Gut Microbiota Dysbiosis in Japanese Female Patients with Nontuberculous Mycobacteria-Associated Lung Disease: An Observational Study.

Abstract

Background/Objectives: Nontuberculous mycobacterial pulmonary disease (NTM-PD) is treated using a combination of multiple antimicrobial agents and prolonged therapy; however, recurrence and reinfection rates remain high. Susceptibility to NTM-PD is not fully understood. We aimed to investigate the association between NTM-PD and gut microbiota and determine the impact of antimicrobial therapy on the composition of the gut microbiota. Methods: We analyzed the gut microbiota of 20 Japanese females with NTM-PD (mean age: 67.9 years; range: 50-80 years) at different treatment stages-before, during, and at recurrence-alongside 20 healthy individuals, using 16S rRNA gene amplicon sequencing. Results: Subgroup A (pre-treatment) showed a small difference in β-diversity when compared with the healthy control (HC) group, while no significant differences in α-diversity were observed. Subgroup B (during treatment) exhibited a larger difference in β-diversity compared with the HC group, along with a decrease in α-diversity. The α-diversity of the gut microbiota in Subgroup C (at recurrence) was lower than that in Subgroup A but higher than that in Subgroup B. In Subgroups A and C, the bacterial taxa Sutterella, Adlercreutzia, Odoribacter, and Prevotella had decreased relative abundance, while Erysipelatoclostridium, Massilimicrobiota, Flavonifractor, Eggerthella, and Fusobacterium had increased relative abundance compared to those in the HC group. Conclusions: The loss of normal resident gut bacteria may hinder reacquisition. Treatment may be associated with the persistence of a dysbiotic gut microbiota, fostering susceptibility to NTM-PD. Gut microbiota dysbiosis may heighten susceptibility to NTM-PD, complicate treatment outcomes, and increase the risk of microbiological recurrence following therapy.