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Non-tuberculous mycobacterial (NTM) lung disease is increasingly common and often misunderstood. In this episode of On Air, Baylor Medicine experts explain how NTM infections develop, when they need treatment, and how patients can protect their lung health. In Episode 7 of the Baylor Medicine Lung Institute podcast On Air, Dr. Shanda Blackmon speaks with Dr. Sunjay Devarajan, a pulmonary specialist with expertise in NTM, bronchiectasis, and cystic fibrosis. They discuss: • What non-tuberculous mycobacteria are and how they differ from tuberculosis • Common NTM species such as Mycobacterium avium complex (MAC) and Mycobacterium abscessus • Why NTM infections vary by geography and climate • Risk factors including bronchiectasis, COPD, immune suppression, and cystic fibrosis • Why not every positive culture requires antibiotic treatment • The importance of airway clearance and mucus management • Environmental exposures such as soil, water, gardening, and hot tubs • Advances in antibiotic therapy and drugs in development • When surgery or lung transplant may be considered • Why multidisciplinary are is essential for complex NTM disease This episode is designed for patients, caregivers, clinicians, and and trainees seeking a clear, practical understanding of NTM lung disease. Medical Disclaimer: This content is for educational purpose only and does not replace medical advice. Please consult a qualified health care provider for diagnosis and treatment. Contact: To learn more or request an appointment, visit https://www.bcm.edu/healthcare/specia... 0:00 Introduction to NTM lung disease 1:45 What are non-tuberculous mycobacteria? 3:30 Common NTM species (MAC vs abscessus) 6:10 Why geography and climate matter 8:40 Risk factors and underlying lung disease 11:20 When NTM does NOT need treatment 14:10 Airway clearance and mucus management 17:30 Hypertonic saline and cough techniques 20:40 Environmental exposures (soil, water, hot tubs) 24:10 Antibiotic therapy and new drugs 28:10 When surgery is considered 32:00 NTM and lung transplant eligibility 35:40 Multidisciplinary care model 38:30 Prevention strategies and closing thoughts