The Lung Microbiota in Nontuberculous Mycobacterial Pulmonary Disease

Bo-Guen Kim, Noeul Kang, Su-Young Kim, Dae Hun Kim, Hojoong Kim, O. Jung Kwon, Hee Jae Huh, Nam Yong Lee, Byung Woo Jhun.


The role of bacterial microbiota in the pathogenesis of nontuberculous mycobacterial pulmonary disease (NTM-PD) is unclear. We aimed to compare the bacterial microbiome of disease-invaded lesions and non-invaded lung tissue from NTM-PD patients.


Nontuberculous mycobacteria (NTM) are ubiquitous organisms found in natural environments and human communities. NTM infection is caused by complex interactions among immune status, microbiological factors, and environmental exposure. Most NTM infections lead to chronic pulmonary disease (PD), and the global burden of NTM-PD is increasing. Among more than 190 species of NTM, the Mycobacterium avium complex (MAC), mainly composed of M. avium and M. intracellulare, is the most common pathogen followed by M. abscessus in many countries.

Materials and Methods:

We screened consecutive NTM-PD patients who underwent adjuvant surgical lung resection, in addition to antibiotic therapy, between July 2012 and February 2019 at Samsung Medical Center, Seoul, South Korea. We identified 40 patients with NTM-PD who consented to the collection of lung tissue. Lung tissue was collected in pairs from each patient, with one sample taken from a disease-invaded lesion and the other taken from normal tissue. We initially attempted to evaluate both bacterial and fungal microbiomes.


We performed microbiome analysis using pairs of disease-invaded and non-invaded lung tissue from NTM-PD patients and identified several predominant taxa according to disease involvement. One of the most notable findings was that Acinetobacter and Enhydrobacter were more abundant at non-involved sites of NTM-PD lung tissues than the involved sites. In particular, Acinetobacter was predominant at non-involved sites even after correcting for false-positive rates.


We would like to express our heartfelt gratitude and respect to Dr. Won-Jung Koh, for giving us invaluable guidance and unfailing support for NTM-PD research. Dr. Won-Jung Koh passed away in August 2019. We dedicate this work to his memory.

Citation: Kim B-G, Kang N, Kim S-Y, Kim DH, Kim H, Kwon OJ, et al. (2023) The lung microbiota in nontuberculous mycobacterial pulmonary disease. PLoS ONE 18(5): e0285143.

Editor: Selvakumar Subbian, Rutgers Biomedical and Health Sciences, UNITED STATES

Received: January 12, 2023; Accepted: April 14, 2023; Published: May 26, 2023.

Copyright: © 2023 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The raw data were registered in the Sequence Read Archive (SRA), and the SRA data (Bioproject.) They are available under the accession number PRJNA931790. The BioSamples are available under accession nos. SAMN33099469 (control) and SAMN33099470 (disease.).

Funding: This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (2020R1C1C1008038). The funders were not involved in study design, data collection and analysis, decision to publish, or manuscript preparation.

Competing interests: The authors have declared that no competing interests exist.