SYSTEMATIC REVIEW article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
This article is part of the Research TopicWorld TB Day 2025: Yes! We Can End TB: Commit, Invest, DeliverView all 11 articles
Non-Tuberculous Mycobacterial Infections in Mainland China and Taiwan: A Systematic Review and Meta-Analysis of Epidemiology, Species Distribution, and Drug Resistance (2013–2024)
Provisionally accepted
- Hainan Medical University, Haikou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
This systematic review and meta-analysis, registered on the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42024540102), investigated the epidemiology, species distribution, and drug resistance of non-tuberculous mycobacteria (NTM) in mainland China and Taiwan from 2013 to 2024. Adhering to PRISMA guidelines, we synthesized data from 43 studies encompassing 17,959 NTM isolates identified from 225,733 suspected tuberculosis patients. The pooled NTM prevalence was 11.27% (95% CI: 9.89%–12.65%), with higher rates observed in coastal and southern regions, such as Guangdong and Shanghai, compared to inland areas. Slowly growing mycobacteria, predominantly Mycobacterium avium complex, accounted for 68.07% of isolates, while rapidly growing species like M. abscessus were more common in southern provinces. Key findings include significant geographic and temporal variations in NTM isolation, with an overall upward trend despite a recent decline in 2022–2023. There was also widespread resistance to first-line antituberculosis drugs, though drugs like clarithromycin and amikacin showed efficacy. Methodological inconsistencies and publication bias (as indicated by Egger's test, P < 0.001) were notable limitations. These results highlight the increasing NTM burden in China, underscoring the urgent need for standardized diagnostic protocols, enhanced surveillance, and region-specific public health strategies to address this growing challenge.
Keywords: NTM (nontuberculous mycobacteria), China, Meta-analysis, Prevalence, Drug Resistance
Received: 30 Jul 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Xu, Lei and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Li Zheng, culturelily@sina.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.