Whole-genome phylogenetic analysis of <i>Mycobacterium avium</i> complex from clinical respiratory samples

<i>Mycobacterium avium</i> complex (MAC) infections are increasingly challenging to manage due to their complex species diversity and varied resistance patterns. This study underscores the genetic diversity within MAC, identifying at least eight species and subspecies among 203 clinical isolates, with <i>M. avium</i> subsp. <i>hominissuis</i> (MAH) being most prevalent at 72.9%. Notably, genetic clustering was observed within MAH and <i>M. intracellulare</i> subsp. <i>chimaera</i>, suggesting potential transmission routes within healthcare settings. Clarithromycin and amikacin resistance was found to be uncommon, aligning with the rarity of resistance-associated genetic mutations. These findings emphasize the need for enhanced infection control measures and routine susceptibility testing to tailor antibiotic therapies effectively.