Skip to main content
SpringerLink
Log in

Mycobacterium avium Complex Disease

  • Chapter
  • First Online:
Nontuberculous Mycobacterial Disease

Part of the book series: Respiratory Medicine ((RM))

Abstract

Mycobacterium avium complex (MAC) comprises at least ten named species of environmental mycobacteria that exhibit ecological and geographic diversity. The prominent human pathogens are M. avium, M. intracellulare, and M. chimaera. MAC virulence factors and host susceptibility contribute to pathogenesis. The diagnosis of pulmonary disease requires satisfaction of clinical, microbiologic, and radiographic criteria. Disseminated and localized extrapulmonary diseases are diagnosed by culture of blood or tissue. Treatment of all forms of MAC disease involves protracted administration of multiple antibiotics, including a macrolide. This therapeutic approach achieves initial success in patients with macrolide-susceptible, treatment-naïve pulmonary disease, but microbiologic recurrence is common. Inadequate treatment regimens increase the risk of emergent macrolide resistance which carries a poor prognosis. Parenteral therapy and surgical resection are beneficial for certain forms of pulmonary and extrapulmonary disease. Prophylaxis against MAC infection is strongly recommended in HIV-AIDS.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tortoli E, Rindi L, Garcia MJ, Chiaradonna P, Dei R, Garzelli C, et al. Proposal to elevate the genetic variant MAC-A, included in the Mycobacterium avium complex, to species rank as Mycobacterium chimaera sp. nov. Int J Syst Evol Microbiol. 2004;54(Pt 4):1277–85. https://doi.org/10.1099/ijs.0.02777-0.

    Article  CAS  PubMed  Google Scholar 

  2. Chand M, Lamagni T, Kranzer K, Hedge J, Moore G, Parks S, et al. Insidious risk of severe Mycobacterium chimaera infection in cardiac surgery patients. Clin Infect Dis. 2017;64(3):335–42. https://doi.org/10.1093/cid/ciw754.

    Article  PubMed  Google Scholar 

  3. Murcia MI, Tortoli E, Menendez MC, Palenque E, Garcia MJ. Mycobacterium colombiense sp. nov., a novel member of the Mycobacterium avium complex and description of MAC-X as a new ITS genetic variant. Int J Syst Evol Microbiol. 2006;56(Pt 9):2049–54. https://doi.org/10.1099/ijs.0.64190-0.

    Article  CAS  PubMed  Google Scholar 

  4. Bang D, Herlin T, Stegger M, Andersen AB, Torkko P, Tortoli E, et al. Mycobacterium arosiense sp. nov., a slowly growing, scotochromogenic species causing osteomyelitis in an immunocompromised child. Int J Syst Evol Microbiol. 2008;58(Pt 10):2398–402. https://doi.org/10.1099/ijs.0.65503-0.

    Article  CAS  PubMed  Google Scholar 

  5. Ben Salah I, Cayrou C, Raoult D, Drancourt M. Mycobacterium marseillense sp. nov., Mycobacterium timonense sp. nov. and Mycobacterium bouchedurhonense sp. nov., members of the Mycobacterium avium complex. Int J Syst Evol Microbiol. 2009;59(Pt 11):2803–8. https://doi.org/10.1099/ijs.0.010637-0.

    Article  CAS  PubMed  Google Scholar 

  6. van Ingen J, Boeree MJ, Kosters K, Wieland A, Tortoli E, Dekhuijzen PN, et al. Proposal to elevate Mycobacterium avium complex ITS sequevar MAC-Q to Mycobacterium vulneris sp. nov. Int J Syst Evol Microbiol. 2009;59(Pt 9):2277–82. https://doi.org/10.1099/ijs.0.008854-0.

    Article  PubMed  Google Scholar 

  7. Kim BJ, Math RK, Jeon CO, Yu HK, Park YG, Kook YH, et al. Mycobacterium yongonense sp. nov., a slow-growing non-chromogenic species closely related to Mycobacterium intracellulare. Int J Syst Evol Microbiol. 2013;63(Pt 1):192–9. https://doi.org/10.1099/ijs.0.037465-0.

    Article  PubMed  Google Scholar 

  8. Rindi L, Garzelli C. Genetic diversity and phylogeny of Mycobacterium avium. Infect Genet Evol. 2014;21:375–83. https://doi.org/10.1016/j.meegid.2013.12.007.

    Article  PubMed  Google Scholar 

  9. Tran QT, Han XY. Subspecies identification and significance of 257 clinical strains of Mycobacterium avium. J Clin Microbiol. 2014;52(4):1201–6. https://doi.org/10.1128/JCM.03399-13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Koh WJ, Jeong BH, Jeon K, Lee NY, Lee KS, Woo SY, et al. Clinical significance of the differentiation between Mycobacterium avium and Mycobacterium intracellulare in M avium complex lung disease. Chest. 2012;142(6):1482–8. https://doi.org/10.1378/chest.12-0494.

    Article  PubMed  Google Scholar 

  11. Kim SY, Shin SH, Moon SM, Yang B, Kim H, Kwon OJ, et al. Distribution and clinical significance of Mycobacterium avium complex species isolated from respiratory specimens. Diagn Microbiol Infect Dis. 2017;88(2):125–37. https://doi.org/10.1016/j.diagmicrobio.2017.02.017.

    Article  PubMed  Google Scholar 

  12. Prevots DR, Marras TK. Epidemiology of human pulmonary infection with nontuberculous mycobacteria: a review. Clin Chest Med. 2015;36(1):13–34. https://doi.org/10.1016/j.ccm.2014.10.002.

    Article  PubMed  Google Scholar 

  13. Hoefsloot W, van Ingen J, Andrejak C, Angeby K, Bauriaud R, Bemer P, et al. The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples: an NTM-NET collaborative study. Eur Respir J. 2013;42(6):1604–13. https://doi.org/10.1183/09031936.00149212.

