Nontuberculous mycobacteria (NTM) can cause severe pulmonary disease in people with cystic fibrosis (pwCF). These infections present unique challenges for diagnosis and treatment, prompting a recent interest in understanding NTM transmission and pathogenesis during chronic infection. Major gaps remain in our knowledge regarding basic pathogenesis, immune evasion strategies, population dynamics, recombination potential, and the evolutionary implications of host and antibiotic pressures of long-term NTM infections in pwCF. Phylogenomic techniques have emerged as an important tool for tracking global patterns of transmission and are beginning to be used to ask fundamental biological questions about adaptation to the host during pathogenesis. In this review, we discuss the burden of NTM lung disease (NTM-LD), highlight the use of phylogenomics in NTM research, and address the clinical implications associated with these studies.

非结核分枝杆菌 (NTM) 可导致囊性纤维化 (pwCF) 患者出现严重的肺部疾病。这些感染给诊断和治疗带来了独特的挑战，引发了人们最近对了解慢性感染期间 NTM 传播和发病机制的兴趣。我们对 pwCF 中长期 NTM 感染的基本发病机制、免疫逃避策略、群体动态、重组潜力以及宿主和抗生素压力的进化影响的认识仍然存在重大差距。系统基因组技术已成为追踪全球传播模式的重要工具，并开始用于询问有关发病过程中对宿主的适应的基本生物学问题。在这篇综述中，我们讨论了 NTM 肺病 (NTM-LD) 的负担，强调了系统基因组学在 NTM 研究中的应用，并讨论了与这些研究相关的临床意义。