{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T22:39:51Z","timestamp":1793313591966,"version":"4.5.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T00:00:00Z","timestamp":1477958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Clinical recurrence of Mycobacterium avium complex (MAC) pulmonary disease occurs in 10 to 40% of patients treated for this disease process. Episodes of clinical recurrence may represent true relapse from the same MAC strain or reinfection with a new strain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The purpose of this study was to investigate the clinical implications of separating patients into these two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study evaluated patients with a clinical recurrence of MAC pulmonary disease at our institution from 2000 to 2012. Isolates were genotyped using pulsed-field gel electrophoresis to differentiate relapse versus reinfection. Change in macrolide susceptibility was also analyzed.<\/jats:p>\n                    <jats:p>Measurements and Main Results: In our cohort, 25% of patients suffered a clinical recurrence. Of the 46 included patients, 25 (54%) suffered a true relapse and 21 (46%) had a reinfection. Median time between completion of therapy and clinical recurrence was significantly lower in the relapse group compared with the reinfection group (210 d vs. 671 d; P\u2009=\u20090.004). The measured convalescent macrolide minimum inhibitory concentrations were significantly more likely to increase in the relapse group compared with the reinfection group (80 vs. 33%; P\u2009=\u20090.002). No differences in clinical outcomes were observed between the two groups at conclusion of the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that patients with true relapse of MAC pulmonary disease present earlier than those with reinfection. Routine use of pulsed-field gel electrophoresis in the management of clinical recurrences may be beneficial, as those suffering a relapse are more likely to have increasing macrolide minimum inhibitory concentrations than those with reinfection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201605-344bc","type":"journal-article","created":{"date-parts":[[2016,9,6]],"date-time":"2016-09-06T13:06:21Z","timestamp":1473167181000},"page":"1956-1961","source":"Crossref","is-referenced-by-count":75,"title":["Relapse versus Reinfection of\n                    <i>Mycobacterium avium<\/i>\n                    Complex Pulmonary Disease. 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