Cheesy MAC
(The Basics)
(The Basics)
MAC stands for
What is Mycobacterium Avium Complex?
The two most prevalent NTM lung infection in the United States
What is MAC and Mycobacterium kansasil?
The type of antibiotic susceptibility testing recommended before TX of MAC
What is macrolide susceptibility?
Patient meets diagnostic criteria for NTM (M. abscessus)
What is trick?
Do not treat for MAC
In vitro MIC for this class of drugs does not correlate with clinical outcomes in slow growing mycobacterium (SGM)
What is the tetracycline class?
Most common site of MAC infection
What are the lungs?
Name the US region with a growing incidence of MAC among patients with CF
What is the northeast?
Preferred macrolide to treat MAC
What is azithromycin?
Patient with ONE positive acid-fast bacilli sputum smear
What is trick?
Do not start treatment for MAC
Pulmonologists & Infectious Disease Specialists
Who are the most common type of providers treating MAC?
Animal species where M. avium was first isolated
What are chickens?
2 positive sputum samples, 1 culture positive culture bronchial lavage, + lung biopsy
What are positive microbiologic diagnostic criteria for MAC?
Inhaled aminogylcoside FDA approved to treat MAC
What is Amikacin liposome inhalation suspension (ALIS) (Arikayce®)?
Patient with cavitary lung disease
What is treat?
Initiate treatment for MAC
In vitro studies showed OMC had potent activity against this NTM species (similar to tigecycline)
What is M. abscessus?
COPD, Chronic Bronchitis, Bronchietasis, Lung cancer, Cystic Fibrosis, Scoliosis, Immunocompromised
What are risk factors of MAC?
Pulmonary symptoms, nodular or cavitary opacities on chest radiography
What are positive clinical symptoms of MAC?
Length of MAC treatment (after culture conversion)
What is 12 months?
HIV patient on optimal ART with CD4 count of 154
What is trick?
Do not offer prophylaxis for MAC
This resistance gene is responsible for inducible macrolide resistance in M. abscessus.
What is erm41?
Name of an elderly, healthy, thin female with a suppressed cough who develops MAC
What is Lady Windermere syndrome?
CT scan with high resolution showing bronchiectasis with multiple small nodules.
What are radiologic positive diagnostic criteria for MAC?
Common 3 drug combination used in MAC
What is azithromycin, ethambutol and rifabutin?
HIV patient on MAC PX with CD4 count >100 for 3 consecutive months
What is trick?
No prophylaxis for MAC needed
This antibiotic used to treat NTM is FDA approved for leprosy and can cause skin discoloration
What is clofazimine?