Discussions

When you walk into a healthcare facility, who is making sure the environment is safe from the spread of infection? Why can this be especially important for the BNTM community? For people with bronchiectasis and NTM, infection prevention is especially important because healthcare facilities bring together many people with respiratory illnesses.

An infection control nurse plays a major role in protecting patients, healthcare workers, visitors, and the community from infections acquired or spread in a healthcare setting.  What does an infection control nurse do? Their job is essentially to prevent infections before they happen and stop them from spreading when they do occur.

Key responsibilities include:

• Monitor infections: Track infections occurring in the hospital, clinic, or other facility and look for patterns or increases.
• Investigate outbreaks: If several patients develop the same infection, the infection-control team investigates where it may have originated and how it is spreading.
• Develop infection-prevention policies: They help establish procedures for hand hygiene, cleaning, sterilization, isolation, PPE, respiratory precautions, and other safety measures. They address questions such as: Should this patient be separated from other patients? How can we protect vulnerable patients in the waiting room?
• Educate healthcare workers: They train staff on infection-prevention practices.
• Monitor compliance: They may observe handwashing, PPE use, cleaning procedures, and other activities to make sure policies are being followed.
• Manage isolation precautions: They help determine what precautions are appropriate for patients with potentially transmissible infections.
• Surveillance: They follow organisms such as C. difficile, influenza, tuberculosis, and other healthcare-associated infections.
• Work with public health departments: Certain infections or outbreaks may need to be reported to the CDC, state, and Local health departments

 Do you have any infection control experiences or suggestions that you would like to share with the community?

You may have wondered: “Why would my pulmonologist want an Infectious Disease (ID) specialist involved in my care?”

It doesn’t necessarily mean you’re “more sick.” Sometimes it means your doctors want another layer of expertise.

An ID doctor may be brought in when:

🔹 A difficult or unusual organism is identified

🔹 NTM is suspected or confirmed
NTM treatment can involve multiple medications, potential drug interactions, side effects, and prolonged therapy.

If there is a question of infection vs. colonization A positive sputum culture doesn’t always mean that treatment is needed. Your clinical symptoms, imaging and microbiology determine the treatment plan.

🔹 The infection keeps coming back
An ID specialist may help determine why and whether additional testing or a different treatment strategy is appropriate.

🔹 Antibiotic choices become complicated- Resistance, allergies, medication interactions, or previous treatment failures may require specialized infectious-disease input.

🔹 Treatment causes significant side effects- The ID doctor can work with the pulmonologist to balance treating the infection while minimizing medication toxicity.

Sometimes the most important role of an ID specialist is simply helping the team answer: Do we treat, what do we treat with?

Has your pulmonologist ever referred you to an Infectious Disease specialist? Did having an ID doctor involved change your treatment plan, or understanding of your cultures? Please share your experience below to assist other members on their journey. 

How do YOU protect your lungs at the doctor’s office?

Going to the doctor is important—but for those living with Bronchiectasis and/or NTM, sitting in a crowded waiting room with people who are coughing can feel a little stressful. 

So let’s learn from each other! What infection-control precautions do YOU take when visiting a doctor’s office?

Do you… 😷 Wear an N95 or KN95?

🚗 Wait in your car until the exam room is ready?
🕐 Try to schedule the first appointment of the day?
🪑 Look for a less-crowded area of the waiting room?
🧴 Carry hand sanitizer?

Open doors with a paper towel or other protective cloth? Use a paper towel to push the elevator button? 

Do airway clearance immediately after the office visit?
📞 Ask the office about their procedures for patients with respiratory symptoms?
🤔 Or do you have another strategy that helps you feel safer?

Do you feel comfortable asking a doctor’s office to help reduce your exposure to respiratory infections—or do you worry about being perceived as “difficult”?

Please your experience below. What works for YOU might be exactly the tip another member of our community needs. Thank you in advance for sharing your experiences. 😍

🫁 INFECTION CONTROL 101: Protecting Your Lungs Starts with the Basics

Do you remember what we learned during the pandemic regarding infection control precautions? The everyday things we do to prevent infection really can make a difference. For people living with bronchiectasis and NTM (BNTM), infection prevention is especially important. You don't have to live in a bubble — but a few simple habits can help reduce your exposure to respiratory germs and other infections.

