NASHVILLE — The Tennessee Titans want to stack up wins, not style points.
On a Sunday when quarterback Ryan Tannehill battled a stomach bug that had him feeling "bad" when he woke up, they found yet another way to do just that, extending the NFL's longest active winning streak to six games.
Tannehill threw for one touchdown and ran for another as the Titans held off the New Orleans Saints, 23-21, to become the second team in league history to win five straight over playoff teams from the season before. They joined the 2003 Philadelphia Eagles with that distinction, though Tennessee is 7-0 overall this season against teams from the most recent playoffs.
"They do know how to win, and I'm thankful for that," coach Mike Vrabel said of his Titans (8-2).
Tennessee, seeking a second straight AFC South Division title, is alone atop the conference standings with the regular season past its halfway point.
The Saints (5-4) dropped their second straight game since losing quarterback Jameis Winston to a season-ending knee injury.
"Disappointing loss," said Saints coach Sean Payton, who was curt after his team had another close finish a week after a last-minute loss to the Atlanta Falcons in an NFC South matchup in New Orleans. "I thought we came in with a good plan. We fought hard. That's what makes it difficult. Just, in the end, too many little things."
Against the Titans, they also played without a trio of starters due to injuries: four-time Pro Bowl running back Alvin Kamara (knee), left tackle Terron Armstead (knee and shoulder) and defensive back C.J. Gardner-Johnson (foot), who was just put on injured reserve.
The Saints, who outgained Tennessee 373-264 in total offensive yards, still had a chance to tie late.
Trevor Siemian — Tennessee's designated survivor quarterback for part of last season — threw a 15-yard touchdown pass to Marquez Callaway with 1:16 left, pulling the visitors within 23-21. However, tight end Adam Trautman was flagged for a false start, pushing the Saints back to the Titans' 7-yard line on the 2-point attempt.
Payton called that penalty "significant," adding: "Obviously it changes the play when you're on the 2 and you go to the 7."
Siemian's pass to his first read, running back Mark Ingram, at the right edge of the end zone was incomplete with Titans cornerback Jackrabbit Jenkins defending. That was the Saints' eighth straight failed 2-point attempt over several seasons.
"I've got to get him a better throw or extend the play," Siemian said.
For the Titans, it was another play that showed what it takes to put together a winning streak in the NFL.
"When it comes to those tight situations where we've got to get a stop, there's no panic on the field, no panic on the sideline," safety Kevin Byard said.
The Titans recovered the ensuing onside kick to seal their tightest victory yet in what wound up their lowest-scoring game in a win this season.
"Obviously we've got to clean some stuff up, but I'm never going to apologize for a win," Tannehill said.
The Saints could have been in position to attempt a PAT for the win if kicker Brian Johnson hadn't missed two of those earlier. Johnson did kick a 20-yard field goal with 5:33 left to pull them within 23-15, but the Titans stopped the Saints on five plays with goal to go and New Orleans trailing 23-12.
Jeffery Simmons, who had a career-high three of the Titans' five sacks one week earlier in a road win against the Los Angeles Rams, had two more by halftime. Harold Landry also had a sack, giving him a career-high 10 for the season, and the Titans had four by halftime.
There were some breaks for Tennessee when it came to extending the streak.
A slight roughing-the-passer penalty on Saints linebacker Kaden Elliss wiped out Tannehill's interception in the end zone by safety Marcus Williams, and Tannehill later scored on a 1-yard sneak for a 13-6 lead. Tannehill also fumbled a snap at the end of the third quarter, and receiver A.J. Brown recovered for a 6-yard gain and a first down.
Dylan Cole stripped Deonte Harris of the ball on the opening kickoff of the third quarter to set up Tannehill's 2-yard touchdown pass to MyCole Pruitt. That prompted fans to start volleying a beach ball around the lower bowl behind the Tennessee sideline.
The ball disappeared as the Saints kept getting the football back in the fourth quarter.
Ingram scored on a 13-yard run late in the third quarter to start the comeback, pulling New Orleans within 20-12. In that same period, he became the franchise's all-time leading rusher as he covered 6 yards on his ninth carry of the game and topped Deuce McAllister's 6,096 yards that had been the record since 2008.
Ingram entered the game needing only 20 rushing yards to pass McCallister but finished with 47 on 14 carries. He also caught four passes for 61 yards.
Wide receiver Ty Montgomery went to the locker room with an injured finger on the Saints' second possession of the game and didn't return.
"That really impacted some of the stuff we were going to do," Payton said.
The Titans placed seven-time Pro Bowl receiver Julio Jones on injured reserve Saturday, and Brown was held to only one catch for 16 yards on a wildcat play with Adrian Peterson handing off to Tannehill. Marcus Johnson came through with five catches for 100 yards.