![]() The mode of MAC transmission is thought to be through inhalation, ingestion, or inoculation of MAC bacteria via the respiratory or gastrointestinal (GI) tract. 2,4,8,11,12 Although epidemiologic associations have been identified, no environmental exposure or behavior has been consistently linked to subsequent risk of developing MAC disease. 13 An estimated 7% to 12% of adults have previously contracted MAC, although rates of disease vary in different geographic locations. 4,7-12 Recent studies conducted using newer bacterial typing technology suggest organisms causing bacteremia in people with HIV include a diversity of species, including the M. avium was the etiologic agent in >95% of people living with HIV with advanced immunosuppression who acquired disseminated MAC disease. ![]() ![]() 1-6 In the era prior to the availability of effective antiretroviral therapy (ART), M. Organisms of the Mycobacterium avium complex (MAC) are ubiquitous in the environment.
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