Nontuberculous mycobacteria (NTM) are diverse microbial species encompassing commensals and pathogens with the ability to cause pulmonary disease in both immunocompetent and immunocompromised individuals. In contrast to Mycobacterium tuberculosis, which has seen a reduction in disease rates in developed countries, the incidence and prevalence of NTM disease is increasing. NTM are difficult to treat with standard antimicrobial regimens and may contain both virulence and antibiotic-resistance genes with potential for pathogenicity. With the advent of molecular techniques, it has been elucidated that these organisms do not reside in isolation and are rather part of a complex milieu of microorganisms within the host lung microbiome. Over the last decade, studies have highlighted the impact of the microbiome on host immunity, metabolism and cell–cell communication. This recognition of a broader community raises the possibility that the microbiome may disrupt the balance between infection and disease. Additionally, NTM disease progression and antimicrobial therapy may affect the healthy steady state of the host and function of the microbiome, contributing to further dysbiosis and clinical deterioration. There have been limited studies assessing how NTM may influence the relationship between microbiome and host. In this review, we highlight available studies about NTM and the microbiome, postulate on virulence mechanisms by which these microorganisms communicate and discuss implications for treatment.

非结核分枝杆菌 (NTM) 是多种微生物物种，包括共生体和病原体，能够在免疫正常和免疫功能低下的个体中引起肺部疾病。与结核分枝杆菌相比随着发达国家发病率的下降，NTM 疾病的发病率和流行率正在上升。NTM 很难用标准的抗菌方案治疗，并且可能包含具有潜在致病性的毒力基因和抗生素抗性基因。随着分子技术的出现，已经阐明这些生物体并不是孤立存在的，而是宿主肺微生物组内微生物复杂环境的一部分。在过去十年中，研究强调了微生物组对宿主免疫、新陈代谢和细胞间通讯的影响。这种对更广泛社区的认识提出了微生物组可能破坏感染和疾病之间平衡的可能性。此外，NTM 疾病进展和抗菌治疗可能会影响宿主的健康稳定状态和微生物组的功能，从而导致进一步的生态失调和临床恶化。评估 NTM 如何影响微生物组与宿主之间关系的研究有限。在这篇综述中，我们重点介绍了有关 NTM 和微生物组的现有研究，假设了这些微生物交流的毒力机制，并讨论了对治疗的影响。