    Article  PubMed  Google Scholar 

  14. Bryant JM, Grogono DM, Greaves D, Foweraker J, Roddick I, Inns T, et al. Whole-genome sequencing to identify transmission of Mycobacterium abscessus between patients with cystic fibrosis: a retrospective cohort study. Lancet. 2013;381(9877):1551–60. https://doi.org/10.1016/S0140-6736(13)60632-7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Telles MA, Yates MD, Curcio M, Ueki SY, Palaci M, Hadad DJ, et al. Molecular epidemiology of Mycobacterium avium complex isolated from patients with and without AIDS in Brazil and England. Epidemiol Infect. 1999;122(3):435–40.

    Article  CAS  Google Scholar 

  16. Taylor RH, Falkinham JO 3rd, Norton CD, LeChevallier MW. Chlorine, chloramine, chlorine dioxide, and ozone susceptibility of Mycobacterium avium. Appl Environ Microbiol. 2000;66(4):1702–5.

    Article  CAS  Google Scholar 

  17. Falkinham JO 3rd, Norton CD, LeChevallier MW. Factors influencing numbers of Mycobacterium avium, Mycobacterium intracellulare, and other mycobacteria in drinking water distribution systems. Appl Environ Microbiol. 2001;67(3):1225–31. https://doi.org/10.1128/AEM.67.3.1225-1231.2001.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Feazel LM, Baumgartner LK, Peterson KL, Frank DN, Harris JK, Pace NR. Opportunistic pathogens enriched in showerhead biofilms. Proc Natl Acad Sci U S A. 2009;106(38):16393–9. https://doi.org/10.1073/pnas.0908446106.

    Article  PubMed  PubMed Central  Google Scholar 

  19. De Groote MA, Pace NR, Fulton K, Falkinham JO 3rd. Relationships between Mycobacterium isolates from patients with pulmonary mycobacterial infection and potting soils. Appl Environ Microbiol. 2006;72(12):7602–6. https://doi.org/10.1128/AEM.00930-06.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Nishiuchi Y, Tamura A, Kitada S, Taguri T, Matsumoto S, Tateishi Y, et al. Mycobacterium avium complex organisms predominantly colonize in the bathtub inlets of patients’ bathrooms. Jpn J Infect Dis. 2009;62(3):182–6.

    CAS  PubMed  Google Scholar 

  21. Falkinham JO 3rd, Iseman MD, de Haas P, van Soolingen D. Mycobacterium avium in a shower linked to pulmonary disease. J Water Health. 2008;6(2):209–13. https://doi.org/10.2166/wh.2008.032.

    Article  PubMed  Google Scholar 

  22. Falkinham JO 3rd. Nontuberculous mycobacteria from household plumbing of patients with nontuberculous mycobacteria disease. Emerg Infect Dis. 2011;17(3):419–24. https://doi.org/10.3201/eid1703.101510.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Wallace RJ Jr, Iakhiaeva E, Williams MD, Brown-Elliott BA, Vasireddy S, Vasireddy R, et al. Absence of Mycobacterium intracellulare and presence of Mycobacterium chimaera in household water and biofilm samples of patients in the United States with Mycobacterium avium complex respiratory disease. J Clin Microbiol. 2013;51(6):1747–52. https://doi.org/10.1128/JCM.00186-13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Chou MP, Clements AC, Thomson RM. A spatial epidemiological analysis of nontuberculous mycobacterial infections in Queensland, Australia. BMC Infect Dis. 2014;14:279. https://doi.org/10.1186/1471-2334-14-279.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Honda JR, Hasan NA, Davidson RM, Williams MD, Epperson LE, Reynolds PR, et al. Environmental Nontuberculous mycobacteria in the Hawaiian islands. PLoS Negl Trop Dis. 2016;10(10):e0005068. https://doi.org/10.1371/journal.pntd.0005068.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kohler P, Kuster SP, Bloemberg G, Schulthess B, Frank M, Tanner FC, et al. Healthcare-associated prosthetic heart valve, aortic vascular graft, and disseminated Mycobacterium chimaera infections subsequent to open heart surgery. Eur Heart J. 2015;36(40):2745–53. https://doi.org/10.1093/eurheartj/ehv342.

    Article  PubMed  Google Scholar 

  27. Sax H, Bloemberg G, Hasse B, Sommerstein R, Kohler P, Achermann Y, et al. Prolonged outbreak of Mycobacterium chimaera infection after open-chest heart surgery. Clin Infect Dis. 2015;61(1):67–75. https://doi.org/10.1093/cid/civ198.

    Article  PubMed  Google Scholar 

  28. Svensson E, Jensen ET, Rasmussen EM, Folkvardsen DB, Norman A, Lillebaek T. Mycobacterium chimaera in heater-cooler units in Denmark related to isolates from the United States and United Kingdom. Emerg Infect Dis. 2017;23(3):507–9. https://doi.org/10.3201/eid2303.161941.

    Article  PubMed  PubMed Central  Google Scholar 

  29. McGarvey JA, Bermudez LE. Phenotypic and genomic analyses of the Mycobacterium avium complex reveal differences in gastrointestinal invasion and genomic composition. Infect Immun. 2001;69(12):7242–9. https://doi.org/10.1128/IAI.69.12.7242-7249.2001.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Stout JE, Hopkins GW, McDonald JR, Quinn A, Hamilton CD, Reller LB, et al. Association between 16S-23S internal transcribed spacer sequence groups of Mycobacterium avium complex and pulmonary disease. J Clin Microbiol. 2008;46(8):2790–3. https://doi.org/10.1128/JCM.00719-08.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Tateishi Y, Hirayama Y, Ozeki Y, Nishiuchi Y, Yoshimura M, Kang J, et al. Virulence of Mycobacterium avium complex strains isolated from immunocompetent patients. Microb Pathog. 2009;46(1):6–12. https://doi.org/10.1016/j.micpath.2008.10.007.

