Understanding NTM and Bronchiectasis
If you live with a chronic lung condition, you may have heard your healthcare provider mention bronchiectasis or non-tuberculous mycobacteria (NTM). These two conditions are often linked, and understanding them can help you better manage your lung health.
What is NTM?
Non-tuberculous mycobacteria (NTM) are a large group of bacteria—more than 200 different species—that are naturally found in soil and water. Although they belong to the same family of bacteria as tuberculosis and leprosy, NTM infections are not contagious. You cannot catch NTM from another person.
Because these bacteria are common in the environment, most people are exposed to them regularly. Many people never become sick because their immune system clears the bacteria before they can cause an infection.
How does NTM infection happen?
NTM most commonly affects the lungs (called pulmonary NTM disease). People can inhale the bacteria through tiny droplets of water, such as from showers, hot tubs, or humid environments, or from dust released when soil is disturbed during activities like gardening.
Who is more likely to develop NTM?
Anyone can be exposed to NTM, but some people are at higher risk of developing an infection. This includes people who:
are over the age of 60
have a lower body weight
have a weakened immune system, such as those living with HIV, rheumatoid arthritis, receiving chemotherapy, or taking long-term oral steroids
have an existing lung condition, including bronchiectasis, COPD, cystic fibrosis, or a history of repeated lung infections
What are the symptoms?
Symptoms of NTM lung disease can develop slowly and may be similar to other chronic lung conditions. They can include:
a persistent cough, with or without mucus
coughing up blood
shortness of breath
fatigue
fever or night sweats
loss of appetite or unintentional weight loss
If you notice these symptoms or they are getting worse, speak with your healthcare provider.
How is NTM diagnosed?
Diagnosing NTM usually requires both imaging and laboratory testing. Your healthcare provider may recommend:
a CT scan of the chest to look for changes in the lungs
one or more sputum (mucus) samples to check for NTM bacteria
How is NTM treated?
Treatment depends on your symptoms, overall health, and the type of NTM bacteria present.
One of the most important parts of treatment is airway clearance. Research has shown that regular airway clearance can help remove mucus and reduce the amount of bacteria in the lungs, whether or not antibiotics are needed.
When antibiotics are recommended, treatment usually involves a combination of three or more antibiotics taken for at least 12 months. These medications may be taken by mouth, inhaled, or given intravenously.
Even with appropriate treatment, NTM can be difficult to eliminate completely. Some people continue to have the bacteria in their lungs despite long-term antibiotic therapy. Your healthcare team will work with you to determine the best treatment plan for your individual situation.
Can NTM be prevented?
Because NTM bacteria are naturally found in soil and water, it is not possible to completely avoid exposure. However, there are steps you can take to reduce your risk, especially if you have bronchiectasis or another chronic lung condition.
Some ways to reduce your exposure include:
Avoid breathing in aerosolized water whenever possible. This includes limiting time in hot tubs, indoor spas, and other environments that create fine water mist, as these can contain NTM bacteria.
Take precautions when gardening or working with soil. Wetting down dry soil before digging, wearing gloves, and considering a well-fitting mask can help reduce the amount of dust you inhale.
Keep your respiratory equipment clean. Nebulizers, inhalers with spacers, and airway clearance devices should be cleaned and disinfected according to the manufacturer's instructions. Allow equipment to dry completely before storing it.
Use sterile or distilled water for respiratory devices when recommended by your healthcare team. Tap water should never be used in respiratory equipment.
Practice good airway clearance. Regular airway clearance helps remove mucus from the lungs, making it harder for bacteria to settle and grow.
Stay as healthy as possible. Regular exercise, staying hydrated, eating a balanced diet, keeping vaccinations up to date, and avoiding smoking all support healthy lungs and may help reduce the risk of respiratory infections.
While these steps can lower your risk, they cannot eliminate it completely. If you develop a persistent cough, increased mucus, unexplained weight loss, fever, night sweats, or worsening shortness of breath, speak with your healthcare provider. Early assessment and treatment can help prevent further lung damage.
What is bronchiectasis?
Bronchiectasis is a chronic lung condition in which the airways become permanently widened and damaged. This makes it more difficult for the lungs to clear mucus.
When mucus builds up, bacteria can grow more easily, increasing the risk of repeated lung infections and ongoing inflammation.
Bronchiectasis can develop after repeated lung infections, such as pneumonia or influenza, although in many people the cause is never identified.
Because bronchiectasis and COPD share many symptoms—including chronic cough, excess mucus, and shortness of breath—they can sometimes be difficult to tell apart. Some people may have both conditions.
Why is airway clearance so important?
Healthy lungs naturally move mucus out of the airways. In bronchiectasis, damaged airways make this process much more difficult.
When mucus stays in the lungs, it can trap bacteria, leading to infection. Infection causes inflammation, which can further damage the airways, creating a cycle of ongoing infections and worsening lung function.
Regular airway clearance helps break this cycle by removing mucus before it builds up.
Effective airway clearance strategies may include:
Active Cycle of Breathing Technique (ACBT)
Oscillating Positive Expiratory Pressure (OPEP) devices, such as the Aerobika®
Nebulized hypertonic saline (when prescribed)
Staying well hydrated
Regular aerobic exercise
Your healthcare provider or respiratory therapist can help you choose the airway clearance routine that works best for you.
If you are looking for Respiratory Therapy support, reach out to us for a free 15-minute Welcome Call. Give us a shout at 236-361-3480 or send us an email to poplar@poplarpulmonary.com.
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