Non-tuberculous mycobacterial infections in mainland China and Taiwan: a systematic review and meta-analysis of epidemiology, species distribution, and drug resistance (2013-2024)
Abstract
Introduction: Non-tuberculous mycobacteria (NTM) represent an emerging public health threat in China. Despite evidence of rising NTM prevalence and significant regional variation, comprehensive and up-to-date nationwide data on epidemiology, species distribution, and drug resistance patterns have been lacking. This study aimed to systematically evaluate the prevalence, geographical and temporal trends, species composition, and antimicrobial resistance of NTM in mainland China and Taiwan from 2013 to 2024.
Methods: Adhering to PRISMA guidelines, this systematic review and meta-analysis (PROSPERO: CRD42024540102) included 43 studies (2013-2024) encompassing 17,959 NTM isolates from 225,733 suspected TB patients. Stata software was used for meta-analysis with a random-effects model; publication bias was assessed via Egger's test and funnel plots.
Results: The pooled NTM prevalence among suspected tuberculosis patients was 11.27% (95% CI: 9.89-12.65%), with marked geographic variation: highest in northeast (24.18%) and southeast coastal regions (12.83%), and lowest in southwest (2.30%). Slowly growing mycobacteria accounted for 68.07% of isolates, dominated by Mycobacterium avium complex (especially M. intracellulare); rapidly growing mycobacteria (26.57%) were more prevalent in southern provinces, with M. abscessus predominant. An overall upward trend in NTM isolation was observed from 2009-2021, followed by a decline in 2022-2023. Widespread resistance to first-line…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 225,733 participants or records.
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