{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T11:01:49Z","timestamp":1789902109499,"version":"4.0.1"},"reference-count":29,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objective:<\/jats:title>\n                    <jats:p>\n                      Drug-resistant (DR) mycobacterial infections present escalating threats in Iran, where facility-specific transmission dynamics and demographic disparities remain poorly characterized. This study evaluated the epidemiology of DR\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      and pulmonary nontuberculous mycobacterial disease over a 9-year period (2016\u20132024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      This retrospective study analyzed 21,700 molecular and culture-confirmed mycobacterial samples. Species identification used line probe assays and Xpert\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      \/rifampin. Drug susceptibility testing followed World Health Organization standards. Statistical analyses identified associations between resistance patterns, hospital sections, gender, and specimen types.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      MDR-TB prevalence surged from 0.35% (2017) to 3.27% (2022), peaking during pandemic disruptions.\n                      <jats:italic toggle=\"yes\">M. simiae<\/jats:italic>\n                      dominated nontuberculous mycobacteria (NTM) resistance (55.63% of resistant isolates), with significant increases in 2024 (7.91%). Airborne infection isolation rooms (AIIRs) paradoxically harbored 18.22% of Multidrug-resistant tuberculosis (MDR-TB)isolates (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001), while pulmonary medicine units contained zoonotic\n                      <jats:italic toggle=\"yes\">M. bovis<\/jats:italic>\n                      reservoirs (0.27% MDR prevalence). Male patients carried higher burdens of MDR-TB (26.01% vs. 12.45%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.005) and\n                      <jats:italic toggle=\"yes\">M. kansasii<\/jats:italic>\n                      (2.05% vs. 0.53%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.012). Diagnostic challenges included 38.14% smear-negative\n                      <jats:italic toggle=\"yes\">M. abscessus<\/jats:italic>\n                      and gastrointestinal NTMs (\n                      <jats:italic toggle=\"yes\">M. genavense<\/jats:italic>\n                      66.66%). Sample type analysis revealed\n                      <jats:italic toggle=\"yes\">M. fortuitum<\/jats:italic>\n                      in 25.0% of abscesses (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05) and\n                      <jats:italic toggle=\"yes\">M. chelonae<\/jats:italic>\n                      in 5.55% of synovial fluid (SF) specimens.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Iran faces converging epidemics of MDR-TB and climate-adapted NTMs concentrated in hospital hotspots, with significant gender disparities. Precision interventions targeting AIIR protocols, water safety regulations, and gender-specific screening are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10766294261463589","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T10:00:33Z","timestamp":1782468033000},"page":"472-487","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends, Patterns, and Demographic Dynamics of Drug Resistance in\n                    <i>Mycobacterium tuberculosis<\/i>\n                    and Nontuberculous: A Multi-Year Analysis at the National Tuberculosis Reference Laboratory"],"prefix":"10.1177","volume":"32","author":[{"given":"Sahar","family":"Sadeghi Mofrad","sequence":"first","affiliation":[{"name":"Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4559-6525","authenticated-orcid":false,"given":"Mohsen","family":"Maleknia","sequence":"additional","affiliation":[{"name":"Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parissa","family":"Farnia","sequence":"additional","affiliation":[{"name":"Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poopak","family":"Farnia","sequence":"additional","affiliation":[{"name":"Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jalaledin","family":"Ghanavi","sequence":"additional","affiliation":[{"name":"Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Akbar","family":"Velayati","sequence":"additional","affiliation":[{"name":"Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"issue":"3","key":"e_1_3_4_2_1","first-page":"285","article-title":"Pattern of drug resistant Mycobacterium tuberculosis in the west and northwest of Iran: A meta-analysis","volume":"14","author":"Ansarin K","year":"2022","unstructured":"1.Ansarin K, , Sahebi L. Pattern of drug resistant Mycobacterium tuberculosis in the west and northwest of Iran: A meta-analysis. Iran J Microbiol 2022;14(3):285\u2013290; doi: 10.18502\/ijm.v14i3.9754","journal-title":"Iran J Microbiol"},{"issue":"4","key":"e_1_3_4_3_1","first-page":"428","article-title":"An updated systematic review and meta-analysis on Mycobacterium tuberculosis antibiotic resistance in Iran (2013\u20132020)","volume":"24","author":"Khademi F","year":"2021","unstructured":"2.Khademi F, , Sahebkar A. An updated systematic review and meta-analysis on Mycobacterium tuberculosis antibiotic resistance in Iran (2013\u20132020). 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