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The Mycobacterium avium Complex: Genomics, Disease, and Beyond.
Sofia Matos1, Isabel Portugal1, João Perdigão1
1Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisbon, Portugal.
Microorganisms
|October 29, 2025
Summary
Nontuberculous mycobacteria, particularly the Mycobacterium avium complex (MAC), are rising opportunistic pathogens. Understanding MAC
Area of Science:
- Microbiology and Infectious Diseases
- Genomics and Epidemiology
Background:
- Nontuberculous mycobacteria (NTM) are opportunistic pathogens, with the Mycobacterium avium complex (MAC) being the most common cause of human infection.
- Increasing global MAC cases necessitate a deeper understanding of their population structure, clinical impact, and resistance mechanisms.
Purpose of the Study:
- To review current knowledge on the population structure, clinical significance, antimicrobial resistance, and host-pathogen interactions of the Mycobacterium avium complex (MAC).
- To highlight the impact of recent advances in whole-genome sequencing (WGS) and molecular techniques on understanding MAC epidemiology and diversity.
Main Methods:
- Review of recent literature utilizing whole-genome sequencing (WGS) and molecular approaches.
- Analysis of clinical data on MAC infections, including pulmonary and extrapulmonary manifestations.
- Examination of studies on antimicrobial resistance, pathogenesis, and host-pathogen interactions.
Main Results:
- WGS has enhanced understanding of MAC taxonomy, population structure, and genetic diversity, aiding transmission and epidemiological studies.
- MAC infections commonly cause chronic pulmonary disease, with varied presentations influenced by species and host factors (e.g., lung disease, immunosuppression).
- Antimicrobial resistance, often due to de novo mutations, contributes to suboptimal treatment outcomes. Host-pathogen interactions, including immune evasion and gut-lung axis dysbiosis, are critical.
Conclusions:
- The Mycobacterium avium complex (MAC) presents a growing global health challenge due to increasing infections and antimicrobial resistance.
- Further research into MAC population dynamics, resistance mechanisms, and host-pathogen interactions is crucial for improving clinical management and treatment outcomes.
- Emerging factors like gut-lung axis dysbiosis warrant investigation for their role in MAC susceptibility and pathogenesis.
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