TB or not TB: emerging mycobacteriaceae detected in a human patient, tree shrews, and soil

Abstract This study investigated the extrapulmonary pathogenesis of a novel Mycobacteroides abscessus subsp. massiliense strain in a young adult, manifesting as a chronic cutaneous infection. Epidemiological investigation proposed pathogen transmission via contaminated Java apple fruit, likely facilitated by tree shrews. The strain, identified through next-generation sequencing, demonstrated resistance to 76.7% of tested antibiotics, and potential heteroresistance among the M. abscessus subsp. massiliense subpopulations were suggested. Mycobacteroides abscessus complex (MAC) is a group of non-tuberculous mycobacteria, typically associated with soil and water, and poses significant clinical challenges due to its resistance to conventional treatments and its similarity to Mycobacterium tuberculosis . The findings underscore the necessity for further genetic studies to confirm heteroresistant subpopulations and address the complexities of MAC infections.