Nontuberculous mycobacteria: when to categorize them in pediatrics

Abstract

Background: The term "nontuberculous mycobacteria" refers to more than 170 different species of bacteria that are not Mycobacterium tuberculosis or M. leprae. These bacteria can cause a variety of infections in children. Accurate diagnosis is crucial, as they can be confused with other diseases. Treatment can be challenging due to antibiotic resistance in some strains. The literature review focuses on improving the diagnosis and treatment of these infections in the pediatric population. The characterization of these bacteria, through methods such as PCR, is essential for effective treatment. Material and methods: A systematic review was performed to determine the need to categorize nontuberculous mycobacteria in pediatrics. Various databases and Boolean operators were used to search for relevant information. Inclusion and exclusion criteria were applied to select documents. The review covered the period from 2012 to 2023. They focused on pediatric studies on nontuberculous mycobacteria. Results: The article "Idiopathic CD4+ lymphocytopenia and juvenile laryngeal papillomatosis" describes a case of juvenile laryngeal papillomatosis (JLP) that was complicated by idiopathic CD4 lymphocytopenia (ICL). Despite treatments and surgeries, JLP progressed. The patient developed ICL based on the decrease in CD4+ lymphocytes without HIV. After receiving interferon-alpha with partial response, he died. The study "Prevalence and species spectrum of both pulmonary and extrapulmonary nontuberculous mycobacteria isolates" highlights the high prevalence of nontuberculous mycobacteria in India, especially M. abscessus. "Nontuberculous Mycobacteria in Denmark" evaluates the incidence and clinical relevance of NTM in Denmark from 1991 to 2015, finding a stable incidence and differences in age groups and species. These studies enrich the understanding of these medical conditions. Conclusion: The four studies analyzed offer a global vision of the incidence and characteristics of nontuberculous mycobacteria (NTM) in various regions. Although they all address NTM, they reveal geographic variability in their incidence and characteristics. A global increase in the incidence of NTM is observed, raising concerns about its clinical relevance. Furthermore, the study in New York highlights the increase in NTM in densely populated urban environments. Botswana underlines the importance of accurate diagnosis, especially in areas with high prevalence of tuberculosis and HIV. In Denmark, no significant increase in the incidence of NTM is observed, suggesting regional variability. Together, these findings emphasize the need to understand the local epidemiology of NTM and the importance of its prevention and control