Lande, LeahAlexander, David C.Wallace, Richard J. Jr.Kwait, RebeccaIakhiaeva, ElenaWilliams, Myra D.Cameron, Andrew D. S.Olshefsky, StephenDevon, RonitVasireddy, RavikiranPeterson, Donald D.Falkinham, Joseph O. III2019-08-192019-08-192019-031080-6040http://hdl.handle.net/10919/93182Attention to environmental sources of Mycobacterium avium complex (MAC) infection is a vital component of disease prevention and control. We investigated MAC colonization of household plumbing in suburban Philadelphia, Pennsylvania, USA. We used variable-number tandemrepeat genotyping and whole-genome sequencing with core genome single-nucleotide variant analysis to compare M. avium from household plumbing biofilms with M. avium isolates from patient respiratory specimens. M. avium was recovered from 30 (81.1%) of 37 households, including 19 (90.5%) of 21 M. avium patient households. For 11 (52.4%) of 21 patients with M. avium disease, isolates recovered from their respiratory and household samples were of the same genotype. Within the same community, 18 (85.7%) of 21 M. avium respiratory isolates genotypically matched household plumbing isolates. Six predominant genotypes were recovered across multiple households and respiratory specimens. M. avium colonizing municipal water and household plumbing may be a substantial source of MAC pulmonary infection.application/pdfenCreative Commons CC0 1.0 Universal Public Domain Dedicationlung-diseasenontuberculous mycobacteriasubsp hominissuiscomplexintracellulareepidemiologyinfectionvntrestablishmentemergenceArticle - Refereedhttps://doi.org/10.3201/eid2503.180336253307891301080-6059