    Article  CAS  PubMed  Google Scholar 

  32. Bruffaerts N, Vluggen C, Roupie V, Duytschaever L, Van den Poel C, Denoel J, et al. Virulence and immunogenicity of genetically defined human and porcine isolates of M. Avium subsp. hominissuis in an experimental mouse infection. PLoS One. 2017;12(2):e0171895. https://doi.org/10.1371/journal.pone.0171895.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Kikuchi T, Watanabe A, Gomi K, Sakakibara T, Nishimori K, Daito H, et al. Association between mycobacterial genotypes and disease progression in Mycobacterium avium pulmonary infection. Thorax. 2009;64(10):901–7. https://doi.org/10.1136/thx.2009.114603.

    Article  CAS  PubMed  Google Scholar 

  34. Takegaki Y. Effect of serotype specific glycopeptidolipid (GPL) isolated from Mycobacterium avium complex (MAC) on phagocytosis and phagosome-lysosome fusion of human peripheral blood monocytes. Kekkaku. 2000;75(1):9–18.

    CAS  PubMed  Google Scholar 

  35. Turenne CY, Wallace R Jr, Behr MA. Mycobacterium avium in the postgenomic era. Clin Microbiol Rev. 2007;20(2):205–29. https://doi.org/10.1128/CMR.00036-06.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Sweet L, Singh PP, Azad AK, Rajaram MV, Schlesinger LS, Schorey JS. Mannose receptor-dependent delay in phagosome maturation by Mycobacterium avium glycopeptidolipids. Infect Immun. 2010;78(1):518–26. https://doi.org/10.1128/IAI.00257-09.

    Article  CAS  PubMed  Google Scholar 

  37. Bhatnagar S, Schorey JS. Elevated mitogen-activated protein kinase signalling and increased macrophage activation in cells infected with a glycopeptidolipid-deficient Mycobacterium avium. Cell Microbiol. 2006;8(1):85–96. https://doi.org/10.1111/j.1462-5822.2005.00602.x.

    Article  CAS  PubMed  Google Scholar 

  38. Belisle JT, Klaczkiewicz K, Brennan PJ, Jacobs WR Jr, Inamine JM. Rough morphological variants of Mycobacterium avium. Characterization of genomic deletions resulting in the loss of glycopeptidolipid expression. J Biol Chem. 1993;268(14):10517–23.

    CAS  PubMed  Google Scholar 

  39. Yamazaki Y, Danelishvili L, Wu M, Macnab M, Bermudez LE. Mycobacterium avium genes associated with the ability to form a biofilm. Appl Environ Microbiol. 2006;72(1):819–25. https://doi.org/10.1128/AEM.72.1.819-825.2006.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Rindi L, Bonanni D, Lari N, Garzelli C. Most human isolates of Mycobacterium avium Mav-a and Mav-B are strong producers of hemolysin, a putative virulence factor. J Clin Microbiol. 2003;41(12):5738–40.

    Article  CAS  Google Scholar 

  41. Ghassemi M, Asadi FK, Andersen BR, Novak RM. Mycobacterium avium induces HIV upregulation through mechanisms independent of cytokine induction. AIDS Res Hum Retrovir. 2000;16(5):435–40. https://doi.org/10.1089/088922200309098.

    Article  CAS  PubMed  Google Scholar 

  42. Vazquez N, Greenwell-Wild T, Rekka S, Orenstein JM, Wahl SM. Mycobacterium avium-induced SOCS contributes to resistance to IFN-gamma-mediated mycobactericidal activity in human macrophages. J Leukoc Biol. 2006;80(5):1136–44. https://doi.org/10.1189/jlb.0306206.

    Article  CAS  PubMed  Google Scholar 

  43. Honda JR, Knight V, Chan ED. Pathogenesis and risk factors for nontuberculous mycobacterial lung disease. Clin Chest Med. 2015;36(1):1–11. https://doi.org/10.1016/j.ccm.2014.10.001.

    Article  PubMed  Google Scholar 

  44. Thomson RM, Armstrong JG, Looke DF. Gastroesophageal reflux disease, acid suppression, and Mycobacterium avium complex pulmonary disease. Chest. 2007;131(4):1166–72. https://doi.org/10.1378/chest.06-1906.

    Article  PubMed  Google Scholar 

  45. Koh WJ, Lee JH, Kwon YS, Lee KS, Suh GY, Chung MP, et al. Prevalence of gastroesophageal reflux disease in patients with nontuberculous mycobacterial lung disease. Chest. 2007;131(6):1825–30. https://doi.org/10.1378/chest.06-2280.

    Article  PubMed  Google Scholar 

  46. Andrejak C, Nielsen R, Thomsen VO, Duhaut P, Sorensen HT, Thomsen RW. Chronic respiratory disease, inhaled corticosteroids and risk of non-tuberculous mycobacteriosis. Thorax. 2013;68(3):256–62. https://doi.org/10.1136/thoraxjnl-2012-201772.

    Article  PubMed  Google Scholar 

  47. van Ingen J, Boeree MJ, Dekhuijzen PN, van Soolingen D. Mycobacterial disease in patients with rheumatic disease. Nat Clin Pract Rheumatol. 2008;4(12):649–56. https://doi.org/10.1038/ncprheum0949.

    Article  CAS  PubMed  Google Scholar 

  48. Dorman SE, Picard C, Lammas D, Heyne K, van Dissel JT, Baretto R, et al. Clinical features of dominant and recessive interferon gamma receptor 1 deficiencies. Lancet. 2004;364(9451):2113–21. https://doi.org/10.1016/S0140-6736(04)17552-1.

    Article  CAS  PubMed  Google Scholar 

  49. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175(4):367–416. https://doi.org/10.1164/rccm.200604-571ST.

    Article  CAS  PubMed  Google Scholar 

  50. Tsukamura M. Diagnosis of disease caused by Mycobacterium avium complex. Chest. 1991;99(3):667–9.

    Article  CAS  Google Scholar 

  51. Koh WJ, Chang B, Ko Y, Jeong BH, Hong G, Park HY, et al. Clinical significance of a single isolation of pathogenic nontuberculous mycobacteria from sputum specimens. Diagn Microbiol Infect Dis. 2013;75(2):225–6. https://doi.org/10.1016/j.diagmicrobio.2012.09.021.

