Analysis of nontuberculous mycobacterial infections in Saudi children from a tertiary care hospital perspective

We present a case series of six children who were infected with different species of Nontuberculous mycobacteria (NTM) and <i>Mycobacterium riyadhense</i> was the most prevalent isolate representing 50% of the total pathogens. Four of the reported cases were immunocompromised with disseminated NTM diseases and two were infected with <i>M. avium</i>, <i>M. abscessus</i>, and the other two infected with <i>M. riyadhense</i>. Most patients responded to medical therapy, except for the <i>M. avium</i> case, which was fatal despite combination therapy. Due to the presence of mycolic acid in the cell wall of NTM isolates, prolonged combination therapy is required for treatment, and in some cases, natural resistance may also emerge. Most of the patients reported in our study were immunocompetent. This suggests that NTM can infect children at various body sites regardless of immune status. We highlighted our experience in diagnosing and treating these patients, with special attention to <i>M. riyadhense</i>.