{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:24:35Z","timestamp":1789979075194,"version":"4.0.1"},"reference-count":35,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2014,8,15]]},"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with pulmonary <jats:italic>Mycobacterium avium<\/jats:italic> complex (MAC) disease are often co-infected with various pathogenic microorganisms. This study aimed to determine the prevalence of co-infection with non-MAC pathogens and the risk factors associated with co-infection in patients with pulmonary MAC disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed the patient characteristics, microbiological results and chest CT findings in 275 patients with pulmonary MAC who visited the Kyoto University Hospital from January 2001 to May 2013. We defined chronic pathogenic co-infection as the isolation of non-MAC pathogens from sputum samples taken on more than two visits that occurred at least 3\u2005months apart.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The participants were predominantly female (74.5%) and infected with <jats:italic>M. avium<\/jats:italic> (75.6%). Chronic co-infection with any pathogen was observed in 124 patients (45.1%). Methicillin-sensitive <jats:italic>Staphylococcus aureus<\/jats:italic> (MSSA; n=64), <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (n=35) and <jats:italic>Aspergillus<\/jats:italic> spp (n=18) were the most prevalent pathogens. The adjusted factors were chronic obstructive pulmonary disease (COPD; OR=4.2, 95% CI 1.6 to 13.1) and pulmonary <jats:italic>M. intracellulare<\/jats:italic> disease (OR=2.2, 95% CI 1.1 to 4.4) in chronic co-infections; COPD (OR=4.2, 95% CI 2.1 to 31.4), long duration of MAC disease (OR=2.2, 95% CI 1.2 to 4.4) and nodules (OR=3.5, 95% CI 1.2 to 13.2) in chronic MSSA co-infection; COPD (OR=7.5, 95% CI 2.1 to 31.4) and lower lobe involvement (OR=9.9, 95% CI 2.0 to 90.6) in chronic <jats:italic>P. aeruginosa<\/jats:italic> co-infection; and use of systemic corticosteroids (OR=7.1, 95% CI 1.2 to 50.9) and pulmonary <jats:italic>M. intracellulare<\/jats:italic> disease (OR=4.0, 95% CI 1.1 to 14.5) in chronic <jats:italic>Aspergillus<\/jats:italic> spp co-infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with pulmonary MAC disease frequently had chronic co-infections with pathogenic microorganisms such as MSSA, <jats:italic>P. aeruginosa<\/jats:italic> and <jats:italic>Aspergillus<\/jats:italic>. The risk factors for chronic co-infection were COPD and pulmonary <jats:italic>M. intracellulare<\/jats:italic> disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2014-000050","type":"journal-article","created":{"date-parts":[[2014,8,29]],"date-time":"2014-08-29T00:47:58Z","timestamp":1409273278000},"page":"e000050","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Prevalence and risk factors for chronic co-infection in pulmonary <i>Mycobacterium avium<\/i> complex disease"],"prefix":"10.1136","volume":"1","author":[{"given":"Kohei","family":"Fujita","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Graduate School of Medicine, Kyoto 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