Molecular epidemiology of non-tuberculous mycobacteria in clinical samples from Jiangxi Province, 2021-2023.
Zhan Qiu Mao, Huilie Zheng, Hui Qiong Yang, Qian Zhong Liu, Yu Hong Xiong, Zhen Qiong Liu, Qi Long Zhang
BMC microbiology · 2026-01
Abstract
BACKGROUND: (NTM) pose diagnostic and therapeutic challenges in tuberculosis (TB)-endemic regions like Jiangxi Province, China, due to clinical and radiological similarities to TB. This study elucidates the molecular epidemiology of NTM in Jiangxi (2021–2023).
METHODS: A retrospective analysis of 20,724 clinical specimens from Jiangxi Chest Hospital was conducted using PCR-reverse blot hybridization assay (PCR-REBA) for NTM species identification. Inclusion required clinical/radiological suspicion of mycobacterial disease and specimens with sufficient volume (≥ 2 mL for liquid samples or ≥ 0.5 g for tissue). Statistical analyses determined prevalence, species distribution, and predictors.
RESULTS: Among 5,331 Mycobacterium-positive specimens, 333 (1.60%; 95% CI: 1.43–1.77) were NTM. Males had significantly lower odds of infection than females (aOR 0.499, < 0.001), with the highest prevalence observed in individuals aged ≥ 65 years (2.64%) compared to the ≤ 24 years reference group (aOR 12.922, 95% CI: 5.288–31.578, < 0.001). Dominant species were(MIN, 51.7%),(MAB, 30.9%), and(MAV, 9.3%). MIN and MAB predominated in pulmonary samples (97.9% of cases), while MAV showed significant extrapulmonary tropism (42.9% vs. 8.6% pulmonary, 0.02). Detection rates fluctuated temporally (peak: 1.93% in 2021; trough: 1.20% in 2022; 0.004), potentially influenced by the COVID-19 pandemic.
CONCLUSION: Jiangxi exhibits a distinct NTM profile with elevated MAB prevalence, emphasizing the need for species-level diagnosis to prevent misclassification as multidrug-resistant TB. Age, sex, and temporal trends emphasizing the critical need for species-level identification to facilitate early, targeted antimicrobial therapy and prevent the misclassification of NTM as multidrug-resistant TB.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12866-026-04732-2.