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. 2025 Jun 26;17(2):77-86.
doi: 10.4103/jgid.jgid_152_24. eCollection 2025 Apr-Jun.

Clinical Presentations and Species Spectrum of Nontuberculous Mycobacteria in Suspected Pulmonary Tuberculosis Cases

Sivasankar Das  1 , Prasanta Raghab Mohapatra  2 , Sutapa Rath  1 , Sourin Bhuniya  2 , Baijayantimala Mishra  1
Affiliations

Clinical Presentations and Species Spectrum of Nontuberculous Mycobacteria in Suspected Pulmonary Tuberculosis Cases

Sivasankar Das et al. J Glob Infect Dis. .

Abstract

Introduction: The prevalence of nontuberculous mycobacteria (NTM) is on the rise worldwide. The diagnosis of NTM lung disease (NTM-LD) is a dilemma. The 2020 guidelines jointly established by the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) outline the criteria for diagnosing pulmonary NTM disease. Herein, we report a series of cases with an analysis of relevant literature to gain insight into the pathogenicity of NTM species, the risk factors involved, and treatment strategies.

Methods: This is a prospective observational study starting from April 2023 to December 2023. A total of 370 suspected pulmonary tuberculosis (TB) patients were included. Clinical specimens were processed for Ziehl-Neelsen staining, GeneXpert Mycobacterium tuberculosis (MTB)/RIF assay, and culture. Culture-positive mycobacteria were classified as MTB complex or NTM based on detection of MPT64 antigen. The NTM isolates were speciated by line probe assay using GenoType® Mycobacterium common mycobacteria (Hain Lifescience, Nehren, Germany). The criteria of ATS/IDSA were applied to confirm NTM-LD.

Results: Nine (n = 9) patients were diagnosed as cases of NTM-LD. Bronchiectasis and previous TB were the most common comorbidities. Mycobacterium scrofulaceum (n = 2), Mycobacterium szulgai (n = 2), Mycobacterium intracellulare (n = 1), Mycobacterium kansasii (n = 1), Mycobacterium abscessus (n = 1), Mycobacterium fortuitum (n = 1), and Mycobacterium interjectum (n = 1) were the species involved. Specific therapeutic drug regimens were administered in four cases, which resulted in clinical improvement.

Conclusion: People with comorbid (LDs) are at risk of NTM-LD. The severity of NTM-LD and mortality also depend on the species involved. New guidelines with evidence-based recommendations should be formulated to simplify the diagnosis and treatment of NTM-LD caused by an array of more than 190 species.

Keywords: Clinical manifestation; nontuberculous mycobacteria; pulmonary; species.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Computed tomography thorax showing bilateral bronchiectatic nodular pattern in two different sections. CT: Computed tomography
Figure 2
Figure 2
Computed tomography thorax showing fibrocavitary changes and bronchiectasis on both sides of lungs in two different sections. CT: Computed tomography
Figure 3
Figure 3
Chest X-ray showing bronchiectatic nodules bilaterally on both hemithorax
Figure 4
Figure 4
Computed tomography thorax showing bilateral nodular opacities and small cavities in four different sections
See this image and copyright information in PMC

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References

    1. van der Laan R, Snabilié A, Obradovic M. Meeting the challenges of NTM-PD from the perspective of the organism and the disease process: Innovations in drug development and delivery. Respir Res. 2022;23:376. - PMC - PubMed
    1. Chin KL, Sarmiento ME, Alvarez-Cabrera N, Norazmi MN, Acosta A. Pulmonary non-tuberculous mycobacterial infections: Current state and future management. Eur J Clin Microbiol Infect Dis. 2020;39:799–826. - PMC - PubMed
    1. Koh WJ. Nontuberculous mycobacteria-overview. Microbiol Spectr. 2017;5:1–7. [doi: 10.1128/microbiolspec.TNMI7-0024-2016] - PMC - PubMed
    1. Moon P, Guillaumin E, Chan ED. Non-tuberculous mycobacterial lung disease due to multiple “minor” risk factors: An illustrative case and a review of these “lesser elements”. J Thorac Dis. 2020;12:4960–72. - PMC - PubMed
    1. Loebinger MR, Quint JK, van der Laan R, Obradovic M, Chawla R, Kishore A, et al. Risk factors for nontuberculous mycobacterial pulmonary disease: A systematic literature review and meta-analysis. Chest. 2023;164:1115–24. - PubMed

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