🧼 YOUR EVERYDAY INFECTION-CONTROL CHECKLIST:

• Keep your respiratory equipment clean- nebulizers, masks, tubing, spacers, and other respiratory equipment can harbor germs if they aren't cleaned properly. Follow your healthcare team's instructions for cleaning, disinfecting, and replacing equipment.
• Be mindful of shared spaces- crowded indoor spaces can mean more exposure to respiratory viruses. During times when respiratory illnesses are circulating heavily, consider improving ventilation, avoiding unnecessary crowds, or wearing a well-fitting mask.
• Clean your hands- wash your hands regularly with soap and water, especially after being out in public, before eating, and after coughing or blowing your nose.
• Practice good cough etiquette-cover coughs and sneezes with a tissue or your elbow and wash your hands afterward.
• Stay home when you're sick- if someone around you has a respiratory infection, give yourself some distance when possible.
• Keep vaccinations up to date-talk with your healthcare provider about recommended vaccines.
• Pay attention to water and environmental exposures- NTM bacteria are naturally found in the environment, including water and soil. Video on Environmental Precautions with Environmental Precautions expert, Jennifer Honda, PhD- https://www.youtube.com/watch?v=LEB1VRoH2Rs

💙 Infection control isn't about fear. It's about control. You can't eliminate every exposure — instead, focus on the small, consistent habits you can control. 🫁 Protect your lungs. Protect your health. Preventative strategies are far easier to deal with than curative strategies. Do you have any additional suggestions?

Please let us know if you have any infection control questions.

Hello!  Did you know there are different types of flu vaccines?  WHAT ARE THE OPTIONS?

🔹 Standard-dose flu vaccine
Traditional injectable flu vaccine. Available for many age groups beginning at 6 months, depending on the specific product and current approvals.

🔹 Cell-based flu vaccine
Made using animal cell culture rather than eggs. Availability and approved age groups may vary by season and product.

🔹 Recombinant flu vaccine — Flublok
Made using recombinant technology rather than growing influenza virus in eggs. Its approved age range and availability should be confirmed for the 2026–27 season.

🔹 High-dose flu vaccine — Fluzone High-Dose
Designed for adults 65 and older. It contains more antigen than standard-dose vaccine to produce a stronger immune response. Product availability and recommendations may change, so confirm current guidance. 

🔹 Adjuvanted flu vaccine — Fluad
Also designed for adults 65+. It contains an adjuvant, an ingredient intended to strengthen the body’s immune response to vaccination. Confirm current approval, availability, and recommendations for 2026–27. 

IF YOU ARE 65+

CDC recommendations for adults 65+ may prefer enhanced flu vaccines, such as high-dose, adjuvanted, or recombinant vaccines.https://www.cdc.gov/vaccines/index.html
Have you discussed what type of flu shot you will be getting this year with your health care provider? 

Hello!  Are you preparing to get the flu vaccine?
The composition of flu vaccines changes every year, it gets updated based on needs scientists observe from the previous year. Flu vaccines for the 2026–2027 season are trivalent and protect against three influenza viruses: H1N1, H3N2 and a B/Victoria virus. 

A new option this season is mFLUSIVA, the first FDA-approved mRNA flu vaccine injection. It is approved for adults 50 to 64 and received accelerated approval for adults 65 and older.

People 65 years and older may also receive Fluzone High-Dose, Fluad or Flublok.  http//www.Drugs.com 

It is best to get your flu vaccine for early fall, or by mid October since the flu vaccine takes a few weeks to be fully effective. Let’s be proactive and protect ourselves. Let us know if you have any questions. 

🫁 RSV VACCINE: AN IMPORTANT LAYER OF PROTECTION FOR THE BNTM COMMUNITY

For individuals living with bronchiectasis and/or NTM lung disease, protecting your lungs from respiratory infections is of utmost importance.

The CDC recommends RSV vaccination for:
• Everyone age 75 and older
• Adults ages 50–74 who are at increased risk for severe RSV, including people with chronic lung disease.

🗓️ How often do you need it? RSV vaccination is NOT currently an annual vaccine.

The best time for eligible adults to get vaccinated is generally early fall, before RSV begins circulating widely.

❤️ Why does this matter for the BNTM community?

