Clinical Characteristics and Risk Factors for Nontuberculous Mycobacterial Pulmonary Disease with Chronic Pulmonary Aspergillosis in Patients

Background: The incidence of patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) complicated by chronic pulmonary aspergillosis (CPA) has been increasing. CPA is known to be associated with complex treatment regimens and a poor prognosis. However, data from mainland China remain scarce. Objective: This single-center retrospective study aimed to evaluate the clinical characteristics, risk factors, and prognoses of patients with NTM-PD who were coinfected with CPA. Methods: We conducted a retrospective review of the medical records of 248 patients diagnosed with NTM-PD. Risk factors for CPA were analyzed via multiple logistic regression, followed by survival analysis. Results: Among the 248 patients with NTM-PD, 66 (26.6%) were diagnosed with CPA. Independent risk factors for NTM-PD and CPA coinfection included male sex(OR 2.13, 95% CI:1.03-4.47), dyspnea(OR 27.9, 95% CI:4.24-570), cavity(OR 5.95, 95% CI:2.76-13.9), use of oral corticosteroids(OR 4.28, 95% CI:1.13-16.6), and interstitial lung disease(OR 15.5, 95% CI:1.89-361). The Kaplan-Meier survival curves indicated a significant divergence between the NTM-PD group and the NTM-PD with CPA group (log-rank test, p = 0.00039; HR 2.01, 95% CI:0.66-6.12). Conclusion: In patients with NTM-PD, the presence of concurrent CPA is associated with a marked increase in mortality. Clinicians should maintain a high index of suspicion for CPA to ensure prompt diagnosis and treatment, particularly in high-risk individuals.