Volume 24 Issue 2
Feb.  2026
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Article Navigation >  Chinese Journal of General Practice  > 2026  >  24(2): 275-279
LIU Wenbin, TANG Leiming, WANG Min, CAI Chengsong, PAN Feng. The diagnostic value of Xpert MTB/RIF for NTM pulmonary disease in smear-positive patients and analysis of the species distribution characteristics of NTM[J]. Chinese Journal of General Practice, 2026, 24(2): 275-279. doi: 10.16766/j.cnki.issn.1674-4152.004378
Citation: LIU Wenbin, TANG Leiming, WANG Min, CAI Chengsong, PAN Feng. The diagnostic value of Xpert MTB/RIF for NTM pulmonary disease in smear-positive patients and analysis of the species distribution characteristics of NTM[J]. Chinese Journal of General Practice, 2026, 24(2): 275-279. doi: 10.16766/j.cnki.issn.1674-4152.004378
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The diagnostic value of Xpert MTB/RIF for NTM pulmonary disease in smear-positive patients and analysis of the species distribution characteristics of NTM

doi: 10.16766/j.cnki.issn.1674-4152.004378

  • Department of Laboratory Medicine, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang 310015, China

Funds:

 2021KY888

  • Received Date: 2025-05-24
    Available Online: 2026-04-11
    Abstract
  •   Objective  To evaluate the diagnostic value of Xpert MTB/RIF for nontuberculous mycobacterial (NTM) pulmonary disease among smear-positive patients and analyze the species distribution of NTM, thereby enhancing the clinical early diagnostic capability for such patients.  Methods  A total of 122 inpatients admitted to the Affiliated Hospital of Hangzhou Normal University from April 2020 to September 2024 were retrospectively selected as research subjects, including 73 cases of NTM lung disease and 49 cases of pulmonary tuberculosis. With smear-positive patients as the analysis subgroup, Kappa analysis was used to verify the consistency of Xpert and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in the differential diagnosis of NTM lung disease and pulmonary tuberculosis, and the species distribution characteristics of NTM were analyzed simultaneously.  Results  The positivity rates of Xpert MTB/RIF were 1.92% (1/52) in smear-positive NTM pulmonary disease, 0% (0/21) in smear-negative NTM pulmonary disease, 100.00% (38/38) in smear-positive pulmonary tuberculosis, and 72.73% (8/11) in smear-negative pulmonary tuberculosis. One case of Mycobacterium abscessus subsp. abscessus was misclassified as Mycobacterium tuberculosis by Xpert MTB/RIF. Among the 73 NTM pulmonary disease cases, single-strain infection accounted for 79.45% (58/73), and mixed infections with two or more NTM strains accounted for 20.55% (15/73). Among the 89 NTM strains detected by MALDI-TOF MS, the more common species were Mycobacterium intracellulare (62.92%, 56/89) and Mycobacterium abscessus (17.98%, 16/89). Xpert MTB/RIF and MALDI-TOF MS demonstrated excellent concordance in distinguishing NTM pulmonary disease from pulmonary tuberculosis among smear-positive patients (Kappa=0.938, P < 0.001).  Conclusion  Mycobacterium intracellulare was the most common NTM species in patients with NTM pulmonary disease, followed by Mycobacterium abscessus. Xpert MTB/RIF can effectively differentiate NTM pulmonary disease from pulmonary tuberculosis in smear-positive patients and exhibits significant clinical value for the diagnosis of smear-positive NTM pulmonary disease.

     

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