LATE-BREAKING ABSTRACT: Poor outcome following lung transplantation in CF patients infected with mycobacterium abscessus appears to be associated with two genetic clusters of mycobacterium abscessus subspecies abscessus

Abstract

Mycobacterium abscessus is associated with poor outcome following lung transplantation. We investigated whether outcome was related to subspecies and genetic cluster. CF patients transplanted at GOSH from 2004 – 2016 were retrospectively examined. Medical notes, microbiology, radiology databases and operative notes were reviewed. All M. abscessus isolates identified to subspecies level by PCR sequencing and genetic cluster determined by variable number tandem repeat (VNTR) profiling and whole genome sequencing. 11 patients with chronic M. abscessus infection (AAFB smear positive) underwent bilateral lung transplantation. Outcomes are shown in table. Dramatically worse outcomes were seen in patients infected with M. abscessus subspecies abscessus, genetic clusters VNTR I and II, compared with other strains. We have reported for the first time an association between lung transplant outcome in CF patients and M. abscessus genetic cluster and advise great caution in transplanting patients infected with genetic clusters VNTR I or II. However, patients infected with other M. abscessus strains appear to have acceptable outcomes.