PT  - JOURNAL ARTICLE
AU  - Wetzstein, Nils
AU  - Diricks, Margo
AU  - Andres, Sönke
AU  - Kuhns, Martin
AU  - Marschall, Lisa
AU  - Biciusca, Teodora
AU  - Smaczny, Christina
AU  - Friesen, Inna
AU  - Niemann, Stefan
AU  - Wichelhaus, Thomas A.
TI  - Genomic diversity and clinical relevance of <em>Mycobacterium simiae</em>
AID  - 10.1183/23120541.00773-2023
DP  - 2024 Mar 01
TA  - ERJ Open Research
PG  - 00773-2023
VI  - 10
IP  - 2
4099  - http://openres.ersjournals.com/content/10/2/00773-2023.short
4100  - http://openres.ersjournals.com/content/10/2/00773-2023.full
SO  - erjor2024 Mar 01; 10
AB  - Introduction Mycobacterium simiae is a slow-growing non-tuberculous mycobacterium that can cause non-tuberculous mycobacterium (NTM) pulmonary disease and extrapulmonary infections. Until now, detailed genomic and clinical characteristics, as well as possible transmission routes of this rare pathogen remain largely unknown.Methods We conducted whole genome sequencing of available M. simiae isolates collected at a tertiary care centre in Central Germany from 2006 to 2020 and set them into context with publicly available M. simiae complex sequences through phylogenetic analysis. Resistance, virulence and stress genes, as well as known Mycobacteriaceae plasmid sequences were detected in whole genome raw reads. Clinical data and course were retrieved and correlated with genomic data.Results We included 33 M. simiae sensu stricto isolates from seven patients. M. simiae showed low clinical relevance with only two patients fulfilling American Thoracic Society (ATS) criteria in our cohort and three receiving NTM-effective therapy. The bacterial populations were highly stable over time periods of up to 14 years, and no instances of mixed or re-infections with other strains of M. simiae were observed. Clustering with <12 single nucleotide polymorphisms distance was evident among isolates from different patients; however, proof for human-to-human transmission could not be established from epidemiological data.Conclusion Overall, the available sequence data for M. simiae complex was significantly extended and new insights into its pathogenomic traits were obtained. We demonstrate high longitudinal genomic stability within single patients. Although we cannot exclude human-to-human transmission, we consider it unlikely in the light of available epidemiological data.Mycobacterium simiae is a rare cause of NTM pulmonary disease. This study demonstrates high longitudinal genomic stability of the pathogen, as well as low clinical relevance in this cohort. https://bit.ly/3SFl9kL