We documented a 6-fold increase in the frequency of nontuberculous mycobacteria isolated from clinical samples in Botswana during 2011–2014. Because antituberculosis treatment is often initiated only on the basis of acid-fast bacilli smear-positive microscopy results, some patients with nontuberculous mycobacterial infections might have received inappropriate treatment.

Keywords: Botswana, nontuberculous mycobacteria, Mycobacterium avium-intracellulare, Tuberculosis and other mycobacteria, bacteria, drug susceptibility

Nontuberculous mycobacteria (NTM) isolated from clinical samples are often classified as contaminants (1). However, some NTM species are pathogenic to humans (2) and, in some parts of the world, cause more illness than infection with Mycobacterium tuberculosis does (3).

In Botswana, as in many other developing countries, patients with acid-fast bacilli–positive sputum are presumed to be infected with M. tuberculosis and are treated with antituberculosis agents (4), even though acid-fast bacilli smear microscopy does not distinguish between M. tuberculosis and NTM, and most antituberculosis drugs might not be effective against NTM (5). This observation, along with the number of increasing reports of NTM worldwide (1,4,6–9), prompted this study

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