    Article  CAS  PubMed  Google Scholar 

  52. Sugihara E, Hirota N, Niizeki T, Tanaka R, Nagafuchi M, Koyanagi T, et al. Usefulness of bronchial lavage for the diagnosis of pulmonary disease caused by Mycobacterium avium-intracellulare complex (MAC) infection. J Infect Chemother. 2003;9(4):328–32. https://doi.org/10.1007/s10156-003-0267-1.

    Article  PubMed  Google Scholar 

  53. Ikedo Y. The significance of bronchoscopy for the diagnosis of Mycobacterium avium complex (MAC) pulmonary disease. Kurume Med J. 2001;48(1):15–9.

    Article  CAS  Google Scholar 

  54. Koh WJ, Kwon OJ, Lee KS. Nontuberculous mycobacterial pulmonary diseases in immunocompetent patients. Korean J Radiol. 2002;3(3):145–57. doi:2002v3n3p145 [pii]

    Article  Google Scholar 

  55. Reich JM, Johnson RE. Mycobacterium avium complex pulmonary disease presenting as an isolated lingular or middle lobe pattern. The Lady Windermere syndrome. Chest. 1992;101(6):1605–9.

    Article  CAS  Google Scholar 

  56. Thomson RM. NTM working group at Queensland TB control Centre and Queensland mycobacterial reference laboratory. Emerg Infect Dis. 2010;16(10):1576–83. https://doi.org/10.3201/eid1610.091201.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Kim RD, Greenberg DE, Ehrmantraut ME, Guide SV, Ding L, Shea Y, et al. Pulmonary nontuberculous mycobacterial disease: prospective study of a distinct preexisting syndrome. Am J Respir Crit Care Med. 2008;178(10):1066–74. https://doi.org/10.1164/rccm.200805-686OC.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Chan ED, Iseman MD. Slender, older women appear to be more susceptible to nontuberculous mycobacterial lung disease. Gend Med. 2010;7(1):5–18. https://doi.org/10.1016/j.genm.2010.01.005.

    Article  PubMed  Google Scholar 

  59. Kartalija M, Ovrutsky AR, Bryan CL, Pott GB, Fantuzzi G, Thomas J, et al. Patients with nontuberculous mycobacterial lung disease exhibit unique body and immune phenotypes. Am J Respir Crit Care Med. 2013;187(2):197–205. https://doi.org/10.1164/rccm.201206-1035OC.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Szymanski EP, Leung JM, Fowler CJ, Haney C, Hsu AP, Chen F, et al. Pulmonary Nontuberculous mycobacterial infection. A multisystem, multigenic disease. Am J Respir Crit Care Med. 2015;192(5):618–28. https://doi.org/10.1164/rccm.201502-0387OC.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Kitada S, Maekura R, Toyoshima N, Naka T, Fujiwara N, Kobayashi M, et al. Use of glycopeptidolipid core antigen for serodiagnosis of mycobacterium avium complex pulmonary disease in immunocompetent patients. Clin Diagn Lab Immunol. 2005;12(1):44–51. https://doi.org/10.1128/CDLI.12.1.44-51.2005.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Kitada S, Kobayashi K, Ichiyama S, Takakura S, Sakatani M, Suzuki K, et al. Serodiagnosis of Mycobacterium avium-complex pulmonary disease using an enzyme immunoassay kit. Am J Respir Crit Care Med. 2008;177(7):793–7. https://doi.org/10.1164/rccm.200705-771OC.

    Article  CAS  PubMed  Google Scholar 

  63. Kitada S, Levin A, Hiserote M, Harbeck RJ, Czaja CA, Huitt G, et al. Serodiagnosis of Mycobacterium avium complex pulmonary disease in the USA. Eur Respir J. 2013;42(2):454–60. https://doi.org/10.1183/09031936.00098212.

    Article  PubMed  Google Scholar 

  64. Embil J, Warren P, Yakrus M, Stark R, Corne S, Forrest D, et al. Pulmonary illness associated with exposure to Mycobacterium-avium complex in hot tub water. Hypersensitivity pneumonitis or infection? Chest. 1997;111(3):813–6.

    Article  CAS  Google Scholar 

  65. Marras TK, Wallace RJ Jr, Koth LL, Stulbarg MS, Cowl CT, Daley CL. Hypersensitivity pneumonitis reaction to Mycobacterium avium in household water. Chest. 2005;127(2):664–71. https://doi.org/10.1378/chest.127.2.664.

    Article  PubMed  Google Scholar 

  66. Centers for Disease Control and Prevention. Respiratory illness in workers exposed to metalworking fluid contaminated with nontuberculous mycobacteria—Ohio, 2001. MMWR. 2002;51(16):349–52.

    Google Scholar 

  67. Hartman TE, Jensen E, Tazelaar HD, Hanak V, Ryu JH. CT findings of granulomatous pneumonitis secondary to Mycobacterium avium-intracellulare inhalation: “hot tub lung”. AJR. 2007;188(4):1050–3. https://doi.org/10.2214/AJR.06.0546.

    Article  PubMed  Google Scholar 

  68. Hanak V, Kalra S, Aksamit TR, Hartman TE, Tazelaar HD, Ryu JH. Hot tub lung: presenting features and clinical course of 21 patients. Respir Med. 2006;100(4):610–5. https://doi.org/10.1016/j.rmed.2005.08.005.

    Article  PubMed  Google Scholar 

  69. Wallace RJ Jr, Brown BA, Griffith DE, Girard WM, Murphy DT, Onyi GO, et al. Initial clarithromycin monotherapy for Mycobacterium avium-intracellulare complex lung disease. Am J Respir Crit Care Med. 1994;149(5):1335–41. https://doi.org/10.1164/ajrccm.149.5.8173775.

    Article  PubMed  Google Scholar 

  70. Dautzenberg B, Piperno D, Diot P, Truffot-Pernot C, Chauvin JP. Clarithromycin in the treatment of Mycobacterium avium lung infections in patients without AIDS. Clarithromycin study group of France. Chest. 1995;107(4):1035–40.

