A cluster of six respiratory cultures positive for Mycobacterium xenopi –Clinical characteristics and genomic characterization

Kendall David Kling*, Rebecca Osborn, Adil Menon, Janna Lynn Williams, Ryan Cardew, Omar Al-Heeti, Phillip Pasquale Santoiemma, Michael Peter Angarone, Samuel Gatesy, Travis Kochan, Teresa R Zembower, Karen M Krueger, Egon A. Ozer, Chao Qi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Mycobacterium xenopi is a slow growing non-tuberculous mycobacterium (NTM) isolated from water systems and has been associated with pseudo-outbreaks and pulmonary infections in humans. We observed a cluster of six respiratory cultures positive for M. xenopi within a six-month period at our institution, approximately double our normal isolation rate of this organism. Only three of the six cases met clinical, radiographic, and microbiologic criteria for NTM infection. An investigation led by our hospital's Healthcare Epidemiology and Infection Program found no epidemiologic link between the six patients. Three isolates underwent whole-genome sequencing (WGS) and phylogenetic analysis confirmed they were non-clonal. In vitro susceptibility data found the isolates were sensitive to macrolides, moxifloxacin, and rifabutin. Our findings suggest that isolation of M. xenopi from pulmonary specimens may be increasing, further defines the genomic population structure of this potentially emerging infection, and establishes WGS as a useful tool for outbreak investigation strain typing.

Original languageEnglish (US)
Article number100397
JournalJournal of Clinical Tuberculosis and Other Mycobacterial Diseases
StatePublished - Dec 2023


  • Mycobacterium xenopi
  • Non-tuberculous mycobacteria
  • Whole-genome sequencing

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pulmonary and Respiratory Medicine


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