Population Genomics and Inference of Mycobacterium avium Complex Clusters in Cystic Fibrosis Care Centers, United States
Nabeeh A. Hasan1
, Rebecca M. Davidson1
, L. Elaine Epperson, Sara M. Kammlade, Sean Beagle, Adrah R. Levin, Vinicius Calado de Moura, Joshua J. Hunkins, Natalia Weakly, Scott D. Sagel, Stacey L. Martiniano, Max Salfinger, Charles L. Daley, Jerry A. Nick, and Michael Strong
Author affiliations: National Jewish Health, Denver, Colorado, USA (N.A. Hasan, R.M. Davidson, L.E. Epperson, S.M. Kammlade, S. Beagle, A.R. Levin, V. Calado de Moura, J.J. Hunkins, N. Weakly, C.L. Daley, J.A. Nick, M. Strong); University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado, USA (S.D. Sagel, S.L. Martiniano); University of South Florida College of Public Health and Morsani College of Medicine, Tampa, Florida, USA (M. Salfinger)
Figure 5. Polyclonal Mycobacterium avium complex (MAC) infections in 15 persons with CF in a study of MAC clusters in CF centers, United States. Persons with CF who had >1 MAC isolate were analyzed for the presence of multiple strains within a given MAC species. For M. avium (top) and M. intracellulare subsp. intracellulare (bottom), each row on the y-axis is a person with CF, and the x-axis represents the number of days after the first MAC isolate with whole-genome sequencing was collected. Each point represents a sequenced isolate and the shape represents a unique genotype. The plots do not represent all positive cultures in the patients’ histories, but they illustrate how strains change, alternate, or both over time. In some cases, different strains were isolated on the same day or within a 1-week period. CF, cystic fibrosis.
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