Nontuberculous mycobacterial infections and bronchiectasis

This chapter provides an overview of infection caused by NTM in bronchiectasis. Despite inconsistent surveillance and case definitions, NTM infection prevalence is rising globally. Risk factors for the development of NTM pulmonary disease (NTM-PD) are driven by environmental exposures, structural airway disease that impairs mucociliary clearance, and immune system impairment. A diagnosis of NTM-PD in bronchiectasis necessitates integrating clinical, radiological and microbiological criteria. Clinical management of NTM-PD in bronchiectasis is multidisciplinary. Pharmacotherapy relies on multidrug regimens for at least 12 months after culture conversion, guided by drug susceptibility testing. Airway clearance and nutritional optimisation are essential adjuncts. Future priorities include clarifying transmission dynamics, validating outcome definitions, developing biomarkers and patient-reported measures, and translating personalised approaches to guide timely diagnosis and targeted therapy in bronchiectasis-associated NTM-PD. <bold>Cite as:</bold> Kumar K, Loebinger MR. Nontuberculous mycobacterial infections and bronchiectasis. <italic>In:</italic> Chalmers JD, Shoemark A, Aliberti S, eds. Bronchiectasis (ERS Monograph). Sheffield, European Respiratory Society, 2026; pp. 179–194 [<ext-link>https://doi.org/10.1183/2312508X.10002025</ext-link>].