The impact of residential villages on the nontuberculous mycobacteria (NTM) in streams flowing through them has not been studied in detail. Water and sediments of streams are highly susceptible to anthropogenic inputs such as surface water flows. This study investigated the impact of seven residential villages in a karst watershed on the prevalence and species spectrum of NTM in water and sediments. Higher NTM species diversity (i.e., 19 out of 28 detected) was recorded downstream of the villages and wastewater treatment plants (WWTPs) compared to sampling sites upstream (i.e., 5). Significantly, higher Zn and lower silicon concentrations were detected in sediments inside the village and downstream of the WWTP's effluents. Higher phosphorus concentration in sediment was downstream of WWTPs compared to other sampling sites. The effluent from the WWTPs had a substantial impact on water quality parameters with significant increases in total phosphorus, anions (Cl-and N-NH3-), and cations (Na+ and K+). The results provide insights into NTM numbers and species diversity distribution in a karst watershed and the impact of urban areas. Although in this report the focus is on the NTM, it is likely that other water and sediment microbes will be influenced as well.

• Keywords
• Human activities, Mycobacterial ecology, Mycobacterium avium, Mycobacterium fortuitum, Village impacts on water streams, Wastewater treatment effluent impacts,
• MeSH
• Phosphorus MeSH
• Water Quality MeSH
• Nontuberculous Mycobacteria * MeSH
• Prevalence MeSH
• Rivers * MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Phosphorus MeSH

BACKGROUND: Inborn errors of IL-12/IL-23-IFNγ immunity underlie Mendelian susceptibility to mycobacterial diseases (MSMD), a group of immunodeficiencies characterized by a highly selective susceptibility to weakly virulent strains of mycobacteria, such as non-tuberculous mycobacteria (NTM) and bacillus Calmette-Guérin (BCG). Cutaneous mycobacterial infections are common in MSMD and may represent a red flag for this immunodeficiency. OBJECTIVES: We present a case series of four paediatric patients with MSMD, specifically with IFNγR1 and STAT1 deficiencies, and cutaneous NTM/BCG infections to increase awareness of this immunodeficiency, which may, in some cases, be intercepted by the dermatologist and thus timely referred to the immunologist. MATERIALS & METHODS: Clinical, laboratory and genetic investigations of the four paediatric patients with MSMD are presented. RESULTS: All four presented patients experienced early complications after BCG vaccination. Two patients suffered recurrent mycobacteriosis, one patient experienced delayed BCG reactivation, and one patient died of disseminated avian mycobacteriosis. The dermatological manifestation in these patients included destructive nasal ulcerations, scrofuloderma of various sites and lupus vulgaris. All patients had a normal basic immune phenotype. CONCLUSION: The presented cases demonstrate that NTM/BCG infections in otherwise seemingly immunocompetent patients should raise suspicion of MSMD. This is of utmost importance as specific therapeutic approaches, such as IFNγ treatment or haematopoietic stem cell transplantation, may be employed to improve the disease outcome.

• Keywords
• MSMD, mendelian susceptibility to mycobacterial diseases, IFNγR1, STAT1, inborn error of immunity, non-tuberculous mycobacteria, BCG, necrotizing granulomas, antituberculotics,
• MeSH
• Skin Diseases, Bacterial * MeSH
• BCG Vaccine adverse effects   MeSH
• Genetic Predisposition to Disease MeSH
• Interferon-gamma MeSH
• Interleukin-12 MeSH
• Interleukin-23 MeSH
• Humans MeSH
• Mycobacterium Infections * genetics   MeSH
• Immunologic Deficiency Syndromes * complications   genetics   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH
• Names of Substances
• BCG Vaccine MeSH
• Interferon-gamma MeSH
• Interleukin-12 MeSH
• Interleukin-23 MeSH