    Article  CAS  Google Scholar 

  71. Wallace RJ Jr, Brown BA, Griffith DE, Girard WM, Murphy DT. Clarithromycin regimens for pulmonary Mycobacterium avium complex. The first 50 patients. Am J Respir Crit Care Med. 1996;153(6 Pt 1):1766–72. https://doi.org/10.1164/ajrccm.153.6.8665032.

    Article  PubMed  Google Scholar 

  72. Tanaka E, Kimoto T, Tsuyuguchi K, Watanabe I, Matsumoto H, Niimi A, et al. Effect of clarithromycin regimen for Mycobacterium avium complex pulmonary disease. Am J Respir Crit Care Med. 1999;160(3):866–72. https://doi.org/10.1164/ajrccm.160.3.9811086.

    Article  CAS  PubMed  Google Scholar 

  73. Wallace RJ Jr, Brown BA, Griffith DE. Drug intolerance to high-dose clarithromycin among elderly patients. Diagn Microbiol Infect Dis. 1993;16(3):215–21.

    Article  Google Scholar 

  74. Wallace RJ Jr, Brown-Elliott BA, McNulty S, Philley JV, Killingley J, Wilson RW, et al. Macrolide/Azalide therapy for nodular/bronchiectatic mycobacterium avium complex lung disease. Chest. 2014;146(2):276–82. https://doi.org/10.1378/chest.13-2538.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Griffith DE, Brown BA, Girard WM, Murphy DT, Wallace RJ Jr. Azithromycin activity against Mycobacterium avium complex lung disease in patients who were not infected with human immunodeficiency virus. Clin Infect Dis. 1996;23(5):983–9.

    Article  CAS  Google Scholar 

  76. Zuckerman JM, Qamar F, Bono BR. Review of macrolides (azithromycin, clarithromycin), ketolids (telithromycin) and glycylcyclines (tigecycline). Med Clin North Am. 2011;95(4):761–91. https://doi.org/10.1016/j.mcna.2011.03.012.

    Article  CAS  PubMed  Google Scholar 

  77. Chaisson RE, Benson CA, Dube MP, Heifets LB, Korvick JA, Elkin S, et al. Clarithromycin therapy for bacteremic Mycobacterium avium complex disease. A randomized, double-blind, dose-ranging study in patients with AIDS. AIDS Clinical Trials Group protocol 157 study team. Ann Intern Med. 1994;121(12):905–11.

    Article  CAS  Google Scholar 

  78. Gordin FM, Sullam PM, Shafran SD, Cohn DL, Wynne B, Paxton L, et al. A randomized, placebo-controlled study of rifabutin added to a regimen of clarithromycin and ethambutol for treatment of disseminated infection with Mycobacterium avium complex. Clin Infect Dis. 1999;28(5):1080–5. https://doi.org/10.1086/514748.

    Article  CAS  PubMed  Google Scholar 

  79. Miwa S, Shirai M, Toyoshima M, Shirai T, Yasuda K, Yokomura K, et al. Efficacy of clarithromycin and ethambutol for Mycobacterium avium complex pulmonary disease. A preliminary study. Ann Am Thorac Soc. 2014;11(1):23–9. https://doi.org/10.1513/AnnalsATS.201308-266OC.

    Article  CAS  PubMed  Google Scholar 

  80. Griffith DE, Brown BA, Girard WM, Griffith BE, Couch LA, Wallace RJ Jr. Azithromycin-containing regimens for treatment of Mycobacterium avium complex lung disease. Clin Infect Dis. 2001;32(11):1547–53. https://doi.org/10.1086/320512.

    Article  CAS  PubMed  Google Scholar 

  81. Koh WJ, Jeong BH, Jeon K, Lee SY, Shin SJ. Therapeutic drug monitoring in the treatment of Mycobacterium avium complex lung disease. Am J Respir Crit Care Med. 2012;186(8):797–802. https://doi.org/10.1164/rccm.201206-1088OC.

    Article  CAS  PubMed  Google Scholar 

  82. Griffith DE, Brown BA, Murphy DT, Girard WM, Couch L, Wallace RJ Jr. Initial (6-month) results of three-times-weekly azithromycin in treatment regimens for Mycobacterium avium complex lung disease in human immunodeficiency virus-negative patients. J Infect Dis. 1998;178(1):121–6.

    Article  CAS  Google Scholar 

  83. Jeong BH, Jeon K, Park HY, Kim SY, Lee KS, Huh HJ, et al. Intermittent antibiotic therapy for nodular bronchiectatic Mycobacterium avium complex lung disease. Am J Respir Crit Care Med. 2015;191(1):96–103. https://doi.org/10.1164/rccm.201408-1545OC.

    Article  CAS  PubMed  Google Scholar 

  84. Jeong BH, Jeon K, Park HY, Moon SM, Kim SY, Lee SY, et al. Peak plasma concentration of azithromycin and treatment responses in Mycobacterium avium complex lung disease. Antimicrob Agents Chemother. 2016;60(10):6076–83. https://doi.org/10.1128/AAC.00770-16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Lam PK, Griffith DE, Aksamit TR, Ruoss SJ, Garay SM, Daley CL, et al. Factors related to response to intermittent treatment of Mycobacterium avium complex lung disease. Am J Respir Crit Care Med. 2006;173(11):1283–9. https://doi.org/10.1164/rccm.200509-1531OC.

    Article  CAS  PubMed  Google Scholar 

  86. Koh WJ, Jeong BH, Jeon K, Park HY, Kim SY, Huh HJ, et al. Response to switch from intermittent therapy to daily therapy for refractory nodular Bronchiectatic Mycobacterium avium complex lung disease. Antimicrob Agents Chemother. 2015;59(8):4994–6. https://doi.org/10.1128/AAC.00648-15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Kobashi Y, Matsushima T, Oka M. A double-blind randomized study of aminoglycoside infusion with combined therapy for pulmonary Mycobacterium avium complex disease. Respir Med. 2007;101(1):130–8. https://doi.org/10.1016/j.rmed.2006.04.002.

