Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Infect Genet Evol. 2019 Aug;72:169-182. doi: 10.1016/j.meegid.2018.10.003. Epub 2018 Oct 11.
Accumulating evidence suggests that human infections caused by nontuberculous mycobacteria (NTM) are increasing worldwide, indicating that NTM disease is no longer uncommon in many countries. As a result of an increasing emphasis on the importance of differential identification of NTM species, several molecular tools have recently been introduced in clinical and experimental settings. These advances have led to a much better understanding of the diversity of NTM species with regard to clinical aspects and the potential factors responsible for drug resistance that influence the different outcomes of NTM disease. In this paper, we review currently available molecular diagnostics for identification and differentiation of NTM species by summarizing data from recently applied methods, including commercially available assays, and their relevant strengths and weaknesses. We also highlight drug resistance-associated genes in clinically important NTM species. Understanding the basis for different treatment outcomes with different causative species and drug-resistance mechanisms will eventually improve current treatment regimens and facilitate the development of better control measures for NTM diseases.
越来越多的证据表明，非结核分枝杆菌（NTM）引起的人类感染在全球范围内正在增加，这表明 NTM 病在许多国家已不再罕见。由于越来越重视区分 NTM 物种的重要性，最近在临床和实验环境中引入了几种分子工具。这些进展使人们对 NTM 物种的多样性有了更好的了解，包括与临床方面和耐药相关的潜在因素，这些因素影响着 NTM 病的不同结果。本文通过总结最近应用的方法（包括市售检测方法）的数据，综述了目前可用于鉴定和区分 NTM 物种的分子诊断方法，并分析了这些方法的优缺点。此外，本文还强调了临床重要的 NTM 物种中的耐药相关基因。了解不同致病物种和耐药机制导致不同治疗结果的基础，最终将改善目前的治疗方案，并有助于制定更好的 NTM 病控制措施。
