Advancing Diagnosis and Management of Mycobacterium tuberculosis and Nontuberculous Mycobacteria Infections

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. The pathogen mycobacteria affects pulmonary and extrapulmonary regions of the human body. More than 100 species of mycobacteria have been identified. The prevalence of infection seems to be rising, and mycobacteria other than M. tuberculosis , sometimes referred to as nontuberculous mycobacteria (NTM), can be harmful to humans. Despite the availability of a plethora of diagnostic assays for mycobacteria, there is not a single perfect diagnostic assay. The conventional diagnostic options, such as culture and microscopy-based assays, are time-consuming and labor-intensive and have low sensitivity and specificity, which hinder the early diagnosis and further delay the employment of treatment regimens in clinical settings. In case of TB infection, the sputum-based assays present considerable risks to lab personnel. Also, sputum-based assays are not suitable for extrapulmonary and pediatric TB; therefore, non–sputum-based alternative assays, such as stool- and urine-based assays, should be explored. Each diagnostic assay shows some limitations that need to be overcome to develop effective, cost-effective, and specific TB diagnostic assays. Compared with conventional diagnostics, novel nanotechnology, artificial intelligence, optical assays, and PCR-based diagnostic assays could be highly efficient. Although targeted next-generation sequencing-based assays are under development, they may prove promising for TB and NTM diagnosis.