Non-tuberculous mycobacterial infection in children

Abstract

Abstract Non-tuberculous mycobacteria (sometimes known as atypical mycobacteria) are environmental mycobacteria found throughout the world in soil, dust, water, foodstuffs and other animals. They are defined simply in contrast to those mycobacteria which cause tuberculosis or leprosy, but a small number of species are considered to be human pathogens in their own right and the incidence of human infections has increased in recent decades. Characterised by their relative resistance to many classes of antibiotics, sometimes including those used to treat tuberculosis, non-tuberculous mycobacteria can cause a wide range of diseases in children, including lymphadenitis, skin and soft tissue infections, respiratory infections and disseminated infections. Diagnosis relies on a high index of clinical suspicion, collection of appropriate samples for culture on specialised media, and is now augmented by evolving molecular techniques. Treatment often involves surgical debridement and complex multi-drug regimens taken over many months, particularly in those children with underlying respiratory or immunological illnesses. Controlled clinical trials to identify optimal combinations of anti-mycobacterial drugs for use by such patients are desperately needed to treat these emerging infections.