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. 2022 Jul 13:10:923968.
doi: 10.3389/fpubh.2022.923968. eCollection 2022.

Trends and Species Diversity of Non-tuberculous Mycobacteria Isolated From Respiratory Samples in Northern China, 2014-2021

Qing Sun  1 , Jun Yan  1 , Xinlei Liao  1 , Chaohong Wang  1 , Chenqian Wang  1 , Guanglu Jiang  1 , Lingling Dong  1 , Fen Wang  1 , Hairong Huang  1 , Guirong Wang  1 , Junhua Pan  2
Affiliations

Trends and Species Diversity of Non-tuberculous Mycobacteria Isolated From Respiratory Samples in Northern China, 2014-2021

Qing Sun et al. Front Public Health. .

Abstract

Background: Pulmonary non-tuberculous mycobacteria (NTM) infection has become a public health concern in China and around the world. The objective of this study was to describe the longitudinal changes in the frequency and diversity of NTM in northern China.

Methods: We retrospectively analyzed data on mycobacterium species in Beijing Chest Hospital from January 2014 to December 2021. The isolates were identified to species level by targeted DNA sequencing.

Results: After excluding duplicates, 1,755 NTM strains were analyzed, which were from 27 provinces in China over 8 years. Among all mycobacteria, the proportion of NTM increased each year, from 4.24% in 2014 to 12.68% in 2021. Overall, 39 different NTM species were identified, including 23 slow growing mycobacteria (SGM) and 16 rapid growing mycobacteria (RGM). The most common species were M. intracellulare (51.62%), M. abscessus (22.22%), M. kansasii (8.32%), M. avium (7.75%) and M. fortuitum (2.05%). The number of NTM species identified also increased each year from 9 in 2014 to 26 in 2021. Most species showed stable isolation rates over the years; however, the proportion of M. avium increased from 3.85 to 10.42% during the study period. Besides, 81 non-mycobacteria strains, including Gordonia (21 isolates), Nocardia (19 isolates) and Tsukamurella (17 isolates), etc., were also discovered.

Conclusion: The proportion of NTM and species diversity increased considerably in northern China from 2014 to 2021. M. intracellulare was the most common NTM isolated among respiratory specimens, followed by M. abscessus and M. kansasii. Rare NTM species and non-mycobacteria pathogens also need attention.

Keywords: M. intracellulare; identification; mycobacterium; non-tuberculous mycobacteria; species.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Continued upward trend in the proportion of NTM isolates over the 8-year study period. Filled circles (•) denote the percentage of NTM isolates each year. MTBC, mycobacterium tuberculosis complex; NTM, non-tuberculous mycobacteria.
Figure 2
Figure 2
The spectrum of NTM species isolated during 2014–2021.
Figure 3
Figure 3
The trends of major NTM species among all the NTM strains between 2014 and 2021.
Figure 4
Figure 4
Distribution of NTM in different provinces of China. RGM rapid growing mycobacteria, SGM slow growing mycobacteria.
Figure 5
Figure 5
Age and gender distribution of the patients with NTM disease during 2014–20.
See this image and copyright information in PMC

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