Bronchiectasis & Pulmonary Nontuberculous Mycobacterium

Bronchiectasis and nontuberculous mycobacterial (NTM) pulmonary infections are chronic conditions. Bronchiectasis is dilation of airways due to an inflammatory process (current or previous), immunologic dysfunction, or a genetic disorder, and is often complicated by chronic or recurrent infections. Often, patients with NTM pulmonary infections have underlying bronchiectasis. We founded the INTEGRATE program as a multidisciplinary approach to diagnosis and treatment of bronchiectasis, primary ciliary dyskinesia, cystic fibrosis related pulmonary disorders, and pulmonary NTM disease. The focus of our program is to provide holistic care for persons with either or both of these conditions. To accomplish this, our team consists of physicians in Pulmonary Medicine, Infectious Diseases, Radiology, Microbiology, as well as providers in physical therapy, respiratory therapy, and pharmacy. Services we provide include consultation for diagnosis and evaluation of bronchiectasis and pulmonary NTM infections, complex disease management, airway clearance, aerosol therapies, multidisciplinary case review, and clinical and translational research programs.

What is Bronchiectasis? 

Bronchiectasis is diagnosed when the small airways in the lung are enlarged. This can be due to many causes which will be evaluated by your doctor, but sometimes cannot be identified. When the enlargement occurs, it is difficult for the lungs to clear naturally producing mucus. As a result, mucus will accumulate and can get impacted over time. Bacteria can accumulate in these sites and cause recurrent infections. The central component of therapy is airway clearance and recurrent evaluation of potential bacteria in the lung.

What are Nontuberculous Mycobacterium Pulmonary Infections?

Nontuberculous mycobacterium (NTM) are environmental bacteria. Only a small fraction of NTM that have been identified cause human diseases, most often pulmonary disease. Even more, not all people with a diagnosis of NTM pulmonary disease need to be treated. This decision is based on symptoms, findings on imaging, the type of organism, and most importantly, the individual’s preference after informed discussion. Treatment regimens include airway clearance and multiple antibiotics over an extended period (greater than one year).

New Patient Referral

Please submit new referrals attention to INTEGRATE clinic for bronchiectasis and pulmonary nontuberculous evaluation. Feel free to contact our clinic for any questions at (415) 353-2961. 

To provide a thorough evaluation and initial consultation, we require a chest CT within the last 6 months, pulmonary function tests within the last 1 year, and if available, all microbiologic data from respiratory samples. We also require clinical notes from referring physician and pulmonary or infectious diseases specialists.

Resources for Patients

Consultation and Collaboration with: 

UCSF Clinics and Sites of Interest:

Our Team
B. Shoshana Zha, MD, PhD Catherine DeVoe, MD Budzik Katerina Byanova​​​​
B. Shoshana Zha, MD/PhD
Assistant Professor, Pulmonary Medicine
Director of Bronchiectasis/ Pulmonary NTM Program
Catherine DeVoe, MD
Assistant Professor, Infectious Diseases, Co-Director of INTEGRATE
Jonathan Budzik, MD, PhD
Assistant Professor, Pulmonary Medicine
Katerina Byanova, MD
Clinical Instructor, Pulmonary Medicine
Mary Ellen Kleinhenz, MD  Brett Elicker, MD  Jeff Tarnow, RCT Vicki Jue, PharmD
Mary Ellen Kleinhenz, MD
Professor, Pulmonary Medicine
Brett Elicker, MD
Professor, Radiology
Chief of Cardiac & Pulmonary Imaging
Jeff Tarnow, RCT
Respiratory Therapy
Vicki Jue, PharmD
   Kathy Bonacinni, PT, DPT Gail Cunningham Sarah Doernberg
Isabella Cheng
Clinical Research Coordinator
Kathy Bonacini, PT, DPT
Physical Therapy
Gail Cunningham
AFB Microbiologist
Sarah Doernberg
Associate Professor, Infectious Diseases
 Monica Fung  Bystritsky Schwartz  
Monica Fung
Assistant Professor, Infectious Diseases
Rachel Bystritsky
Assistant Professor, Infectious Diseases
Brian Schwartz
Associate Professor, Infectious Diseases