water in the transmission of MABS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 289 isolates were cultured from respiratory samples (n\u2009=\u2009231) and drinking water sources (n\u2009=\u200958) across Queensland, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Whole-genome sequences were analyzed to identify DCCs and determine relatedness. Half of the isolates (n\u2009=\u2009144; 49.8%) clustered with previously described DCCs, of which 30 formed a clade within DCC5. Pan-genomic analysis of the water-associated DCC5 clade revealed an enrichment of genes associated with copper resistance. Four instances of plausible epidemiological links were identified between genomically related clinical and water isolates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We provide evidence that drinking water is a reservoir for MABS and may be a vector in the chain of MABS infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202409-1824oc","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T10:17:16Z","timestamp":1741774636000},"page":"842-853","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":17,"title":["Infection by Clonally Related\n                    <i>Mycobacterium abscessus<\/i>\n                    Isolates: The Role of Drinking Water"],"prefix":"10.1093","volume":"211","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0686-171X","authenticated-orcid":false,"given":"Rachel M.","family":"Thomson","sequence":"first","affiliation":[{"name":"Greenslopes Clinical School, Gallipoli Medical Research, The University of Queensland, Greenslopes, Queensland, Australia"},{"name":"Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4599-9164","authenticated-orcid":false,"given":"Nicole","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Wellcome Sanger Institute, Cambridge, United Kingdom"},{"name":"Institute of Microbiology and Infection, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0142-7458","authenticated-orcid":false,"given":"Rebecca E.","family":"Stockwell","sequence":"additional","affiliation":[{"name":"Lung Bacteria Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia"},{"name":"Child Health Research Centre, The University of Queensland, Herston, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0149-5768","authenticated-orcid":false,"given":"Josephine","family":"Bryant","sequence":"additional","affiliation":[{"name":"Wellcome Sanger Institute, Genome Campus, Hinxton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-8243","authenticated-orcid":false,"given":"Steven L.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Microbiome and Host Health Program, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia"},{"name":"College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5073-2272","authenticated-orcid":false,"given":"Lex E. 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