Non-tuberculous mycobacterium affecting adults in Eastern India: Case series from a resource limited tertiary care setting

Non-tuberculous mycobacteria (NTM) are among the less commonly reported causes of infection which are being increasingly reported owing to better diagnostic tools and physician awareness. We report a series of six patients presenting to the Department of Tropical Medicine, School of Tropical Medicine, West Bengal, India over a one year period (2017-2018) who were diagnosed with NTM infection by culture of pus samples or bone marrow aspirates. Identification of NTM was carried out by initial Ziehl Neelsen staining followed by culture andDNAsequencing of isolates for species identification. Of the six patients, two were HIV positive.Mycobacterium avian complex (MAC) and M. Senegalese were isolated from one patient each and M. abscessus from the remaining 4 patients. All patients were treated using the standard guidelines for periods of 6 to 12 months. Clinical response was noted after 1 to 2 months of therapy with complete response around 3 to 6 months. No relapse was noted during a 9 month follow up.DNA sequencing provided a significant advantage for diagnosis and enabled appropriate treatment with a good outcome on these six patients.Non-responding surgical site infections and disseminated infection in HIV patients not responding to anti-tuberculous and antifungal therapy should be considered for diagnosis of NTM.