Comparison of Clinical Features, Virulence, and Relapse among XXXX Complex Species.

@entity1 @entity4594 @entity1514 @entity281 @entity3069
RATIONALE: Traditionally, @entity3069 complex (MAC) has been composed of @entity3069 and @entity4594 ; however, advances in genetic sequencing have allowed discovery of several novel species. With these discoveries, investigation of differences in risk factors, virulence, and clinical outcomes have emerged. OBJECTIVES: We conducted a retrospective cohort study evaluating all MAC isolates obtained from pulmonary specimens at our institution from 2000 to 2012 and investigated the clinical courses associated with distinct MAC species. METHODS: To classify isolates into distinct species, a multilocus sequence analysis using rpoB and internal transcribed spacer (ITS) as targets was performed. We reviewed @entity1 medical records to analyze clinical characteristics and outcomes for the cohort. MEASUREMENTS AND MAIN RESULTS: Of the isolates from the 448 included @entity1 , 54% were @entity3069 , 18% were @entity4594 , and 28% were M. chimaera. Using American @entity1514 Society/Infectious Diseases Society of America criteria, @entity1 whose isolates were identified as @entity3069 (adjusted odds ratio [AOR], 2.14; 95% confidence interval [CI], 1.33-3.44) or @entity4594 (AOR, 3.12; 95% CI, 1.62-5.99) were more likely to meet criteria for @entity281 than @entity1 with M. chimaera. @entity1 infected with M. chimaera were more likely to be prescribed an immunosuppressant compared with all other @entity1 (AOR, 2.75; 95% CI, 1.17-6.40). @entity1 treated for infections with @entity3069 (AOR, 5.64; 95% CI, 1.51-21.10) and M. chimaera (AOR, 4.47; 95% CI, 1.08-18.53) were more likely to have a clinical relapse/reinfection than those with @entity4594 . CONCLUSIONS: Our findings suggest that specific MAC species have varying degrees of virulence and classifying MAC isolates into distinct species aids in identifying which @entity1 are at higher risk of clinical relapse/reinfection.