When you already have compromised or damaged airways, another respiratory infection can potentially put additional stress on your lungs. RSV vaccination can help reduce the risk of serious RSV disease.

Talk with your healthcare provider about whether the RSV vaccine is right for you.

Protect your lungs. Prevent what you can. 💙 https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/adults.html

Hello! Are you up to date with your Tdap vaccine? The multiple letters on some vaccines can be very confusing. Regarding the tetanus, diphtheria and pertussis vaccines-adults generally receive Tdap, not the childhood DTaP vaccine.

💉 Tdap protects against three bacterial infections:

• Tetanus — can enter through cuts or wounds and cause severe muscle spasms.
• Diphtheria — can cause serious throat and breathing problems.
• Pertussis (whooping cough) — particularly important for people with underlying lung disease because a prolonged cough or respiratory infection can be especially difficult to manage.

How often do adults need it? According to CDC recommendations:

• One Tdap dose is recommended for adults who have never received Tdap.
• After that, adults should receive Td or Tdap every 10 years.
• Tdap can be used instead of Td for the 10-year booster. 

Preventing pertussis (whooping cough) is particularly relevant to people who already have compromised or damaged airways. A pertussis infection can cause weeks of severe coughing, which may be particularly disruptive for someone with bronchiectasis.

 Vaccination history and the recommended schedule are normally used to determine whether or not an adult needs Tdap. Please discuss your vaccination record with your healthcare provider rather than assuming you’re protected. Please let us know if you have any questions.

August is National Immunization Month. I thought I would review IMMUNOLOGY 101.

Ever wonder what actually happens inside your body after you get a vaccine? 💉

Think of your immune system as your body’s security team. Its job is to recognize things that don’t belong—such as bacteria and viruses—and respond to them. 
What does a vaccine do?

A vaccine gives your immune system a safe preview of a specific germ or part of it.

It essentially says: “Here’s what the enemy looks like. Learn it now, so you’re ready if you encounter it later.”

Your immune system responds by making antibodies and immune memory cells. If the real germ appears later, your immune system can recognize it and respond much faster.

When you already have chronic lung disease, avoiding additional respiratory infections can be particularly important.

Vaccines don’t prevent every respiratory infection but they can help protect against other vaccine-preventable infections that may cause serious respiratory illness or complications.

Your age, health conditions, previous vaccinations and medications can all affect which vaccines you need and when. 

Vaccination isn’t about making your immune system “stronger.” It’s about training your immune system to recognize a specific threat before you encounter the real thing.

And immunity isn’t always perfect. You can sometimes still become infected after vaccination—but vaccination can reduce the risk of serious illness.

Please ask your healthcare team to review your vaccination history and discuss which vaccines are appropriate for you.

Knowledge is part of your BNTM lung-health toolkit. 🫁💙 Do you have plans for your next vaccination? 

Have you received the pneumococcal vaccine? Why is this vaccine important?

People living with bronchiectasis have structural changes in their airways and are at increased risk for respiratory infections, including serious pneumococcal disease.

Pneumococcal vaccination helps protect against Streptococcus pneumoniae, a bacterium that can cause pneumonia, bloodstream infections and meningitis.

💉 Which pneumococcal vaccine?

There are currently three pneumococcal conjugate vaccines:

• PCV15
• PCV20
• PCV21

There is also PPSV23.

The number refers to the number of pneumococcal serotypes covered by the vaccine. 

For an adult with chronic lung disease who has never received a pneumococcal vaccine, current CDC guidance generally provides these choices:

Option 1:
PCV20 — one dose

OR

PCV21 — one dose

OR

Option 2:
PCV15 → PPSV23
The PPSV23 is generally given at least 1 year later. In certain immunocompromising situations, the interval can be shortened to 8 weeks. 
I realize that all if these different numbers can be confusing… please let us know if you have any questions. 

SHINGLES VACCINE: ANOTHER LAYER OF PROTECTION FOR THE BNTM COMMUNITY 💙

If you’re living with Bronchiectasis and/or NTM lung disease, protecting your overall health is an important part of managing your respiratory health.

One vaccine worth talking to your healthcare provider about is the shingles (zoster) vaccine.

