The Prevalence and Trend of Nontuberculous Mycobacterial Infection in Hospitalized Children in the United States From 2000 to 2022.

BACKGROUND

Nontuberculous mycobacteria (NTM) are increasingly recognized as significant pathogens, particularly in immunocompromised children. However, population-based data on pediatric NTM hospitalizations in the United States are scarce. The objective of our study was to describe the national epidemiology and analyze trends of NTMs among hospitalized children.

METHODS

A retrospective serial cross-sectional study using the 2000-2022 Kids' Inpatient Database was conducted. NTM infections were identified using International Classification of Diseases, Ninth and Tenth Revisions codes, and demographics, trends and clinical outcomes were compared with non-NTM discharges. Sample weighting was employed to produce national estimates.

RESULTS

Of a total of 26.1 million discharges from 2000 to 2022, 5508 had NTM infections (0.02%). NTM infections were more common in older White children with private insurance and higher household income and disproportionately occurred in urban locations, children's hospitals and in the Western United States. The prevalence of NTM hospitalizations increased from 1.2 per 10,000 discharges in 2000 to 2.6 per 10,000 discharges in 2022 ( P < 0.001). Children with NTM infections had higher rates of complex chronic conditions, cystic fibrosis, HIV infection and invasive mechanical ventilation compared with other discharges. They also experienced significantly longer hospital stays, higher hospital charges and a higher mortality rate.

CONCLUSIONS

The prevalence of NTM infections among hospitalized children in the United States has increased from 2000 to 2022. Pediatric NTM infections are associated with substantial clinical and economic burden, predominantly affecting patients who are immunocompromised or have chronic conditions. Enhanced awareness, surveillance and targeted research are needed to improve prevention and management strategies.