Abstract
The incidence of NTM lung diseases has been increasing worldwide, Species-level identification of NTM is very important due to the treatment regimen and prognosis associated with species-based differences in the treatment of NTM lung disease. Aim The study performed species identification of the NTM by analyzed sputum of PTB suspected patients, also sought investigated the presence of this broad diversity of it is species collected. Methods: The study was conducted in the TB LAB of NCDC, from March to August 2016. A total of 1503 sputum samples were collected from patients suspected to have pulmonary tuberculosis. The preliminary diagnosis was performed using ZNS followed by liquid culture in MAGIT 906, positive cultures obtained were differentiated as either NTM or MTC using a commercial kits TBc antigen test. more identification analysis done for NTM species after give positive growth on LJ media by determinate their grow speed, and colony pigmentation production ability, finally using molecular technique in main two step, by used SO-IMA, and the hsp65 genes sequencing, identified all of NTM to specie level Results: Out of 1503 there were 180 MAGIT positive cultures isolated, , 30/180 (16.6%) specimens were MTC positive by TBc test, therefor; out of 150 specimen MAGIT positive culture with negative result for MTB by TBc test, 130/180 (86.6%) showed growth on LJ media , 40/130 (30.7%) with clear growth , and 90/130 (69.2%) with contamination, 130 which grow on LJ media showed positive AFB in 37/130 indirect ZNS smear, the sensitivity of indirect ZNS is 37/45 (82.2%). by SO-IMBA 34/45 (75.5%) where identified as NTM, with high diversity of the species, the resulted as follow (64.9%) SGM were more frequently, M. kansasii was most of it (32.3%) , followed by (11.7%) M. avium, and lastly (8.8%) M, gordonae, while, there were less frequent was RGM (35.1%) as M. abscessus, M. fortuitum , 4/34 (11.7%) for both, also it was identified 8/34 (21.6%) of the isolates as genus species, 6/8 of them identified by sequencing methods NTM species resulted, as M. Elephantis, M. Monacense, M. Peregrinum and /or M. Porcinum, M. lentiflavum, and M. Paragordonae all with same percentage 2.9%, while, M. Holasticum that also recognized by sequencing, there were another one species identified by PRA LFP technique , so it is comprise approximately 6% of total NTM identified. Only one species 1/8 2.9% of genius species identified by S0-IMBA, by sequencing technique was M. Tuberculosis complex, he is sudanness male patient. The demographic data of all patients who confirmed having NTM, their mean age was 46.9 years old with minimum and maximum age was 4 years to 75 years old, Male was higher than female by (66.66%) by double, and all were Libyan nationality. Conclusion: This study showed a high diversity of NTM in Libya for the first time, this diversity of NTM suggests the need for immediate and accurate nationwide characterization of them for proper treatment and management of patients.