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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;

EZplex MTBC/NTM;

VereMTB Detection Kit

Line probe assays (LiPA)

Inno-LiPA Mycobacteria assay;

Genotype Mycobacterium CM and AS assays

Others -

MALDI-TOF

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

HPLC

PCR-RFLP ; PCR sequencing

NAATs –

Accuprobe analysis

Anyplex MTB/NTM MDR-TB

EZplex MTBC/NTM;

Genedia MTB/NTM Detection Kit

LiPAs

Inno-LiPA Mycobacteria assay;

GenoType Mycobacterium CM -AS

Others -

MALDI-TOF

Next gen sequencing

MPT64 - [27, 28]

HPLC - [29, 30]

PCR-RFLP/Sequencing - [31,32,33,34]

NAAT

[35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53]

LIPA –

[49, 54,55,56,57,58]

Others –

[59,60,61,62,63,64,65,66]

LTBI –

[67,68,69,70]