Nontuberculous mycobacterial (NTM) pulmonary infections affect >85,000 people per year in the United States, with associated annual medical costs recently estimated at $815 million. Individuals with cystic fibrosis (CF) are at a 1,000-fold greater risk of NTM infection than the general population, and prevalence rates of NTM infection in CF are rising. Infection with NTM can result in progressive lung damage, lung function decline, and death for individuals with CF. Morbidity also commonly results from toxic effects of current treatment regimens, and not all individuals with NTM infection will benefit from treatment. The determinants of NTM-driven pulmonary disease, including which individuals are at risk for infection and which will benefit from treatment, are largely unknown. Incomplete knowledge of the pathogenesis of NTM infection is a significant impediment to better targeting NTM screening practices and treatment efforts. Recent culture-independent studies have revealed complex microbial communities in the CF airways in which the structure and metabolic activities of these communities have been closely linked with lung disease progression. These and other studies suggest that alterations of the CF airway microbiota may influence NTM infection and subsequent clinical course. We are studying the microbiome and metabolome of CF sputum samples along with clinical data to identify the microbial determinants of NTM infection in CF.
Sponsored by the Host Microbiome Initiative