    Article  PubMed  Google Scholar 

  88. Peloquin CA, Berning SE, Nitta AT, Simone PM, Goble M, Huitt GA, et al. Aminoglycoside toxicity: daily versus thrice-weekly dosing for treatment of mycobacterial diseases. Clin Infect Dis. 2004;38(11):1538–44. https://doi.org/10.1086/420742.

    Article  CAS  PubMed  Google Scholar 

  89. Jarand J, Davis JP, Cowie RL, Field SK, Fisher DA. Long-term follow-up of Mycobacterium avium complex lung disease in patients treated with regimens including Clofazimine and/or rifampin. Chest. 2016;149(5):1285–93. https://doi.org/10.1378/chest.15-0543.

    Article  PubMed  Google Scholar 

  90. Martiniano SL, Wagner BD, Levin A, Nick JA, Sagel SD, Daley CL. Safety and effectiveness of Clofazimine for primary and refractory Nontuberculous mycobacterial infection. Chest. 2017. https://doi.org/10.1016/j.chest.2017.04.175.

  91. Yang B, Jhun BW, Moon SM, Lee H, Park HY, Jeon K, et al. Clofazimine-containing regimen for the treatment of Mycobacterium abscessus lung disease. Antimicrob Agents Chemother. 2017;61(6). https://doi.org/10.1128/AAC.02052-16.

  92. Griffith DE, Brown-Elliott BA, Langsjoen B, Zhang Y, Pan X, Girard W, et al. Clinical and molecular analysis of macrolide resistance in Mycobacterium avium complex lung disease. Am J Respir Crit Care Med. 2006;174(8):928–34. https://doi.org/10.1164/rccm.200603-450OC.

    Article  CAS  PubMed  Google Scholar 

  93. Koh WJ, Hong G, Kim SY, Jeong BH, Park HY, Jeon K, et al. Treatment of refractory Mycobacterium avium complex lung disease with a moxifloxacin-containing regimen. Antimicrob Agents Chemother. 2013;57(5):2281–5. https://doi.org/10.1128/AAC.02281-12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Brown-Elliott BA, Philley JV, Griffith DE, Thakkar F, Wallace RJ Jr. In vitro susceptibility testing of Bedaquiline against Mycobacterium avium complex. Antimicrob Agents Chemother. 2017;61(2). https://doi.org/10.1128/AAC.01798-16.

  95. Diacon AH, Pym A, Grobusch MP, de los Rios JM, Gotuzzo E, Vasilyeva I, et al. Multidrug-resistant tuberculosis and culture conversion with bedaquiline. N Engl J Med. 2014;371(8):723–32. https://doi.org/10.1056/NEJMoa1313865.

    Article  CAS  PubMed  Google Scholar 

  96. Philley JV, Wallace RJ Jr, Benwill JL, Taskar V, Brown-Elliott BA, Thakkar F, et al. Preliminary results of Bedaquiline as salvage therapy for patients with Nontuberculous mycobacterial lung disease. Chest. 2015;148(2):499–506. https://doi.org/10.1378/chest.14-2764.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Svensson EM, Murray S, Karlsson MO, Dooley KE. Rifampicin and rifapentine significantly reduce concentrations of bedaquiline, a new anti-TB drug. J Antimicrob Chemother. 2015;70(4):1106–14. https://doi.org/10.1093/jac/dku504.

    Article  CAS  PubMed  Google Scholar 

  98. Brown-Elliott BA, Crist CJ, Mann LB, Wilson RW, Wallace RJ Jr. In vitro activity of linezolid against slowly growing nontuberculous mycobacteria. Antimicrob Agents Chemother. 2003;47(5):1736–8.

    Article  CAS  Google Scholar 

  99. Winthrop KL, Ku JH, Marras TK, Griffith DE, Daley CL, Olivier KN, et al. The tolerability of linezolid in the treatment of nontuberculous mycobacterial disease. Eur Respir J. 2015;45(4):1177–9. https://doi.org/10.1183/09031936.00169114.

    Article  CAS  PubMed  Google Scholar 

  100. Brown-Elliott BA, Wallace RJ Jr. In vitro susceptibility testing of Tedizolid against Nontuberculous mycobacteria. J Clin Microbiol. 2017;55(6):1747–54. https://doi.org/10.1128/JCM.00274-17.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  101. Olivier KN, Shaw PA, Glaser TS, Bhattacharyya D, Fleshner M, Brewer CC, et al. Inhaled amikacin for treatment of refractory pulmonary nontuberculous mycobacterial disease. Ann Am Thorac Soc. 2014;11(1):30–5. https://doi.org/10.1513/AnnalsATS.201307-231OC.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  102. Griffith DE, Eagle G, Thomson R, Aksamit TR, Hasegawa N, Morimoto K et al. Amikacin Liposome Inhalation Suspension for Treatment-Refractory Lung Disease Caused by Mycobacterium avium Complex. Am J Respir and Crit Care Med, In Press, 2018.

    Google Scholar 

  103. Mitchell JD. Surgical approach to pulmonary nontuberculous mycobacterial infections. Clin Chest Med. 2015;36(1):117–22. https://doi.org/10.1016/j.ccm.2014.11.004.

    Article  PubMed  Google Scholar 

  104. Watanabe M, Hasegawa N, Ishizaka A, Asakura K, Izumi Y, Eguchi K, et al. Early pulmonary resection for Mycobacterium avium complex lung disease treated with macrolides and quinolones. Ann Thorac Surg. 2006;81(6):2026–30.

    Article  Google Scholar 

  105. Koh WJ, Kim YH, Kwon OJ, Choi YS, Kim K, Shim YM, et al. Surgical treatment of pulmonary diseases due to nontuberculous mycobacteria. J Korean Med Sci. 2008;23(3):397–401. https://doi.org/10.3346/jkms.2008.23.3.397.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Mitchell JD, Bishop A, Cafaro A, Weyant MJ, Pomerantz M. Anatomic lung resection for nontuberculous mycobacterial disease. Ann Thorac Surg. 2008;85(6):1887–92.; discussion 1892-3. https://doi.org/10.1016/j.athoracsur.2008.02.041.

