Longitudinal Assessment of Clinical Pulmonary Mycobacterium Avium Isolates in Treated Patients Using Whole Genome Sequencing

What this Trial Is About

Researchers are investigating why some patients with Mycobacterium avium pulmonary disease (Mav-PD) continue to have positive sputum cultures despite treatment or experience a return to positive cultures after initially testing negative. This observational study uses whole genome sequencing (WGS) to determine if new strains of M. avium are causing persistent or recurrent infections. The study also examines differences between participants living in the Toronto/York region and those living elsewhere. Participants will undergo WGS testing on M. avium isolates collected from their sputum before treatment and every three months during treatment until the sputum becomes culture-negative. If sputum cultures become positive again, those isolates will also be analyzed by WGS. Additionally, samples from the participants' home water environment, such as faucets and showerheads, will be collected and analyzed to see if the same strains are present. All participants will receive standard care treatment as determined by their doctors. During the study, participants will provide sputum samples monthly and home environmental samples will be collected. Researchers will analyze these samples to identify the presence of M. avium strains and to understand if infections are due to treatment failure or new infections. The primary outcome measures the proportion of patients with persistent positive sputum cultures over 24 months. Secondary outcomes include detecting multiple strains in sputum and identifying home sources of infection. The study will last up to 24 months, with ongoing monitoring of participants' sputum and environmental samples.

M. Avium WGS During Mav-PD Treatment