🦠 Why does shingles matter?
Shingles is caused by reactivation of the chickenpox virus that remains dormant in the body. It can cause a painful rash, nerve pain, and sometimes serious complications.
Why should the BNTM community care?People living with chronic lung disease may already have a lot on their plate. Preventing an additional illness—and the complications that can come with it—is one way to help protect your health and avoid unnecessary setbacks.

💉 Shingrix is the recommended shingles vaccine for adults 50 and older, and it may also be recommended for certain adults 19 and older who are immunocompromised. It is given as a 2-dose series.
Please speak with your doctor to find out if the shingles vaccine is appropriate for you, especially if you take medications that affect your immune system or have other health conditions.
Remember: Vaccines are not about treating BNTM—they’re about preventing additional illnesses that can make living with a chronic lung condition more challenging.

💙 Protect your lungs. Protect your health. Stay up to date on recommended vaccines. Please let us know if you have any specific questions. 

Hi,

Recently found out I have MAC again (successfully treated m.avium species 10 years ago) but now have intracellular species and seems to be macrolide resistant. I have been looking at some very negative outcomes online for this scenario and wondering is there is anyone else out these who is experiencing this and what to expect moving forward for treatment plan .

I have had colonized Pseudomonas for 2 years. Recently I took a strong dose of Levaquin (after having no antibiotics for the past 2 years) for pneumonia and the last sputum culture indicated no presence of Pseudomonas.

I fear a reoccurrence and am asking others to comment on this smart and persistent bacteria.

I have heart issues while on treatment. I'm considering stopping treatment. Anybody here just watching and keeping an eye on MAC with out treatment?

For the first time, my culture showed the presence of Pseudomonas. :-(

How do I weig the pros and cons of to attempt eradication?

The link below from the CDC offers detailed information on this subject: https://www.cdc.gov/ncird/whats-new/reduce-your-risk-from-respiratory-viruses-this-holiday-season.html#cdc_generic_section_2-now-is-the-time-to-take-action

This is one term that is not frequently spoken about. Below is information on rhinoviruses from the CDC:https://www.cdc.gov/rhinoviruses/about/index.html

I was on 6 rounds of Steroids, including IV, for a severe mold allergy. Then diagnosed with MAC after.

Hi - I have had a history of bronchiectasis since 2005. The thing the doctors told me was to be careful if you catch a cold or flu as that can turn into pneumonia. Fast forward to fall of 2014, I had been having night sweats for years but now I felt like I was getting a fever all the time, that kind of light headed feeling, than the mucus increased. I went to the Dr. and was just told I have a bug, take some mucus meds. The low grade fever stayed, along with the extra mucus, back to the dr., this time some prednisone. The fevers went a bit higher and I started just sleeping a lot between coughing fits. Dr. number 3 gave me a script for some super cough meds and ceftin antibiotics. I demanded a chest X-ray due to wanting to make sure pneumonia was not setting in, Dr. said if you are not better in a week than we will X-ray, I told him no we need to do it now!. So I got the X-ray and yes I had pneumonia in both lungs. I was sent for some blood work which said I tested positive for mycoplasma pneumonia. The ceftin seemed to be helping and I started feeling better. Even the cough lessened. I was telling people I have coughed for 10 years and now it is like a bad memory, why hadn't I taken ceftin before this, it is like a miracle. 7 days after I finished the ceftin all the symptoms returned. This was repeated 5 more times when I said this is crazy and found the most amazing ID doctor. Her first ? is why are you here, I told her I was tired of being so sick.....she took my history did an exam ordered some test and said " I believe you have MAC" - followed up with pulmonary Dr., had bronchoscopy and that confirmed the NTM MAI - Than it was the wait for what meds. to take. I continued to take the ceftin until the big 3 were chosen. This all took from Nov. 2014 till May 13th 2015 - "1 year ago today" - I have had 2 neg cultures for MAI, one did show aspergillus which i am not being treated for as It is probably colonized and not causing any further problems. - During this year of treatment I did have an episode of coughing up blood, but for the fast action of my pulmonary Dr. within a week I had another bronchoscopy and a PICC line to treat a very bad pseudomonas infection. This has been a roller coaster of a ride with leaning how to cope with this physically and mentally. I am still learning.......

Norma

Is there something I can do to prevent infections and at the same time help me breathe better

I've heard many people refer to the term "MAC" when they talk about NTM. What is MAC? What's the difference between MAC and NTM?