{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T15:37:23Z","timestamp":1789227443336,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The global prevalence of nontuberculous mycobacterial pulmonary disease (NTM\u2010PD) has been steadily increasing. A few small retrospective studies have reported a poor prognosis associated with chronic pulmonary aspergillosis (CPA) as a complication of NTM\u2010PD. Furthermore, the prognostic impact of CPA may have been inadequately assessed due to differences in background factors. This study aimed to identify the risk factors for CPA in NTM\u2010PD and compare the risk of in\u2010hospital mortality between patients with and without aspergillosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were obtained from a large\u2010scale claims database. Patients with NTM\u2010PD who met the inclusion criteria and those who developed CPA after the NTM diagnosis were identified. The incidence of CPA was evaluated, and risk factors were identified using multiple logistic analyses. Mortality rates were evaluated and compared between patients with and without aspergillosis after adjusting for background CPA risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of CPA was 2.29% (265\/11,587). The identified risk factors included male sex, chronic respiratory failure, asthma, interstitial pneumonia, pulmonary tuberculosis sequelae and systemic corticosteroid use. A total of 219 patients with CPA were matched with control cases using propensity scores based on age and identified risk factors for CPA. The adjusted hazard ratio for in\u2010hospital mortality was 2.6 (95% CI: 1.8\u20133.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CPA as a complication of NTM\u2010PD is associated with significantly higher mortality rates. Clinicians should consider the necessity of promptly diagnosing CPA in patients with NTM\u2010PD and the associated risk factors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.70022","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T05:36:46Z","timestamp":1736314606000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Risk Factors and Prognostic Effects of Aspergillosis as a Complication of Nontuberculous Mycobacterial Pulmonary Disease: A Nested Case\u2013Control Study"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0696-5386","authenticated-orcid":false,"given":"Takahiro","family":"Takazono","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"},{"name":"Department of Respiratory Medicine Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7872-8147","authenticated-orcid":false,"given":"Shotaro","family":"Ide","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"},{"name":"Infectious Diseases Experts Training Center Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4277-4509","authenticated-orcid":false,"given":"Motohiko","family":"Adomi","sequence":"additional","affiliation":[{"name":"Datack Inc.  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