In countries with a high TB prevalence, many cases of MAC are misdiagnosed and treated as TB since most of the diagnoses are made based on positive AFB sputum results and positive findings on chest radiography. MAC infection also has been reported from other parts of the world, including Australia, Japan, Tanzania, and Zambia, among others. In these countries, most of the infections were caused by MAC. In 2004, a similar study in New Zealand estimated the incidence of NTM disease at 1.92 per 100,000 population. Most of these cases occurred in individuals older than 60 years. Similarly, a population-based UK study showed an increase in the incidence of pulmonary MAC infections between 20, from 1.3 cases to 2.2 cases per 100,000 population. A surveillance study in France from 2001-2003 estimated that the incidence of NTM pulmonary infections in patients without HIV infection was over 0.7 per 100,000 inhabitants. M avium paratuberculosis is a well-known cause of paratuberculosis (Johne Disease) in cattle, but its role in the etiology of Crohn disease in humans remains to be proven. M avium hominissuis is the only important subspecies associated with human infection, although M avium paratuberculosis has a possible association with Crohn disease. M avium is further divided into four subspecies based on molecular, biochemical, and growth characteristics: M avium subspecies hominissuis, M avium subspecies avium, M avium subspecies paratuberculosis, and M avium subspecies silvaticum. However, their role in causing human disease has not been established except for Mycobacterium chimaera, whose role also remains controversial.
Additional species of MAC have been identified using genetic sequencing technology. MAC infections are caused by M avium and M intracellulare, which are acid-fast atypical mycobacteria that belong to group III in the Runyon classification of nontuberculous mycobacteria.
Guidelines for Diagnosis, Treatment, and Prevention of NTM Infections, Including MAC Infection.Disseminated MAC Infection in Patients with AIDS.Pulmonary MAC Infection in Immunocompetent Patients.Chest Radiography and Computed Tomography.Mycobacterium Avium Complex (MAC) (Mycobacterium Avium-Intracellulare )