Bright Varghese1, Mushira Enani2, Mohammed Shoukri3, Sameera AlJohani4, Sahar AlThawadi5, Sahal Al-Hajoj6. 1. Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia. Electronic address: bvarghese99@kfshrc.edu.sa. 2. Medical Specialties Department, King Fahad Medical City, Riyadh, 12231, Saudi Arabia. Electronic address: menani@kfmc.med.sa. 3. National Biotechnology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia. Electronic address: shoukri@kfshrc.edu.sa. 4. Department of Pathology and Laboratory Medicine, King Abdul Aziz Medical City, Riyadh, 14611, Saudi Arabia. Electronic address: johanis@ngha.med.sa. 5. Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and research Centre, Riyadh, 11211, Saudi Arabia. Electronic address: sthawadi@kfshrc.edu.sa. 6. Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia; College of Medicine, Al Faisal University, Riyadh, 1153, Saudi Arabia. Electronic address: hajoj@kfshrc.edu.sa.
Abstract
BACKGROUND: Non-tuberculous mycobacteria (NTM) causing pulmonary and extra-pulmonary diseases are increasing worldwide. A large paucity of data related to pediatric NTM diseases exists globally and particularly in Saudi Arabia. METHODS: The first nationwide exploratory study on existence of NTM diseases among Saudi Arabian children (0-14 years old) has been carried out during 2016-2017. Suspected NTM isolates with clinical and demographical data were enrolled from regional reference laboratories. Species level identification of isolates was carried out by commercial line probe assays and gene sequencing. RESULTS: In 12 months, 52 culture positive cases with 44(84.6%) confirmed disease incidences were identified. Demographically, Saudi nationals (86.5%) were dominated and 77.3% cases have different comorbid conditions. Lymphadenitis (40.4%) followed by 26.9% of pulmonary cases with 42.8% of confirmed clinical relevance were mainly reported. Species identification showed Mycobacterium simiae (31.8%), M. abscessus (23.1%) and nine other species including rarely encountering M. riyadhense. Ascites caused by M. monacense, pulmonary disease caused by M. riyadhense and M. monacense were rarest clinical events and reported for the first time globally in a pediatric cohort. CONCLUSIONS: Diverse NTM diseases even in immunocompetent children are an upcoming challenge in Saudi Arabia. Lack of awareness on NTM disease must be addressed with immediate development of management plans.
BACKGROUND:Non-tuberculous mycobacteria (NTM) causing pulmonary and extra-pulmonary diseases are increasing worldwide. A large paucity of data related to pediatric NTM diseases exists globally and particularly in Saudi Arabia. METHODS: The first nationwide exploratory study on existence of NTM diseases among Saudi Arabian children (0-14 years old) has been carried out during 2016-2017. Suspected NTM isolates with clinical and demographical data were enrolled from regional reference laboratories. Species level identification of isolates was carried out by commercial line probe assays and gene sequencing. RESULTS: In 12 months, 52 culture positive cases with 44(84.6%) confirmed disease incidences were identified. Demographically, Saudi nationals (86.5%) were dominated and 77.3% cases have different comorbid conditions. Lymphadenitis (40.4%) followed by 26.9% of pulmonary cases with 42.8% of confirmed clinical relevance were mainly reported. Species identification showed Mycobacterium simiae (31.8%), M. abscessus (23.1%) and nine other species including rarely encountering M. riyadhense. Ascites caused by M. monacense, pulmonary disease caused by M. riyadhense and M. monacense were rarest clinical events and reported for the first time globally in a pediatric cohort. CONCLUSIONS: Diverse NTM diseases even in immunocompetent children are an upcoming challenge in Saudi Arabia. Lack of awareness on NTM disease must be addressed with immediate development of management plans.
Keywords:
M. abscessus; M. kubicae; M. monacense; M. riyadhense; Mycobacterium simiae; NTM epidemiology; Pediatric non tuberculous mycobacterial disease; Saudi Arabia
Authors: Sarah M Johnson; Cecilia Piñera; Elizabeth Whittaker; Natalie Kirkhope; Onn M Kon; Giovanni Satta; Maria Elvira Balcells; Caroline Foster Journal: Clin Drug Investig Date: 2022-05-16 Impact factor: 3.580