Concordance Analysis Between Sputum and Bronchoscopic Specimens on Nontuberculous Mycobacteria Pulmonary Disease

Q: What was the purpose of this study?

To evaluate concordance between sputum and bronchoscopic specimens for diagnosing nontuberculous mycobacteria (NTM) pulmonary disease, and to compare outcomes by number of positive cultures.

Q: How many patients were included and how many underwent bronchoscopy?

A total of 400 patients were included, and 100 of them underwent bronchoscopy.

Q: Which factors were associated with radiologic progression or the need for treatment?

Multivariate analysis identified body mass index, membership in the single-isolation group, and fibrocavitary radiologic type as significant factors.

Sep 30, 2026

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This retrospective study evaluated how consistently sputum and bronchoscopic specimens identify nontuberculous mycobacteria (NTM) in pulmonary disease diagnosis. Patients with NTM isolated from respiratory specimens between 2010 and 2022 were analyzed, focusing on species concordance and clinical outcomes. Of 400 patients, 100 underwent bronchoscopy, with most showing matching NTM species. Multivariate analysis linked radiologic progression or treatment needs to body mass index, single-isolation status, and fibrocavitary radiologic type, while discordant species were rare.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background/Objectives

Methods

Results

Conclusions

1. Introduction

2. Materials and Methods

2.1. Study Design and Population

2.2. Data Collection

Article Concordance Analysis Between Sputum and Bronchoscopic Specimens on Nontuberculous Mycobacteria Pulmonary Disease Sojung Park , Jin Hwa Lee , Nam Eun Kim and Yune-Young Shin * Academic Editors: Shunsuke Mori and Young-Tae Jeon Received: 22 October 2025 Revised: 14 December 2025 Accepted: 29 December 2025 Published: 30 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; [spark85@ewha.ac.kr](spark85@ewha.ac.kr) (S.P.); [jinhwalee@ewha.ac.kr](jinhwalee@ewha.ac.kr) (J.H.L.) * Correspondence: [tripplea@ewha.ac.kr](tripplea@ewha.ac.kr); Tel.: +82-2-2650-5713; Fax: +82-2-2650-2559 Abstract Background/Objectives: This study evaluated the concordance between sputum and bronchoscopic specimens in diagnosing nontuberculous mycobacteria (NTM) pulmonary disease. Methods: We retrospectively analyzed patients with NTM isolated from respiratory specimens between 2010 and 2022 . Our analysis assessed species concordance across the two diagnostic methods and compared clinical outcomes between patients with multiple positive cultures and those with a single positive culture. Results: A total of 400 patients were included, 100 of whom underwent bronchoscopy. Among these, 61 demonstrated concordant NTM species between sputum and bronchoscopic specimens, while 38 had NTM cultured from only one source. One patient showed a discordant result, with Mycobacterium abscessus isolated from bronchoalveolar lavage and Mycobacterium avium from sputum. Multivariate analysis identified several factors associated with radiologic progression or the need for treatment: body mass index (HR, 0.847; 95% CI, 0.794–0.902; p < 0.001), membership in the single-isolation group (HR, 0.400; 95% CI, 0.184–0.871; p = 0.021), and fibrocavitary radiologic type (HR, 2.318; 95% CI, 1.470–3.655; p < 0.001) . Conclusions: Only a small number of cases showed different NTM species identified by sputum and bronchoscopy. Keywords: diagnosis; nontuberculous mycobacteria; Mycobacterium avium complex; sputum; bronchial washing; prognosis 1. Introduction The prevalence of nontuberculous mycobacterial (NTM) pulmonary disease (PD) is rising worldwide [1–4] . As recognition of NTM as significant pathogens grows, accurate diagnosis and effective treatment of NTM-PD have become critical medical priorities. Diagnosis of NTM-PD requires fulfillment of clinical, microbiological, and radiological diagnostic criteria [5–7] . In particular, microbiological confirmation demands positive results from at least two separate sputum or one bronchial wash or lavage specimen. A single isolation of NTM from expectorated sputum may be insufficient for diagnosis, as respiratory specimens are prone to environmental contamination. Accordingly, current guidelines recommend bronchoscopy for patients suspected of NTM-PD who either fail to produce culture-positive sputum or are unable to expectorate sputum [6,7] . Nevertheless, the growing prevalence of NTM infections and advances in specimen processing suggest that even a single positive result may be clinically significant. Sin et al. reported that NTM-PD diagnosed using methods other than sputum culture was associated with slower disease progression and a slower risk of advancement compared with NTM-PD diagnosed through sputum culture [8] . This study compared the diagnostic agreement on NTM species between sputum and bronchoscopic specimens in patients with suspected NTM-PD. We also examined radiologic progression and treatment requirements in patients diagnosed using two or more respiratory specimens versus those diagnosed with a single specimen. 2. Materials and Methods 2.1. Study Design and Pop

FAQs

What was the purpose of this study?

To evaluate concordance between sputum and bronchoscopic specimens for diagnosing nontuberculous mycobacteria (NTM) pulmonary disease, and to compare outcomes by number of positive cultures.

How many patients were included and how many underwent bronchoscopy?

A total of 400 patients were included, and 100 of them underwent bronchoscopy.

Which factors were associated with radiologic progression or the need for treatment?

Multivariate analysis identified body mass index, membership in the single-isolation group, and fibrocavitary radiologic type as significant factors.

Sep 30, 2026

Upload by Rainbow Cat