Meoli Aniello, Deolmi Michela, Iannarella Rosanna, Esposito Susanna
Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, via Gramsci 14, 43126 Parma, Italy.
Pathogens. 2020 Jul 9;9(7):553. doi: 10.3390/pathogens9070553.
Non-tuberculous mycobacteria (NTMs) are ubiquitous and opportunistic emerging bacteria with the potential to colonize and eventually infect either immunocompromised or immunocompetent individuals. In the last three decades, the prevalence of disease caused by NTMs has increased in several countries. The increased prevalence of NTM infection can be explained by an ageing population with rising comorbidities, HIV infection, the common use of immunosuppressive drugs, and improved diagnostic methods. The aim of this review is to demonstrate the clinical relevance of NTMs in children, describing their features and manifestations, diagnostic tools, and therapeutic approaches. We collected data from the literature about NTM infections in young patients over the past five years (2014-2019) using the keywords "non-tuberculous", "mycobacteria", "paediatric", "NTM", "cystic fibrosis", and "children". Recent literature points out that NTMs are ubiquitous, with several species including both those that are pathogens for humans and those that are not. This means that, if a mycobacterium is isolated from a patient's specimen, we have to distinguish between a simple colonization and an NTM-related disease. The start of treatment depends on many factors that are necessary to consider, such as clinical and imaging features, patient comorbidity and immunocompetence, drug adverse effects, and compliance with a very long therapy that can last many months. Due to the increasing prevalence and clinical relevance of NTMs, guidelines for their optimal management, especially in the presence of chronic underlying disease, are urgently needed.
非结核分枝杆菌（NTMs）是普遍存在的机会性新兴细菌，有可能在免疫功能低下或免疫功能正常的个体中定植并最终感染。在过去三十年中，由NTMs引起的疾病在多个国家的患病率有所上升。NTM感染患病率增加的原因可以解释为人口老龄化、合并症增多、HIV感染、免疫抑制药物的普遍使用以及诊断方法的改进。本综述的目的是证明NTMs在儿童中的临床相关性，描述其特征和表现、诊断工具及治疗方法。我们使用关键词“非结核”“分枝杆菌”“儿科”“NTM”“囊性纤维化”和“儿童”，从过去五年（2014 - 2019年）有关年轻患者NTM感染的文献中收集数据。近期文献指出，NTMs普遍存在，包括几种对人类致病和不致病的菌种。这意味着，如果从患者标本中分离出分枝杆菌，我们必须区分单纯定植和与NTM相关的疾病。治疗的开始取决于许多需要考虑的因素，如临床和影像学特征、患者合并症和免疫功能、药物不良反应以及对可能持续数月的长期治疗的依从性。由于NTMs的患病率和临床相关性不断增加，迫切需要针对其最佳管理的指南，尤其是在存在慢性基础疾病的情况下。
