Abstract

Background Nontuberculous mycobacteria pulmonary disease (NTM-PD) frequently coexists with bronchiectasis. This study aimed to compare clinical profiles and identify risk factors between NTM-PD patients with/without bronchiectasis and explore differences between rapid- vs slow-growing non-tuberculous mycobacteria (NTM) species.Methods A retrospective analysis was conducted on patients diagnosed with NTM-PD and admitted to Beijing Tsinghua Changgung Hospital between April 2021 and April 2025. Among 496 inpatients with pulmonary diseases who underwent metagenomic next-generation sequencing (mNGS) analysis of bronchoalveolar lavage fluid, NTM were identified in 57 patients. Ultimately, 43 of these cases were confirmed and diagnosed as having NTM-PD. Relevant clinical data were collected, and the association between each variable and adverse outcomes was assessed using univariate and multivariate logistic regression analyses.Results Among the 43 confirmed NTM-PD patients, 24 had concurrent bronchiectasis (NTM-PD with bronchiectasis group) and 19 did not (NTM-PD group). In terms of baseline characteristics, the NTM-PD with bronchiectasis had a significantly higher proportion of females (79.17% vs 31.57%, P=0.002) and lower BMI (19.46 vs 22.46, P=0.023). Slow-growing NTM (SGM, mainly Mycobacterium avium complex [MAC]) was more common in the NTM-PD with bronchiectasis group (70.83% vs 31.58%, P=0.010); rapid-growing NTM (RGM, mainly M. abscessus) was more prevalent in the NTM-PD group (57.89% vs 20.83%, P=0.013). The positive rate of T-SPOT.TB in the NTM-PD group was higher than that in the NTM-PD with bronchiectasis group (47.37% vs 8.33%, P=0.010). Multivariate logistic regression identified female sex as an independent risk factor for NTM-PD complicated with bronchiectasis (OR=17.784, 95% CI: 1.103–286.857, P=0.042), while T-SPOT.TB was not (OR=0.047, 95% CI: 0.002–1.341, P=0.074).Conclusion Female sex is an independent risk factor for NTM-PD complicated with bronchiec