OBJECTIVE  To investigate the clinical characteristics, species distribution and drug resistance profiles of patients with nontuberculous mycobacteria pulmonary disease （NTM-PD）, providing references for clinical diagnosis and treatment.

METHODS  A total of 257 patients with NTM-PD, who were admitted to the Fourth Hospital of Nanning, Guangxi, from Jan. 2019 to Jul. 2024, were enrolled as study subjects. Their clinical characteristics, species distribution and drug resistance profiles were analyzed.

RESULTS  The study included 257 patients clinically confirmed with NTM-PD, comprising 85 males and 172 females, with a higher proportion of patients aged ≥60 years （53.31%）. The majority of patients were farmers （66.93%）. Excluding 34 cases with untypable species, totally 19 strains were isolated form 223 patients. Infection types included single and mixed infections: 194 cases were single infections, predominantly Mycobacterium abscessus （34.08%）, Mycobacterium intracellulare （28.25%） and Mycobacterium avium （5.83%）. And 29 cases （13.00%） were mixed infections, primarily involving co-infection with M. avium and M. intracellulare （6.73%）. There was statistically significant difference in age distribution among patients with different infection types （P=0.027）. Among patients infected with different strains, the incidence of the symptom "cough with sputum production ≥2 weeks" showed statistically significant difference （P=0.039）. Drug susceptibility testing was performed on 67 cases: NTM exhibited high resistance rates to imipenem/cilastatin, doxycycline and minocycline （＞92%）. M. abscessus demonstrated higher resistance rates to ethambutol （89.29%）, rifampin （82.14%）, tobramycin （67.86%） and rifabutin （60.71%） than other species （P＜0.001）. Intracellulare-abscessus M. showed higher resistance rates to gatifloxacin （100.00%） than other species （P＜0.001）. M. avium exhibited higher resistance to azithromycin （50.00%） than other species （P＜0.05）.

CONCLUSIONS  In Nanning City, Guangxi, NTM-PD predominantly affects middle-aged and elderly populations, with a higher proportion of female cases. The primary species include M. abscessus, M. intracellulare and M. avium. The distribution of NTM species varies across age groups, and drug resistance profiles differ among species of NTM. Effective treatment regimens should be tailored based on the predominant pathogenic species and their resistance profiles in this region.