Comparison of Clinical Characteristics and Treatment Outcome Between Localized and Disseminated Nocardiosis in a Tertiary Hospital in China

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2024 Jun 19

PMID 38894887

Authors

Li Zhang

Menglan Zhou

Ziran Wang

Hongqiong Zhu

Jing Lin

Minya Lu

Ying Ge

Yingchun Xu

Taisheng Li

Zhengyin Liu

Affiliations

Soon will be listed here.

Abstract

Background: In China, due to the large population, infections caused by Nocardia may not be as rare. Unfortunately, there is still inadequate knowledge of the clinical impact caused by Nocardia. This study aimed to compare the clinical characteristics and treatment of localized and disseminated nocardiosis.

Methods: The clinical and microbiological data of patients diagnosed with nocardiosis in a tertiary hospital in Beijing from July 2011 to July 2021 were collected and retrospectively analyzed.

Results: Among the 54 nocardiosis cases, 34 cases were in the localized infection group, while 20 cases in the disseminated infection group. The proportion of patients with chronic structural lung disease was higher in the localized group (=0.010). In contrast, patients with disseminated infections were more prone to receive long-term glucocorticoids and/or immunosuppressants (=0.027). Pulmonary nodules were prominent features of imaging changes in patients with disseminated infections (=0.027) whereas bronchial dilatation was more common in patients with localized infections (=0.025). In addition, the disseminated group had longer average hospitalization days relative to the localized group (=0.016), but there was no significant difference in mortality between them (=0.942).

Conclusion: There were differences in the clinical profiles between patients with localized and disseminated nocardiosis in terms of clinical presentation, infection site, radiological features, treatment, and prognosis. These findings may provide references for the management and treatment of patients with nocardiosis.

References

Traxler R, Bell M, Lasker B, Headd B, Shieh W, McQuiston J . Updated Review on Species: 2006-2021. Clin Microbiol Rev. 2022; 35(4):e0002721. PMC: 9769612. DOI: 10.1128/cmr.00027-21. View

Restrepo A, Clark N . Nocardia infections in solid organ transplantation: Guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation. Clin Transplant. 2019; 33(9):e13509. DOI: 10.1111/ctr.13509. View

Nso N, Nassar M, Guzman Perez L, Shaukat T, Trandafirescu T . Localized Pulmonary Nocardia farcinica Infection As the Presenting Symptom of Acquired Immunodeficiency Syndrome. Cureus. 2021; 13(8):e17611. PMC: 8483601. DOI: 10.7759/cureus.17611. View

Beucler N, Farah K, Choucha A, Meyer M, Fuentes S, Seng P . Nocardia farcinica cerebral abscess: A systematic review of treatment strategies. Neurochirurgie. 2021; 68(1):94-101. DOI: 10.1016/j.neuchi.2021.04.022. View

Meena D, Kumar D, Bohra G, Midha N, Garg M . Clinical Characteristics and Treatment Outcome of Central Nervous System Nocardiosis: A Systematic Review of Reported Cases. Med Princ Pract. 2022; 31(4):333-341. PMC: 9485982. DOI: 10.1159/000525509. View

Li J, Shen H, Yu T, Tao X, Hu Y, Wang H . Isolation and Characterization of Nocardia Species from Pulmonary Nocardiosis in a Tertiary Hospital in China. Jpn J Infect Dis. 2021; 75(1):31-35. DOI: 10.7883/yoken.JJID.2020.1096. View

Tremblay J, Thibert L, Alarie I, Valiquette L, Pepin J . Nocardiosis in Quebec, Canada, 1988-2008. Clin Microbiol Infect. 2010; 17(5):690-6. DOI: 10.1111/j.1469-0691.2010.03306.x. View

Lucas S, