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INTRODUCTION: Nontuberculous mycobacteria (NTM) are increasingly recognized as clinically significant pathogens, particularly in immunocompromised individuals and patients with chronic lung disease. A key determinant of their persistence and pathogenicity is the ability to form biofilms, which confer antimicrobial tolerance and complicate eradication. It is important to distinguish biofilm-associated phenotypic tolerance (persistence) from genetic antimicrobial resistance, as these are distinct phenomena with different mechanisms. Biofilm-related persistence is transient and non-genetic, allowing bacteria to survive antibiotic exposure without acquiring resistance mutations, while genetic resistance involves stable heritable changes. Both mechanisms contribute to treatment failure and prolonged infection.
Cano-Fernández et al. (Thu,) studied this question.