Prevalence and Risk Factors of Nontuberculous Mycobacterial Infection in a Coastal Area, Southern China

Abstract Background: Nontuberculous mycobacterial (NTM) infections are becoming more common, but the epidemiologic characteristics of NTM in much of the world remain largely unknown. The purpose of this study was to evaluate the prevalence and risk factors for NTM infection in a southern coastal area of China. Results: 1759 individuals suspected of having tuberculosis were included in the analysis, of whom 140 (7.96%) had NTM isolated from their sputa. The NTM species identified by the Kraken 2/Bracken and Hain methods were highly consistent. M. abscessus complex bacilli were the most prevalent species isolated (n=58, 41.43%), followed by the Mycobacterium avium complex (MAC) (n=41, 29.29%). Residency in Shenzhen for more than 2 years (OR 4.205; 95% CI 1.851-9.552; P = 0.001) and a history of prior TB (OR 4.263; 95% CI 1.871-9.714; P = 0.001) increased the risk for NTM infections. Whole-genome sequencing data from many of the MAC isolates showed high genomic diversity and heterogeneity. Conclusion: M. abscessus was the most common causative NTM species found in symptomatic patients in this region. Living in Shenzhen for more than 2 years and having a previous history of TB were associated with an increased risk of NTM infection. MAC genomes are often heterogenous.