Mycobacterium abscessus soft tissue infections associated with subcutaneous injection of lipolytic agents: An outbreak report and novel molecular epidemiology analysis approach.

Authors

Xavier Quan-Nguyen, Nicholas Waglechner, Maxime Veillette, Pier-Alexandre Vasil, Floriane Point, Bouchra Tannir, Melissa Zarandi-Nowroozi, Catherine Tsimiklis, Nadine Pétrin, Marty Teltscher, Anna Urbanek, Pierre-Marie Akochy, Joseph Cox, Robyn Lee, Simon Grandjean Lapierre

Published in

Canada communicable disease report = Releve des maladies transmissibles au Canada. Volume 52. Issue 6. Pages 256-263. Epub Jun 30, 2026.

Abstract

Management of Mycobacterium abscessus (M. abscessus) skin and soft tissue infections outbreaks require collaboration between clinicians, public health authorities and reference laboratories providing bacterial molecular identification and genotyping.
This study reports on a M. abscessus skin and soft tissue outbreak linked to mesotherapy treatments in Montréal, Canada. We present an innovative approach combining Nanopore long read and Illumina short read whole-genome sequencing data with a novel open access bioinformatic molecular epidemiology pipeline to support public health investigations by identifying genomically related isolates.
Public health investigations and physician questionnaires were used for outbreak identification and investigation. The complete genomes of six isolates from four individuals were sequenced. Nanopore and Illumina data were combined to assemble genomes de novo using a hybrid approach. Single nucleotide polymorphisms (SNPs) were identified within each genome by mapping the short reads to a reference genome. Single nucleotide polymorphisms distances among isolates, and between isolates and the reference genome were used alongside core SNP alignment analyses to evaluate genetic similarity between isolates and other contemporary M. abscessus genomes.
Identified individuals had received mesotherapy injections from the same esthetician within a one-month period. Outbreak isolates were genomically nearly identical, differing by only 0-2 SNPs when using the earliest collected isolate as a reference. A phylogenetic tree revealed genetic distinctness between outbreak isolates and other contemporary M. abscessus isolates from Montréal.
Genomic sequencing and the presented bioinformatic approach can identify M. abscessus genomic relatedness suggestive of clinical outbreaks. This approach can support public health investigations, particularly when epidemiological links are uncertain.

PMID:
42603027
Bibliographic data and abstract were imported from PubMed on 15 Aug 2026.

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