MAC/MIA ?

Posted by fingerlessknitts @fingerlessknitts, Nov 9, 2023

What is the difference between MAC and MIA?
Searches show MAC/MIA
Can you have one without the other?
Tx

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

Thank you
There’s lots of helpful advice
Although I don’t see any mention of MIA
I’ll read thought again incase I missed something

REPLY
@fingerlessknitts

Thank you
There’s lots of helpful advice
Although I don’t see any mention of MIA
I’ll read thought again incase I missed something

Jump to this post

MAC= Mycobacterium avium
MAI= Mycobacterium intracellulare

Both are considered NTM. Exposure can vary by geographic location. Here is a snippet of that description from Dr. Falkinham's research on NTM (2021).

Geographic Distribution of Mycobacterium Disease and Species in the United States.
The prevalence of NTM disease across the United States is not uniform, but exhibits “hot spots” and “low spots”. Florida, Louisiana, Santa Barbara, Philadelphia (Lande et al., 2019), and New York City are hot spots, while upstate New York and the southwest are low spots (Adjemian et al., 2012). High soil moisture content and humidity are strong predictors of NTM presence. High NTM numbers are also associated with recirculating hot water systems in hospitals and high-rise condominiums and apartments.
Distinct NTM species also have unique distributions. On the eastern coast of the United States there exists a “Fall Line” that separates the geology of the rocky Appalachian Mountains (Piedmont) from the sandy coastal Tidewater region. Cities on the “Fall Line” include: Philadelphia (PA), Georgetown and Richmond (VA), Fayetteville (NC), Columbia (SC), and August (GA). Florida is entirely to the east of the “Fall Line”. To the east of the “Fall Line” patients are more likely to be infected with Mycobacterium abscessus, while to the west of the “Fall Line” patients are more often infected with members of the Mycobacterium avium complex (MAC). One of the current objectives of the Falkinham Lab is to find out why.

You can find the full paper by searching the subtopic in the group Bronchiectasis and MAC. Perhaps others will weigh in. I do not know what the treatment differences are and if it's possible to have both together. Does this help?

REPLY

Hi there!
MAC stands for Mycobacterium Avium Complex. It is a group of 12 bacteria. MAI, Mycobacterium avium-intercellulare, is one of the bacteria in that group. The confusing part is that some medical professionals often use the terms "MAC" and "MAI" interchangeably.

Many laboratories do not have the ability to "sub-speciate" to determine which of the 12 MAC bacteria is infecting a person. That is why samples are often sent to higher-level labs like the ones at the Mayo, National Jewish Health and UT Tyler.

When I had a bronchoscopy in 2018, a sample was sent to National Jewish for sub-speciation and it was determined that the bacteria was m. intercellulare (MAI). So, in my case, the term MAI was not being used in a general sense, but rather based on my lab analysis.

Although I was able to clear the bacteria without antibiotics, if I had opted for the 3-drug treatment, it would have been identical to those being treated for m.avium, another bacterium in the Complex.

I hope this is helpful.
Linda Esposito

REPLY

Thank you that makes sense I have the MIA bacteria determined by a spudum sample
Drs do not seem to be concerned even when I explained ( tried to explain) I have been working seasonally in a greenhouse planting little green thing for 15+ years
By the way this is in small town Ontario Canada

REPLY
@becleartoday

Hi there!
MAC stands for Mycobacterium Avium Complex. It is a group of 12 bacteria. MAI, Mycobacterium avium-intercellulare, is one of the bacteria in that group. The confusing part is that some medical professionals often use the terms "MAC" and "MAI" interchangeably.

Many laboratories do not have the ability to "sub-speciate" to determine which of the 12 MAC bacteria is infecting a person. That is why samples are often sent to higher-level labs like the ones at the Mayo, National Jewish Health and UT Tyler.

When I had a bronchoscopy in 2018, a sample was sent to National Jewish for sub-speciation and it was determined that the bacteria was m. intercellulare (MAI). So, in my case, the term MAI was not being used in a general sense, but rather based on my lab analysis.

Although I was able to clear the bacteria without antibiotics, if I had opted for the 3-drug treatment, it would have been identical to those being treated for m.avium, another bacterium in the Complex.

I hope this is helpful.
Linda Esposito

Jump to this post

I am curious to know what process you used to clear the bacteria without antibiotics.

REPLY

Once the type of bacteria is determined does the treatment change?

REPLY
@fingerlessknitts

Thank you
There’s lots of helpful advice
Although I don’t see any mention of MIA
I’ll read thought again incase I missed something

Jump to this post

From Wikipedia Mycobacterium avium-intracellulare infection (MAI) is an atypical mycobacterial infection, i.e. one with nontuberculous mycobacteria or NTM, caused by Mycobacterium avium complex (MAC), which is made of two Mycobacterium species, M. avium and M. intracellulare.[1] This infection causes respiratory illness in birds, pigs, and humans, especially in immunocompromised people. In the later stages of AIDS, it can be very severe. It usually first presents as a persistent cough. It is typically treated with a series of three antibiotics for a period of at least six months.

REPLY
@isabellad

Once the type of bacteria is determined does the treatment change?

Jump to this post

Only if the bacteria is one of the more rare ones like M. ascessus or M. kliebsella.
The determining factor in which drugs to use is the "susceptibility testing" done in the lab after the culture grows.
You can learn about that here:
https://connect.mayoclinic.org/discussion/resources-for-the-abcs-on-bronchiectasis-and-mac-ntm/?pg=3#comment-962706
Sue

REPLY
@noisylungs31

From Wikipedia Mycobacterium avium-intracellulare infection (MAI) is an atypical mycobacterial infection, i.e. one with nontuberculous mycobacteria or NTM, caused by Mycobacterium avium complex (MAC), which is made of two Mycobacterium species, M. avium and M. intracellulare.[1] This infection causes respiratory illness in birds, pigs, and humans, especially in immunocompromised people. In the later stages of AIDS, it can be very severe. It usually first presents as a persistent cough. It is typically treated with a series of three antibiotics for a period of at least six months.

Jump to this post

Hello, and welcome to Mayo Connect. We are a support community for patients and caregivers in our journeys with many different diseases and conditions.
What brings you to Connect?
Sue

REPLY
Please sign in or register to post a reply.