Comparison of the sputum microbiome between stable nontuberculous mycobacteria pulmonary disease patient and those requiring antibiotic treatment

<bold>Background:</bold> We investigated whether there is a distinction in the sputum microbiome between patients with stable non-tuberculous mycobacterial pulmonary disease (NTM-PD) who do not require antibiotic treatment and those who require antibiotics. <bold>Methods:</bold> We collected sputum samples from 21 stable NTM-PD patients (stable group) and 14 NTM-PD patients needing antibiotic treatment (treatment group). We also obtained 13 follow-up samples from the stable group. We analyzed the 48 samples using 16S rRNA gene sequencing (V3–V4 region) and compared the groups. <bold>Results:</bold> In the linear discriminant analysis effect size (LEfSe) analysis, the species <italic>Porphyromonas pasteri</italic>, <italic>Haemophilus parahaemolyticus</italic> and <italic>Prevotella nanceiensis</italic> were more prevalent in the sputum of the stable group compared to the treatment group (all effect size > 3.00, p < 0.05). No taxa showed differences in alpha-/beta-diversity or LEfSe between the 21 baseline and 13 follow-up sputum samples in the stable group. In the stable group, the genus <italic>Bergeyella</italic> and <italic>Prevotella oris</italic> were less common in patients who achieved spontaneous culture conversion (n = 9) compared to those with persistent NTM positivity (n = 12) (effect size 3.04, p = 0.039 for <italic>Bergeyella</italic>; effect size 3.64, p = 0.033 for <italic>P. oris</italic>). In the treatment group, <italic>H. parainfluenzae</italic> was more common in patients with treatment success (n = 7) than in treatment-refractory patients (n = 7) (effect size 4.74, p = 0.013). <bold>Conclusions:</bold> Our study identified distinct bacterial taxa in the sputum of NTM-PD patients based on disease status. These results suggest that a microbime helps maintain disease stability or aids control of NTM.