title: Diagnostic delay of pulmonary nontuberculous mycobacterial infection in China.
abstract: BACKGROUND
  Nontuberculous mycobacteria (NTM) infection is an emerging, but neglected public health concern in China.
  
  
  RESULTS
  To investigate diagnostic delay of NTM diseases in China, we analyzed 91 patients with pulmonary NTM infection in ShandongProvince. The median diagnostic delay time of the analyzed patients was 84 days, which was significantly associated with rural inhabitance (135 days vs. 73 days of urban inhabitance, p < 0.01) and lower level of first visiting hospitals/clinics (70 and 82 days of tertiary and secondary hospitals/clinics respectively vs. 120 days of primary hospitals/clinics, p < 0.05). M. farcinogenes was isolated from a 79-year-old male patient, which is the first report of pulmonary infection in humans.
  
  
  CONCLUSIONS
  Our results indicate a significant diagnostic delay of NTM diseases in China, especially for rural patients with limited access to higher-level healthcare services.
authors.affiliation: Katharine Hsu International Research Center of Human Infectious Diseases, Shandong Provincial Chest Hospital, Shandong University, Jinan, Shandong 25013 China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jing
authors.affiliation: Katharine Hsu International Research Center of Human Infectious Diseases, Shandong Provincial Chest Hospital, Shandong University, Jinan, Shandong 25013 China.
authors.forename: Wanming
authors.initials: W
authors.lastname: Tan
authors.affiliation: Katharine Hsu International Research Center of Human Infectious Diseases, Shandong Provincial Chest Hospital, Shandong University, Jinan, Shandong 25013 China.
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Deng
authors.affiliation: Katharine Hsu International Research Center of Human Infectious Diseases, Shandong Provincial Chest Hospital, Shandong University, Jinan, Shandong 25013 China.
authors.forename: Dachuan
authors.initials: D
authors.lastname: Gao
authors.affiliation: Clinical Center on TB, Chinese Center for Disease Control and Prevention, Beijing, 101149 China.
authors.forename: Liang
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Laboratory Medicine, Shandong Provincial Hospital, Jinan, Shandong 250021 China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Lu
authors.affiliation: The Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital Research Institute, Houston, Texas 77030 USA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Graviss
authors.affiliation: Katharine Hsu International Research Center of Human Infectious Diseases, Shandong Provincial Chest Hospital, Shandong University, Jinan, Shandong 25013 China ; The Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital Research Institute, Houston, Texas 77030 USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
keywords: China; Infection; Nontuberculous mycobacterium