{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:38:23Z","timestamp":1787981903637,"version":"build-2784847793"},"reference-count":78,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"National Research Foundation of Korea, Ministry of Science and ICT","award":["RS-2024-00405542"],"award-info":[{"award-number":["RS-2024-00405542"]}]},{"name":"National Research Foundation of Korea, Ministry of Education","award":["NRF-2021R1I1A2045131"],"award-info":[{"award-number":["NRF-2021R1I1A2045131"]}]},{"DOI":"10.13039\/501100003653","name":"Korea National Institute of Health","doi-asserted-by":"publisher","award":["2025-ER2010-00"],"award-info":[{"award-number":["2025-ER2010-00"]}],"id":[{"id":"10.13039\/501100003653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,3,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Pulmonary disease caused by\n                      <jats:italic toggle=\"yes\">Mycobacterium avium<\/jats:italic>\n                      complex (MAC-PD) is a chronic, recurrent disease, and its high recurrence rate after treatment makes clinical management difficult. Distinguishing whether recurrence is due to persistence of existing strains or reinfection with new strains is essential for establishing treatment strategies, preventing overuse of antimicrobials, and establishing infection control measures. According to reports, 54%\u201374% of MAC-PD recurrence is due to reinfection, which may be mainly related to environmental reservoirs such as household water supply. In this review, we present various clinical scenarios in which MAC-PD recurrence may occur and examine genotyping techniques as a strategy to distinguish and respond to them. From traditional methods such as IS\n                      <jats:italic toggle=\"yes\">1245<\/jats:italic>\n                      -based restriction fragment length polymorphism, pulsed-field gel electrophoresis, and\n                      <jats:italic toggle=\"yes\">hsp65<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">rpoB<\/jats:italic>\n                      gene sequencing to high-resolution analysis techniques such as multilocus sequence testing and whole-genome sequencing, the latest molecular typing methods are comprehensively summarized. Integrating these genotype data into clinical settings, standardizing single-nucleotide polymorphism-based interpretation thresholds, and promoting the establishment of a global MAC strain database will make a substantial contribution to more accurately distinguishing the recurrence mechanisms of MAC-PD and establishing personalized treatment strategies.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        The global burden of nontuberculous mycobacterial pulmonary disease (PD) is increasing, with\n                        <jats:italic toggle=\"yes\">Mycobacterium avium<\/jats:italic>\n                        (MAC)-PD being the most prevalent and clinically challenging form. Its low treatment success rates, high frequency of recurrence, and persistent environmental exposure complicate both diagnosis and management. A critical clinical issue is determining whether recurrence represents true relapse, due to persistence of the original strain, or reinfection with a new strain, as this guides treatment and prevents overtreatment. Genotypic strategies capable of resolving strain-level differences can improve diagnostic accuracy, prevent misclassification, and ultimately support more informed treatment decisions. Therefore, integrating genotyping data into clinical workflows, standardizing single-nucleotide polymorphism thresholds, and establishing a global MAC strain database will not only support personalized treatment but also enhance the broader public health response to this disease.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.01086-25","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T14:37:14Z","timestamp":1762353434000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Understanding recurrence in\n                    <i>Mycobacterium avium<\/i>\n                    complex pulmonary disease: genotypic strategies to support clinical decision-making"],"prefix":"10.1128","volume":"64","author":[{"given":"Minh Phuong","family":"Trinh","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00saywf64","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology and Convergence Medical Science, College of Medicine, Gyeongsang National University","place":["Jinju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0854-4582","authenticated-orcid":true,"given":"Sung Jae","family":"Shin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01wjejq96","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Institute for Immunology and Immunological Diseases, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1782-5351","authenticated-orcid":true,"given":"Min-Kyoung","family":"Shin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00saywf64","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology and Convergence Medical Science, College of Medicine, Gyeongsang National University","place":["Jinju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2014.10.002"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-16559-z"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2020.05.006"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2303.161827"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200604-571ST"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-025-03504-4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.01640-23"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-2538"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.04577-14"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60632-7"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01665-10"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1099\/ijsem.0.001376"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.aaf8156"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.60"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.12771\/emj.2025.00080"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00170-2018"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-017-0834-4"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/femspd\/ftx020"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0128772"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1462-5822.2005.00667.x"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201605-344BC"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005068"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2014.10.003"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.2217\/fmb-2023-0279"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2180-9-159"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01392-06"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmyco.2015.05.005"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0237345"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2013.10.001"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1038\/srep41410"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2011.06.018"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2007.01786.x"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00436-25"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02503-2016"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.36.12.3694-3697.1998"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1161194"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8091315"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201802-0321OC"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.onehlt.2022.100374"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1099\/mic.0.030684-0"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2503.180336"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idcr.2022.e01491"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201903-0669LE"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00489-23"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2025.1665685"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1253020"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01626-22"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms10071447"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1101\/gr.5.4.408"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(84)90436-7"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.98.4.1901"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1348-0421.2007.tb03880.x"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.3.1094-1104.2000"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.31.2.175-178.1993"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2072-1439.2013.12.24"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.2723"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8010098"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.95.6.3140"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1099\/ijs.0.02777-0"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2015.09.029"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0071831"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-31908-x"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.03920-22"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrg3226"},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00250-2019"},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa241"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13073-024-01359-8"},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70277-3"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2025.180338"},{"key":"e_1_3_2_71_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.02790-13"},{"key":"e_1_3_2_72_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41551-021-00760-7"},{"key":"e_1_3_2_73_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-food-022814-015729"},{"key":"e_1_3_2_74_2","doi-asserted-by":"publisher","DOI":"10.1038\/s43856-023-00259-z"},{"key":"e_1_3_2_75_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.imj.2025.100203"},{"key":"e_1_3_2_76_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1410672"},{"key":"e_1_3_2_77_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.1083497"},{"key":"e_1_3_2_78_2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-022-01890-z"},{"key":"e_1_3_2_79_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41587-021-01108-x"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01086-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01086-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:03:08Z","timestamp":1773234188000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.01086-25"}},"subtitle":[],"editor":[{"given":"Mark","family":"Nicol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":78,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,11]]}},"alternative-id":["10.1128\/jcm.01086-25"],"URL":"https:\/\/doi.org\/10.1128\/jcm.01086-25","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]},"assertion":[{"value":"2025-11-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01086-25"}}