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Open Access Highly Accessed Research article

Factors associated with the isolation of Nontuberculous mycobacteria (NTM) from a large municipal water system in Brisbane, Australia

Rachel M Thomson1*, Robyn Carter2, Carla Tolson2, Chris Coulter2, Flavia Huygens3 and Megan Hargreaves4

Author Affiliations

1 Gallipoli Medical Research Centre, Greenslopes Private Hospital, Brisbane, QLD, Australia

2 QLD Mycobacterial Reference Laboratory, Pathology Queensland, RBWH Campus, Herston Rd, Herston, QLD 4006, Australia

3 Queensland University of Technology, Institute of Health and Biomedical Innovation, Kelvin Grove Campus, Brisbane, QLD 4059, Australia

4 Queensland University of Technology, Faculty of Science and Technology, George Street, Brisbane, QLD 4001, Australia

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BMC Microbiology 2013, 13:89  doi:10.1186/1471-2180-13-89

Published: 22 April 2013

Abstract

Background

Nontuberculous mycobacteria (NTM) are normal inhabitants of a variety of environmental reservoirs including natural and municipal water. The aim of this study was to document the variety of species of NTM in potable water in Brisbane, QLD, with a specific interest in the main pathogens responsible for disease in this region and to explore factors associated with the isolation of NTM. One-litre water samples were collected from 189 routine collection sites in summer and 195 sites in winter. Samples were split, with half decontaminated with CPC 0.005%, then concentrated by filtration and cultured on 7H11 plates in MGIT tubes (winter only).

Results

Mycobacteria were grown from 40.21% sites in Summer (76/189) and 82.05% sites in winter (160/195). The winter samples yielded the greatest number and variety of mycobacteria as there was a high degree of subculture overgrowth and contamination in summer. Of those samples that did yield mycobacteria in summer, the variety of species differed from those isolated in winter. The inclusion of liquid media increased the yield for some species of NTM. Species that have been documented to cause disease in humans residing in Brisbane that were also found in water include M. gordonae, M. kansasii, M. abscessus, M. chelonae, M. fortuitum complex, M. intracellulare, M. avium complex, M. flavescens, M. interjectum, M. lentiflavum, M. mucogenicum, M. simiae, M. szulgai, M. terrae. M. kansasii was frequently isolated, but M. avium and M. intracellulare (the main pathogens responsible for disease is QLD) were isolated infrequently. Distance of sampling site from treatment plant in summer was associated with isolation of NTM. Pathogenic NTM (defined as those known to cause disease in QLD) were more likely to be identified from sites with narrower diameter pipes, predominantly distribution sample points, and from sites with asbestos cement or modified PVC pipes.

Conclusions

NTM responsible for human disease can be found in large urban water distribution systems in Australia. Based on our findings, additional point chlorination, maintenance of more constant pressure gradients in the system, and the utilisation of particular pipe materials should be considered.