{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:59:51Z","timestamp":1783036791994,"version":"3.54.6"},"reference-count":29,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Asmarley Trust"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2022,10,23]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Non-tuberculous mycobacteria (NTM) are environmental microorganisms and opportunistic pathogens in individuals with pre-existing lung conditions such as cystic fibrosis (CF) and non-CF bronchiectasis. While recent studies of<jats:italic>Mycobacterium abscessus<\/jats:italic>have identified transmission within single CF centres as well as nationally and globally, transmission of other NTM species is less well studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To investigate the potential for transmission of the<jats:italic>Mycobacterium avium<\/jats:italic>complex (MAC) we sequenced 996 isolates from 354 CF and non-CF patients at the Royal Brompton Hospital (London, UK; collected 2013\u20132016) and analysed them in a global context. Epidemiological links were identified from patient records. Previously published genomes were used to characterise global population structures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified putative transmission clusters in three MAC species, although few epidemiological links could be identified. For<jats:italic>M. avium<\/jats:italic>, lineages were largely limited to single countries, while for<jats:italic>Mycobacterium chimaera<\/jats:italic>, global transmission clusters previously associated with heater-cooler units (HCUs) were found. However, the immediate ancestor of the lineage causing the major HCU-associated outbreak was a lineage already circulating in patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CF and non-CF patients shared transmission chains, although the lack of epidemiological links suggested that most transmission is indirect and may involve environmental intermediates or asymptomatic carriage in the wider population.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.01237-2022","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T16:35:19Z","timestamp":1671035719000},"page":"2201237","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["<i>M<\/i><i>ycobacterium avium<\/i>complex genomics and transmission in a London 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