Laboratory diagnosis of nontuberculous mycobacteria – an update – Part 1^★: Epidemiology, environment sources, and guidance for the provider

The nontuberculous mycobacteria (NTM) are now more frequently encountered in the laboratory compared to 20–30 years ago. New media and molecular assays have been introduced for the accurate detection and identification of an increased number of new NTM species. Furthermore, antimicrobial drug resistance genes have been characterized for the detection of macrolide and aminoglycoside resistance. NTM are often involved in nosocomial outbreaks where water sources are often the culprit. The authors of this 3-part publication aimed to provide an update on current clinical diagnostics for NTM as well as information about testing water or environmental samples for NTM, since this is often requested of the clinical laboratory. For an NTM disease to develop, a trifecta of elements/forces are in play: host characteristics, the NTM, and the environment.