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We read with great interest the paper by Wickremasinghe et al on the prevalence of non-tuberculous mycobacteria (NTM) in patients with bronchiectasis.1 They showed that the prevalence of NTM was uncommon (only 2%) both in 50 newly referred patients and 50 follow up patients. However, the authors stated in the Discussion that “it is now our practice to screen our patients routinely once a year” because a large number of NTM isolates (28%) were detected by routine surveillance in their retrospective analysis of 71 patients with NTM sputum isolates.1
NTM pulmonary infection associated with bronchiectasis is increasing worldwide.2 However, should routine periodic screening for NTM infection be necessary for all adult patients with bronchiectasis? Is sputum culture a sufficiently sensitive method to exclude active NTM infection? Are negative sputum studies sufficient to dissuade one from the diagnosis of active NTM infection?
Bronchiectasis in general can manifest in one of two forms: as a local or focal obstructive …