Dataset Information

Mycobacterium avium in Community and Household Water, Suburban Philadelphia, Pennsylvania, USA, 2010-2012.

ABSTRACT: Attention to environmental sources of Mycobacterium avium complex (MAC) infection is a vital component of disease prevention and control. We investigated MAC colonization of household plumbing in suburban Philadelphia, Pennsylvania, USA. We used variable-number tandem-repeat genotyping and whole-genome sequencing with core genome single-nucleotide variant analysis to compare M. avium from household plumbing biofilms with M. avium isolates from patient respiratory specimens. M. avium was recovered from 30 (81.1%) of 37 households, including 19 (90.5%) of 21 M. avium patient households. For 11 (52.4%) of 21 patients with M. avium disease, isolates recovered from their respiratory and household samples were of the same genotype. Within the same community, 18 (85.7%) of 21 M. avium respiratory isolates genotypically matched household plumbing isolates. Six predominant genotypes were recovered across multiple households and respiratory specimens. M. avium colonizing municipal water and household plumbing may be a substantial source of MAC pulmonary infection.

SUBMITTER: Lande L

PROVIDER: S-EPMC6390762 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Mycobacterium avium in Community and Household Water, Suburban Philadelphia, Pennsylvania, USA, 2010-2012.

Lande Leah L Alexander David C DC Wallace Richard J RJ Kwait Rebecca R Iakhiaeva Elena E Williams Myra M Cameron Andrew D S ADS Olshefsky Stephen S Devon Ronit R Vasireddy Ravikiran R Peterson Donald D DD Falkinham Joseph O JO

Emerging infectious diseases 20190301 3

Attention to environmental sources of Mycobacterium avium complex (MAC) infection is a vital component of disease prevention and control. We investigated MAC colonization of household plumbing in suburban Philadelphia, Pennsylvania, USA. We used variable-number tandem-repeat genotyping and whole-genome sequencing with core genome single-nucleotide variant analysis to compare M. avium from household plumbing biofilms with M. avium isolates from patient respiratory specimens. M. avium was recovere ...[more]

PMID: 30789130

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Project description:CTX-M beta-lactamases were thought to be rare in the United States, but a recent study in Texas showed that up to 70% of extended-spectrum beta-lactamase (ESBL)-containing members of the Enterobacteriaceae family were CTX-M positive (J. S. Lewis, M. Herrera, B. Wickes, J. E. Patterson, and J. H. Jorgensen, Antimicrob. Agents Chemother. 51:4015-4021, 2007). We used PCR to detect CTX-M in all 291 extended-spectrum cephalosporin-resistant gram-negative bacteria isolated in our laboratory during 2007. Thirty (48%) Escherichia coli isolates, 6 (3%) Klebsiella sp. isolates, and 7 (100%) Proteus mirabilis isolates tested were CTX-M positive, with 15% of all Enterobacteriaceae tested being positive. The E. coli CTX-M groups were I (57%), IV (37%), II (3%), and not groupable (3%); three of the group IV isolates were positive for CTX-M-18, and three of the group I isolates were positive for CTX-M-15. One of seven positive P. mirabilis isolates was in group II, with the remainder being positive for a CTX-M-25-like beta-lactamase; and 33% of the Klebsiella sp. isolates were in group I or IV, with the remainder not being in groups I to IV. CTX-M-producing bacteria were isolated from urine (n = 13), blood (n = 13), wounds (n = 12), and the respiratory tract (n = 4). All 31 CTX-M-positive isolates tested for the presence of ESBL were confirmed to produce ESBLs by the use of tests recommended by the CLSI. Pulsed-field gel electrophoresis of the CTX-M-positive isolates showed that six P. mirabilis isolates were clonal and that there were seven different E. coli clusters. Five of seven P. mirabilis isolates were from blood cultures. The CLSI tests for the confirmation of ESBL production reliably detect these isolates if both cefotaxime and ceftazidime are tested, but only about half would be classified as a possible CTX-M producers on the basis of the antibiogram alone. A new panprimer set increases the ability to detect CTX-M-producing strains. CTX-M-positive bacteria are common in our geographic region, are often invasive, and, with the exception of P. mirabilis, are multiclonal.

Project description:BackgroundPeople who use drugs (PWUD) are at increased risk for blood-borne viruses, including hepatitis B (HBV) and delta (HDV). Despite the public health threats both viruses present, awareness remains low among at-risk communities and providers who serve them. This study assessed barriers to HBV and HDV prevention, diagnosis, and linkage to care, evaluated existing levels of knowledge, and identified educational needs and preferences among both PWUD and service providers.MethodsFor this mixed-methods study, data were collected through an anonymous online provider-focused survey, and interviews with PWUD, non-medical staff, and healthcare providers at a harm reduction organization in Philadelphia, PA, USA. Convenience sampling was used for recruitment of both key informants and survey respondents. Survey respondents were categorized according to their type of practice. For the interviews, a codebook was created for qualitative analysis. Data were subsequently organized into thematic categories.ResultsThe top provider-related barriers limiting HBV screening were identified as confusion about insurance coverage (48%) and competing priorities (45%). Barriers to vaccination included patient hesitancy (52%) and challenges with administering multiple doses (39%). Respondents indicated low knowledge of HDV tests (62%) and cited guideline complexity (31%) as barriers to HDV testing. HBV and HDV awareness within the community and among staff was poor. Findings demonstrated that stigma related to drug use and harm reduction posed a significant barrier to care. Participants recommended awareness campaigns tailored for the PWUD community that are non-stigmatizing and non-judgmental, clear, factual, digestible, and interactive, with empowering steps to protect health.ConclusionThis study identified major gaps in HBV and HDV service delivery for PWUD, including poor basic knowledge, the need to address this through culturally appropriate, non-stigmatizing and tailored educational programming, and challenges with access to vaccination and testing. Continued initiatives are needed to close disparities, and to continue to provide financial and political support for harm reduction organizations, a frequently cited facilitator of healthcare access for PWUD. Significant efforts are essential to address lack of vaccination, testing, and linkage to care, and to improve health outcomes among PWUD.

Dataset Information

Mycobacterium avium in Community and Household Water, Suburban Philadelphia, Pennsylvania, USA, 2010-2012.

Publications

Mycobacterium avium in Community and Household Water, Suburban Philadelphia, Pennsylvania, USA, 2010-2012.

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