    Article  PubMed  Google Scholar 

  107. Yu JA, Pomerantz M, Bishop A, Weyant MJ, Mitchell JD. Lady Windermere revisited: treatment with thoracoscopic lobectomy/segmentectomy for right middle lobe and lingular bronchiectasis associated with non-tuberculous mycobacterial disease. Eur J Cardiothorac Surg. 2011;40(3):671–5. https://doi.org/10.1016/j.ejcts.2010.12.028.

    Article  PubMed  Google Scholar 

  108. Morimoto K, Namkoong H, Hasegawa N, Nakagawa T, Morino E, Shiraishi Y, et al. Macrolide-resistant Mycobacterium avium complex lung disease: analysis of 102 consecutive cases. Ann Am Thorac Soc. 2016;13(11):1904–11. https://doi.org/10.1513/AnnalsATS.201604-246OC.

    Article  PubMed  Google Scholar 

  109. Moon SM, Park HY, Kim SY, Jhun BW, Lee H, Jeon K, et al. Clinical characteristics, treatment outcomes, and resistance mutations associated with macrolide-resistant Mycobacterium avium complex lung disease. Antimicrob Agents Chemother. 2016;60(11):6758–65. https://doi.org/10.1128/AAC.01240-16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  110. Bermudez LE, Nash K, Petrofsky M, Young LS, Inderlied CB. Clarithromycin-resistant mycobacterium avium is still susceptible to treatment with clarithromycin and is virulent in mice. Antimicrob Agents Chemother. 2000;44(10):2619–22.

    Article  CAS  Google Scholar 

  111. Lee G, Lee KS, Moon JW, Koh WJ, Jeong BH, Jeong YJ, et al. Nodular bronchiectatic Mycobacterium avium complex pulmonary disease. Natural course on serial computed tomographic scans. Ann Am Thorac Soc. 2013;10(4):299–306. https://doi.org/10.1513/AnnalsATS.201303-062OC.

    Article  PubMed  Google Scholar 

  112. Kotilainen H, Valtonen V, Tukiainen P, Poussa T, Eskola J, Jarvinen A. Prognostic value of American Thoracic Society criteria for non-tuberculous mycobacterial disease: a retrospective analysis of 120 cases with four years of follow-up. Scand J Infect Dis. 2013;45(3):194–202. https://doi.org/10.3109/00365548.2012.722227.

    Article  PubMed  Google Scholar 

  113. Marras TK, Campitelli MA, Lu H, Chung H, Brode SK, Marchand-Austin A, et al. Pulmonary Nontuberculous mycobacteria-associated deaths, Ontario, Canada, 2001-2013. Emerg Infect Dis. 2017;23(3):468–76. https://doi.org/10.3201/eid2303.161927.

    Article  PubMed  PubMed Central  Google Scholar 

  114. Andrejak C, Thomsen VO, Johansen IS, Riis A, Benfield TL, Duhaut P, et al. Nontuberculous pulmonary mycobacteriosis in Denmark: incidence and prognostic factors. Am J Respir Crit Care Med. 2010;181(5):514–21. https://doi.org/10.1164/rccm.200905-0778OC.

    Article  PubMed  Google Scholar 

  115. Gochi M, Takayanagi N, Kanauchi T, Ishiguro T, Yanagisawa T, Sugita Y. Retrospective study of the predictors of mortality and radiographic deterioration in 782 patients with nodular/bronchiectatic Mycobacterium avium complex lung disease. BMJ Open. 2015;5(8):e008058. https://doi.org/10.1136/bmjopen-2015-008058.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Fleshner M, Olivier KN, Shaw PA, Adjemian J, Strollo S, Claypool RJ, et al. Mortality among patients with pulmonary non-tuberculous mycobacteria disease. Int J Tuberc Lung Dis. 2016;20(5):582–7. https://doi.org/10.5588/ijtld.15.0807.

    Article  CAS  PubMed  Google Scholar 

  117. Horsburgh CR Jr. Mycobacterium avium complex infection in the acquired immunodeficiency syndrome. N Engl J Med. 1991;324(19):1332–8. https://doi.org/10.1056/NEJM199105093241906.

    Article  PubMed  Google Scholar 

  118. Horsburgh CR Jr, Havlik JA, Ellis DA, Kennedy E, Fann SA, Dubois RE, et al. Survival of patients with acquired immune deficiency syndrome and disseminated Mycobacterium avium complex infection with and without antimycobacterial chemotherapy. Am Rev Respir Dis. 1991;144(3 Pt 1):557–9. https://doi.org/10.1164/ajrccm/144.3_Pt_1.557.

    Article  PubMed  Google Scholar 

  119. Torriani FJ, McCutchan JA, Bozzette SA, Grafe MR, Havlir DV. Autopsy findings in AIDS patients with Mycobacterium avium complex bacteremia. J Infect Dis. 1994;170(6):1601–5.

    Article  CAS  Google Scholar 

  120. Ward TT, Rimland D, Kauffman C, Huycke M, Evans TG, Heifets L. Randomized, open-label trial of azithromycin plus ethambutol vs. clarithromycin plus ethambutol as therapy for Mycobacterium avium complex bacteremia in patients with human immunodeficiency virus infection. Veterans affairs HIV research consortium. Clin Infect Dis. 1998;27(5):1278–85.

    Article  CAS  Google Scholar 

  121. Dunne M, Fessel J, Kumar P, Dickenson G, Keiser P, Boulos M, et al. A randomized, double-blind trial comparing azithromycin and clarithromycin in the treatment of disseminated Mycobacterium avium infection in patients with human immunodeficiency virus. Clin Infect Dis. 2000;31(5):1245–52. https://doi.org/10.1086/317468.

