Abstract:

Objective To provide insights for early differential diagnosis and treatment by comparatively analyzing the clinical features and drug-resistance patterns of tuberculosis （TB） and non-tuberculous mycobacterial （NTM） disease. Methods We retrospectively collected data on patients diagnosed with TB （TB group） and NTM disease （NTM group） from January 2022 to December 2024. Clinical characteristics and antimicrobial resistance profiles were analyzed and compared between the two groups. Results The specimens of TB group and NTM group mainly came from sputum. TB patients were predominantly young and middle-aged males aged 15-40 years，whereas NTM patients were mainly males aged 61 years and older. Compared with the NTM group，the TB group had significantly higher rates of cough （χ²=18.850，P<0.01），hemoptysis （χ²=31.780，P<0.01），and CT findings including patchy opacities （χ²=11.680，P=0.001），nodular lesions （χ²=12.590，P<0.01），and bronchial changes （χ²=22.640，P<0.01）. The TB group also showed higher prevalences of hypertension （χ²=12.600，P<0.01），anemia （χ²=4.637，P=0.031），diabetes history （χ²=34.330，P<0.01），leukopenia （χ²=9.470，P=0.002），and emphysema （χ²=16.430，P<0.001）. Drug-resistance analysis indicated a relatively high isoniazid resistance rate in the TB group （22.65%），whereas the NTM group exhibited high levels of resistance to most anti-tuberculosis drugs. Conclusion TB patients in this cohort were predominantly young to middle-aged adults，while NTM disease occurred mainly in elderly patients. The observed differences in clinical presentation and susceptibility profiles may assist early differential diagnosis and guide appropriate treatment strategies.

Key words: tuberculosis, mycobacterium infections, nontuberculous, specimen source, clinical features, drug-resistance-analysis