Recognising and managing non-tuberculous mycobacterial pulmonary disease

Non-tuberculous mycobacteria (NTM) are organisms that live in water systems, soil and vegetation. Humans come into contact with NTM every day, but relatively few people become unwell as a result. In those that do, pulmonary symptoms are the most common effects. The incidence of NTM pulmonary disease (NTM-PD) is increasing worldwide. However, early diagnosis of the infection is challenging and treatment can be unsuccessful. Moreover, the effects of the coronavirus disease 2019 (COVID-19) pandemic are likely to have delayed diagnosis of many cases of NTM-PD.Patients with NTM-PD have multiple needs, so appropriate person-centred support should be in place. This article explains the epidemiology, risk factors, symptoms, diagnosis and treatment of NTM-PD. It also details the long-term follow-up care and support that healthcare services should provide to patients in the community and emphasises the need for community NTM infection services and NTM nurse specialist roles.