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Research Article
Yanlin Zhao
National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention
Corresponding Author
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Background: Information on prevalence and resistance spectrum of nontuberculous mycobacteria (NTM) in China is mainly based on regional or local data. A national survey of NTM pulmonary disease was carried out based on acid-fast positive sputum samples collected in 2013.
Methods: Sputum samples collected from enrolled presumptive cases were cultured using L-J medium in 72 nationwide tuberculosis surveillance sites from the 31 Chinese mainland provinces and isolates were sent to national tuberculosis reference laboratory (NTRL). The species of re-cultured strains were identified by MALDI-TOF MS and minimal inhibitory concentrations (MICs) were determined to evaluate the drug susceptibility of NTM isolates.
Results: Of 4917 mycobacterial isolates cultured, 317 (6.4%, 95% CI, 5.8% to 7.2%) were confirmed as NTM, among which 287 (7.7%, 95% CI, 6.9% to 8.6%) were from the southern region. In inland and coastal China, 87.7% (95% CI, 78.7% to 93.2%) and 50.0% (95% CI, 43.7% to 56.3%) of isolates, respectively, were slow growing mycobacteria (SGM), with the remaining rapid growing mycobacteria (RGM). A total of 29 species were detected, M. abscessus had higher clarithromycin-inducible resistance rates than M. massiliense (65.67% vs 2.22%). M. kansasii was present lower resistance rates in linezolid and moxifloxacin than Mycobacterium avium-intracellulare complex and other SGM.
Conclusions: More NTM pulmonary disease was observed in southern and coastal China (p<0.01). SGM was widely distributed, and more RGM are present in southern and coastal China (p<0.01). The antimicrobial resistance spectrum of different NTM species was significant different, accurate species identification would be facilitated to NTM pulmonary disease treatment.
Keywords
NTM, Pulmonary Disease, Prevalence, Drug Resistance
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CURRENT STATUS: Under Review
Version 1
Posted 09 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 27 Feb, 2021
Review #2 received
Received 25 Feb, 2021
Review #4 received
Received 24 Feb, 2021
Review #1 received
Received 20 Feb, 2021
Review #3 received
Received 15 Feb, 2021
Reviewer #4 agreed
On 11 Feb, 2021
Reviewer #3 agreed
On 11 Feb, 2021
Reviewer #2 agreed
On 10 Feb, 2021
Reviewers invited
Invitations sent on 07 Feb, 2021
Reviewer #1 agreed
On 07 Feb, 2021
Reviews received
Received 07 Feb, 2021
Editor assigned
On 03 Feb, 2021
Editor invited
On 03 Feb, 2021
Submission checks complete
On 03 Feb, 2021
First submitted
On 31 Jan, 2021
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Subject Areas
Infectious Diseases
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A new preprint design is coming!
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This preprint is under consideration at Infectious Diseases of Poverty. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Yanlin Zhao
National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 09 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 27 Feb, 2021
Review #2 received
Received 25 Feb, 2021
Review #4 received
Received 24 Feb, 2021
Review #1 received
Received 20 Feb, 2021
Review #3 received
Received 15 Feb, 2021
Reviewer #4 agreed
On 11 Feb, 2021
Reviewer #3 agreed
On 11 Feb, 2021
Reviewer #2 agreed
On 10 Feb, 2021
Reviewers invited
Invitations sent on 07 Feb, 2021
Reviewer #1 agreed
On 07 Feb, 2021
Reviews received
Received 07 Feb, 2021
Editor assigned
On 03 Feb, 2021
Editor invited
On 03 Feb, 2021
Submission checks complete
On 03 Feb, 2021
First submitted
On 31 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Information on prevalence and resistance spectrum of nontuberculous mycobacteria (NTM) in China is mainly based on regional or local data. A national survey of NTM pulmonary disease was carried out based on acid-fast positive sputum samples collected in 2013.
Methods: Sputum samples collected from enrolled presumptive cases were cultured using L-J medium in 72 nationwide tuberculosis surveillance sites from the 31 Chinese mainland provinces and isolates were sent to national tuberculosis reference laboratory (NTRL). The species of re-cultured strains were identified by MALDI-TOF MS and minimal inhibitory concentrations (MICs) were determined to evaluate the drug susceptibility of NTM isolates.
Results: Of 4917 mycobacterial isolates cultured, 317 (6.4%, 95% CI, 5.8% to 7.2%) were confirmed as NTM, among which 287 (7.7%, 95% CI, 6.9% to 8.6%) were from the southern region. In inland and coastal China, 87.7% (95% CI, 78.7% to 93.2%) and 50.0% (95% CI, 43.7% to 56.3%) of isolates, respectively, were slow growing mycobacteria (SGM), with the remaining rapid growing mycobacteria (RGM). A total of 29 species were detected, M. abscessus had higher clarithromycin-inducible resistance rates than M. massiliense (65.67% vs 2.22%). M. kansasii was present lower resistance rates in linezolid and moxifloxacin than Mycobacterium avium-intracellulare complex and other SGM.
Conclusions: More NTM pulmonary disease was observed in southern and coastal China (p<0.01). SGM was widely distributed, and more RGM are present in southern and coastal China (p<0.01). The antimicrobial resistance spectrum of different NTM species was significant different, accurate species identification would be facilitated to NTM pulmonary disease treatment.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- GraphicalAbstractImage.jpg
Note: The designations employed and the presentation of the material on this map do not imply the expression of any opinion whatsoever on the part of Research Square concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. This map has been provided by the authors.
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