    Article  CAS  PubMed  Google Scholar 

  122. Cohn DL, Fisher EJ, Peng GT, Hodges JS, Chesnut J, Child CC, et al. A prospective randomized trial of four three-drug regimens in the treatment of disseminated Mycobacterium avium complex disease in AIDS patients: excess mortality associated with high-dose clarithromycin. Terry Beirn community programs for clinical research on AIDS. Clin Infect Dis. 1999;29(1):125–33. https://doi.org/10.1086/520141.

    Article  CAS  PubMed  Google Scholar 

  123. Dube MP, Sattler FR, Torriani FJ, See D, Havlir DV, Kemper CA, et al. A randomized evaluation of ethambutol for prevention of relapse and drug resistance during treatment of Mycobacterium avium complex bacteremia with clarithromycin-based combination therapy. California collaborative treatment group. J Infect Dis. 1997;176(5):1225–32.

    Article  CAS  Google Scholar 

  124. Benson CA, Williams PL, Currier JS, Holland F, Mahon LF, MacGregor RR, et al. A prospective, randomized trial examining the efficacy and safety of clarithromycin in combination with ethambutol, rifabutin, or both for the treatment of disseminated Mycobacterium avium complex disease in persons with acquired immunodeficiency syndrome. Clin Infect Dis. 2003;37(9):1234–43. https://doi.org/10.1086/378807.

    Article  CAS  PubMed  Google Scholar 

  125. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Disseminated Mycobacterium avium complex disease. In: Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. AIDSinfo. 2013. https://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf. Accessed 19 June 2017.

  126. Chaisson RE, Keiser P, Pierce M, Fessel WJ, Ruskin J, Lahart C, et al. Clarithromycin and ethambutol with or without clofazimine for the treatment of bacteremic Mycobacterium avium complex disease in patients with HIV infection. AIDS. 1997;11(3):311–7.

    Article  CAS  Google Scholar 

  127. Karakousis PC, Moore RD, Chaisson RE. Mycobacterium avium complex in patients with HIV infection in the era of highly active antiretroviral therapy. Lancet Infect Dis. 2004;4(9):557–65. https://doi.org/10.1016/S1473-3099(04)01130-2.

    Article  PubMed  Google Scholar 

  128. Aberg JA, Yajko DM, Jacobson MA. Eradication of AIDS-related disseminated mycobacterium avium complex infection after 12 months of antimycobacterial therapy combined with highly active antiretroviral therapy. J Infect Dis. 1998;178(5):1446–9.

    Article  CAS  Google Scholar 

  129. Pierce M, Crampton S, Henry D, Heifets L, LaMarca A, Montecalvo M, et al. A randomized trial of clarithromycin as prophylaxis against disseminated Mycobacterium avium complex infection in patients with advanced acquired immunodeficiency syndrome. N Engl J Med. 1996;335(6):384–91. https://doi.org/10.1056/NEJM199608083350603.

    Article  CAS  PubMed  Google Scholar 

  130. Havlir DV, Dube MP, Sattler FR, Forthal DN, Kemper CA, Dunne MW, et al. Prophylaxis against disseminated Mycobacterium avium complex with weekly azithromycin, daily rifabutin, or both. California collaborative treatment group. N Engl J Med. 1996;335(6):392–8. https://doi.org/10.1056/NEJM199608083350604.

    Article  CAS  PubMed  Google Scholar 

  131. Benson CA, Williams PL, Cohn DL, Becker S, Hojczyk P, Nevin T, et al. Clarithromycin or rifabutin alone or in combination for primary prophylaxis of Mycobacterium avium complex disease in patients with AIDS: a randomized, double-blind, placebo-controlled trial. The AIDS Clinical Trials Group 196/Terry Beirn community programs for clinical research on AIDS 009 protocol team. J Infect Dis. 2000;181(4):1289–97. https://doi.org/10.1086/315380.

    Article  CAS  PubMed  Google Scholar 

  132. El-Sadr WM, Burman WJ, Grant LB, Matts JP, Hafner R, Crane L, et al. Discontinuation of prophylaxis against Mycobacterium avium complex disease in HIV-infected patients who have a response to antiretroviral therapy. Terry Beirn community programs for clinical research on AIDS. N Engl J Med. 2000;342(15):1085–92. https://doi.org/10.1056/NEJM200004133421503.

    Article  CAS  PubMed  Google Scholar 

  133. Lindeboom JA, Kuijper EJ, Bruijnesteijn van Coppenraet ES, Lindeboom R, Prins JM. Surgical excision versus antibiotic treatment for nontuberculous mycobacterial cervicofacial lymphadenitis in children: a multicenter, randomized, controlled trial. Clin Infect Dis. 2007;44(8):1057–64. https://doi.org/10.1086/512675.

    Article  CAS  PubMed  Google Scholar 

  134. Rahal A, Abela A, Arcand PH, Quintal MC, Lebel MH, Tapiero BF. Nontuberculous mycobacterial adenitis of the head and neck in children: experience from a tertiary care pediatric center. Laryngoscope. 2001;111(10):1791–6. https://doi.org/10.1097/00005537-200110000-00024.

    Article  CAS  PubMed  Google Scholar 

  135. Panesar J, Higgins K, Daya H, Forte V, Allen U. Nontuberculous mycobacterial cervical adenitis: a ten-year retrospective review. Laryngoscope. 2003;113(1):149–54. https://doi.org/10.1097/00005537-200301000-00028.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, CO, USA

    Michael R. Holt & Charles L. Daley

Authors
  1. Michael R. Holt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Charles L. Daley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles L. Daley .

Editor information

Editors and Affiliations

  1. Professor of Medicine, University of Texas Health Science Center, Tyler, TX, USA

    David E. Griffith

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Holt, M.R., Daley, C.L. (2019). Mycobacterium avium Complex Disease. In: Griffith, D. (eds) Nontuberculous Mycobacterial Disease. Respiratory Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-93473-0_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-93473-0_11

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-93472-3

  • Online ISBN: 978-3-319-93473-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation