Molecular Detection of Mycobacterium tuberculosis and Nontuberculous Mycobacteria with Drug Resistance Profiling Using Line Probe Assay in Clinical Samples from Suspected Tuberculosis Patients in North Sumatra, Indonesia

BACKGROUND: Tuberculosis (TB) remains a major global health challenge. In addition to Mycobacterium tuberculosis (MTB), nontuberculous mycobacteria (NTM) are increasingly recognized as causative agents of mycobacterial infections. However, the limited access to rapid diagnostics often delays appropriate treatment. Accurate and timely differentiation is critical for selecting effective antibiotic regimens. In Indonesia, there is a lack of population-based data comparing MTB and NTM in TB-suspected cases. This study aimed to detect and differentiate MTB and NTM in clinical samples from suspected TB patients in North Sumatra and to assess their drug resistance profiles using a molecular diagnostic approach. METHODS: We conducted a prospective cohort study using 56 clinical samples (45 smear-positive sputum and 11 fine-needle aspiration biopsies) from suspected TB patients in North Sumatra. DNA was extracted and analyzed using the Genoscholar™ NTM + multidrug-resistant TB (MDR-TB) II line probe assay (LPA) to detect MTB, NTM, and anti-TB drug resistance. RESULTS: Of the 56 samples, 40 (71.4%) were positive for MTB, 2 (3.6%) for Mycobacterium avium, and 5 (8.9%) for other NTM species, while 9 (16.1%) were negative. MDR MTB was detected in 9 (28%) sputum samples and 1 (12.5%) biopsy sample. Both M. avium isolates were susceptible to rifampicin and isoniazid, while resistance profiles for the other NTM species could not be determined. CONCLUSION: LPA effectively differentiated MTB from NTM and identified drug resistance patterns in clinical samples. Implementation of this rapid diagnostic tool may strengthen TB management in high-burden areas such as North Sumatra, enabling earlier and more targeted treatment.