Evolving bacteria a global threat to cystic fibrosis patients

Mycobacterium abscessus is drug resistant and resists conventional cleaning methods

A multi-drug resistant infection is spreading around the world among cystic fibrosis patients.

It is not known how the life-threatening infection has moved so quickly from continent to continent, and aside from resisting most known drugs, conventional cleaning is not enough to eliminate the pathogen.

A detailed genetic analysis of the organism, Mycobacterium abscessus, has been carried out by the University of Cambridge and the Wellcome Trust Sanger Institute..

They determined that the organism has managed to become a global threat to those with CF and other lung diseases, and published their findings on Thursday in the journal Science.

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“It is in Ireland all right, but it is in very small numbers,” said Philip Watt, chief executive of the Cystic Fibrosis Association of Ireland.

"The clinicians here are very concerned about abscessus and are monitoring people very closely," he said.

“My strong sense is that the clinicians are on top of it and are looking for it.”

The association was “reassured” by the approach taken so far, he said.

Highest per capita rate

Ireland has the highest per capita rate of CF in the world. It is an inherited condition that arises when both parents are positive for the CF gene.

The Cambridge/Sanger study sequenced the entire DNA of 1,000 samples of the organism collected from 517 people attending CF centres in Europe, the US and Australia.

These DNA fingerprints showed the organism had gone global. It also showed that it was becoming more dangerous as it evolves.

It can trigger severe pneumonia and is difficult to counter, with fewer than one in three cases being treated successfully, the researchers said.

The thinking was the organism emerged naturally in the environment but then evolved to jump from person to person, gaining in strength as it does so, the researchers said.

It resists conventional cleaning and transmission is also believed to have been passed on from contact with surfaces and by airborne transmission.

“It would be a threat to our patients,” said Mr Watt. “That is why we work so hard for dedicated CF facilities in Ireland and why we pay for them as well.”

Dick Ahlstrom

Dick Ahlstrom

Dick Ahlstrom, a contributor to The Irish Times, is the newspaper's former Science Editor.