Comparative evaluation of molecular technologies for the identification of prevalent non-tuberculous mycobacteria in pulmonary infections: a systematic review and meta-analysis.
Xiang Chen, Jiawen Sun, Xibin Chen et al.
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In 30 seconds
This systematic review and meta-analysis assessed molecular methods for identifying non-tuberculous mycobacteria (NTM) and detecting antibiotic resistance in human studies published between 2005 and 2024. It included 49 studies of identification and 33 of resistance. MALDI-TOF MS, PCR-based methods, sequencing, DNA chips and DNA strips all had pooled identification sensitivities above 0.92; sample type significantly influenced MALDI-TOF MS performance. Resistance patterns varied, including 69.20% ethambutol resistance in M. avium and 54.22% imipenem resistance among rapidly growing mycobacteria.
Key findings
- All evaluated molecular technologies had pooled sensitivities above 0.92 for NTM species identification.
- Sample type significantly affected MALDI-TOF MS identification performance.
- Ethambutol resistance in M. avium was 69.20%.
- Imipenem resistance among rapidly growing mycobacteria was 54.22%; clarithromycin resistance varied within the M. abscessus complex.
Why it matters
Accurate species identification and susceptibility testing are important to selecting appropriate therapy for NTM pulmonary disease. The review indicates that several molecular approaches can identify NTM with high pooled sensitivity, while performance may depend on specimen type. Its findings also underscore that resistance is heterogeneous across NTM groups, so species-level identification alone may not resolve susceptibility questions.
What to keep in mind
The review reports substantial variation in resistance patterns and a sample-type effect for MALDI-TOF MS; pooled results across different methods and studies may not apply uniformly to every setting.