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Table 1 Summary of key features of pulmonary TB and NTM diseases

From: Of tuberculosis and non-tuberculous mycobacterial infections – a comparative analysis of epidemiology, diagnosis and treatment

Category Tuberculosis (TB) Pulmonary Non-tuberculous mycobacteria (NTM) infections References
1. Causative agent M. tuberculosis complex organisms M. avium complex. M. abscessus, M. kansasii, M. malmoense, M. xenopi [2, 5, 6]
2. Mode of transmission Inhalation of contaminated aerosols from patients with pulmonary TB Primarily acquired from the environment - lack of person-to-person transmission [3, 6]
3. Sex with higher disease burden Male Female [1, 13]
4. Predisposition/Co-morbidities HIV, DM, Immunosuppression Bronchiectasis, Previous history of TB, CF, COPD [1, 14,15,16,17,18,19,20,21]
5. Diagnosis
5.1 Clinical Lung involvement, alveolar infiltration, cavitation,
lymphadenopathy and pleural effusion
Nodular or cavitary opacities on chest radiograph, or an HRCT scan that shows multifocal bronchiectasis with multiple small nodules [6, 22]
5.2 Radiological X-ray; rarely CT X-ray; PET/CT or HRCT [6, 22]
Samples for the diagnostic test Sputum samples, bronchial or bronchioalveolar lavage aspirates, or tracheal aspirates; Gastric aspirate Sputum, bronchial wash, or lavage; Gastric aspirate not preferred due to failure to indicate active pNTM disease [22, 23]
5.3 Microbiological test
5.3.1 Staining Acid fast staining; Ziehl Neelson staining Acid fast staining; Ziehl Neelson staining [22,23,24]
5.3.2 Culture Solid, Liquid - MGIT 960 system; the VersaTREK system; MB/BacT Alert 3D Solid or liquid including MGIT but with PNB [23, 25, 26]
5.4 Molecular biological test TB Ag MPT64 RAPID
Nucleic acid amplification test (NAAT)
Amplified Mycobacterium tuberculosis direct (MTD); Amplicor Mycobacterium tuberculosis Test;
Xpert MTB-Rif system;
Xpert MTB-Rif Ultra
Loop-mediated isothermal amplification (LAMP)-based MTB detection system;
Cross-priming amplification (CPA)-based TB diagnostic system;
CE-IVD Genedrive;
Anyplex II MTB/MDR and MTB/XDR;
Anyplex MTB/NTM MDR-TB kit;
VereMTB Detection Kit
Line probe assays (LiPA)
Inno-LiPA Mycobacteria assay;
Genotype Mycobacterium CM and AS assays
Others -
Next gen sequencing
For Latent TB –
Tuberculin skin test
IGRA test - QuantiFERON-TB Gold, QFT-GIT, QFT-Plus and T-SPOT.TB
TB Ag MPT64 RAPID – to differentiate M. tb complex from NTM
PCR-RFLP ; PCR sequencing
Accuprobe analysis
Genedia MTB/NTM Detection Kit
Inno-LiPA Mycobacteria assay;
GenoType Mycobacterium CM -AS
Others -
Next gen sequencing
MPT64 - [27, 28]
HPLC - [29, 30]
PCR-RFLP/Sequencing - [31,32,33,34]
[49, 54,55,56,57,58]
Others –