Nocardiosis: a single-center experience and literature review

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Luís Filipe Gomes Malheiro

    Autor

Participantes de fora da FMUP

  • Besteiro, B
  • Coutinho, D
  • Fragoso, J
  • Figueiredo, C
  • Nunes, S
  • Azevedo, C
  • Teixeira, T
  • Selaru, A
  • Abreu, G

Unidades de investigação

Abstract

Introduction: Nocardiosis is a rare bacterial infection caused by Nocardia spp. However, an increasing incidence has been described whereby data about epidemiology and progno-sis are essential. Methods: A retrospective descriptive study was conducted among patients with positive Nocardia spp. culture, from January 2019 to January 2023, at a Terciary Hospital in Portugal. Results: Nocardiosis was considered in 18 cases with a median age of 63.8-years-old. At least one immunosuppressive cause was identified in 70% of patients. Five patients had Dissem-inated Nocardiosis (DN). The lung was the most common site of clinical disease (77.8%) and Nocardia was most commonly identified in respiratory tract samples. The most frequently isolated species were Nocardia nova/africana (n = 7) followed by Nocardia cyriacigeorgica (n = 3) and Nocardia pseudobrasiliensis (n = 3). The majority of the patients (94.4%) received antibi-otic therapy, of whom as many as 55.6% were treated with monotherapy. The most fre-quently prescribed antibiotic was trimethoprim-sulfamethoxazole. Selected antimicrobial agents were generally effective, with linezolid and cotrimoxazole (100% Susceptibility [S]) and amikacin (94% S) having the most activity against Nocardia species. The median (IQR) duration of treatment was 24.2 (1-51.4) weeks for DN; The overall one-year case fatality was 33.3% (n = 6) and was higher in the DN (66.7%). No recurrence was observed. Conclusion: Nocardiosis is an emerging infectious disease with a poor prognosis, particularly in DN. This review offers essential epidemiological insights and underscores the impor-tance of gaining a better understanding of the microbiology of nocardiosis. Such knowledge can lead to the optimization of antimicrobial therapy and, when necessary, guide appropri-ate surgical interventions to prevent unfavorable outcomes.(c) 2023 Published by Elsevier Espana, S.L.U. on behalf of Sociedade Brasileira de Infectologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Dados da publicação

ISSN/ISSNe:
1413-8670, 1678-4391

Brazilian Journal of Infectious Diseases  Elsevier Editora Ltda

Tipo:
Article
Páginas:
-
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 2

Citações Recebidas na Scopus: 7

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Keywords

  • Nocardiosis; Prognosis; Epidemiology; Antibiotics

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The impact of SARS-CoV-2 viral load on the mortality of hospitalized patients. A retrospective analysis

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