Understanding the Landscape of Antimicrobial Resistance and Virulence Determinants in Mycobacterium Abscessus through Pan-Genome Analysis

Abstract

Mycobacterium abscessus is an opportunistic pathogen that belongs to the Nontuberculous mycobacteria group. MAB was not identified as a pathogen until 40 years after it was discovered. However, its prevalence has risen over time. MAB primarily affects patients with underlying conditions such as cystic fibrosis, chronic pulmonary obstructive disorder, and bronchiectasis, frequently resulting in a decline in lung function. MAB has been linked to outbreaks of soft tissue infections and infections after cosmetic surgery, in addition to causing pulmonary infections. MAB is resistant to a variety of medications, including macrolides, tetracyclines, beta-lactams, and aminoglycosides. MAB is naturally resistant to anti-TB medications like rifabutin, clofazimine, and bedaquiline.Mycobacterium abscessus subsp. abscessus (MAA), Mycobacterium abscessus subsp. massiliense (MAM), and Mycobacterium abscessus subsp. bolletii (BOL) are the three subspecies of MAB. The resistance phenotypes of these three subspecies to various drugs differ significantly. As a result of different drug susceptibility profiles, targeted methods for delineating subspecies are important. MAB is found in soil, water, and household plumbing systems and can survive inside amoebas. It was long thought that MAB was acquired from the environment. However, efforts to sequence the entire genome have revealed evidence of possible human-to-human transmission via genetically similar clusters known as dominant circulating clones. These DCC have been repeatedly attributed for MAB's nationwide and rare intercontinental spread. MAB infection incidences are typically underreported, particularly in TB-epidemic countries like India, due to overlapping symptoms such as nodular lesions that mimic TB lung condition and association with other comorbidities such as COPD and CF. Because MAB can acquire genes from other microorganisms, the possibility of developing antimicrobial resistance genes and virulence factors