Clinical characteristics of non-tuberculous mycobacterium in central China were analyzed based on the macropathogenic mNGS sequencing technology

Objective: Metagenomics next generation sequencing (mNGS) was used to investigate the pathogenic factors, epidemic characteristics and clinical characteristics of non-tuberculous mycobacterium in central China. Methods： The pathological data of 320 patients with mycobacterium infection diagnosed in the Department of Pathology of Hunan People's Hospital from June 2019 to December 2023 were collected, including HE staining, acid-fast and fungal fluorescence staining, and macrogenetic pathoomics next generation sequencing (mNGS) detection to classify mycobacterium pathogens. Results： Among 320 patients with mycobacterium detection, 249 were positive for mycobacterium tuberculosis and 71 were positive for non-mycobacterium tuberculosis. Thirteen non-tuberculous mycobacterium genera were identified in the samples from central China, including M. chelonis, M. avium complex group, M. abscess, M. Gordon, M. intracellular, M. tobacco-Kansas, M. paracondontium, M. Aubris, M. margherita, M. fortuitus, M. smegmatis and M. margherita. Conclusion: Non-tuberculous mycobacterium infections gradually increased, and the clinical infection mode began to change from single strain infection to multi-strain combined complex infection. It was very difficult to distinguish non-tuberculous mycobacterium from mycobacterium tuberculosis by simple pathologic diagnosis. The application of mNGS contributed to solving this problem and improving the clinical diagnosis rate and early treatment.