Nontuberculous mycobacteria (NTM) are ubiquitous environmental organisms able to cause severe opportunistic human infections. Their distribution patterns are subject to geographical variations. This study describes their isolation frequencies from clinical specimen in the three French overseas departments of the Americas, namely, Guadeloupe, Martinique, and French Guiana during 1994–2012. A total of 651 strains from as many patients (one isolate per species per patient) were analysed regarding regional isolation patterns and potential pattern changes over time. The Mycobacterium avium complex was the most common group of NTM in Guadeloupe and French Guiana. In Martinique it was the second most common after the rapidly growing mycobacteria. M. fortuitum was the most commonly isolated species in all three departments. Some species (M. kansasii, M. xenopi, and M. terrae complex) displayed a clear regional preference. Furthermore a change in isolation frequency was observed for M. intracellulare (increase) and M. kansasii (decrease) in Guadeloupe. In conclusion, marked regional differences in isolation frequencies of NTM species were observed in the study area. Results are discussed in context of variables such as study populations, risk factors, methodology employed, isolation from pulmonary versus sterile isolation sites (blood, urine, and CSF), and in vitro drug-susceptibility patterns. 1. Introduction Aside from the obligate pathogens Mycobacterium tuberculosis and M. leprae, the genus Mycobacterium includes a high number of environmental organisms commonly referred to as nontuberculous (NTM) or atypical mycobacteria (the list of prokaryotic names with standing in nomenclature [1] lists 164 mycobacterial species and 13 subspecies). Environmental mycobacteria can be found in a wide range of aquatic and terrestrial habitats. They have been isolated from dusts, aerosols, and biofilms [2] and are frequently recovered from domestic or hospital water distribution systems [3]. A number of these environmental mycobacteria act as opportunistic pathogens causing a variety of diseases. Such infections are often linked to predisposing factors like immunodeficiency or underlying lung disease [4]. Apart from pulmonary infections, NTM can be implicated in skin disease, soft tissue infection, skeletal infections, lymphadenitis, foreign body-related infections (e.g., catheter-related infections), and bacteremia in AIDS patients amongst others [4, 5]. A considerable increase in NTM infections has been observed in the 1980s and early 1990s [6, 7]. While improved
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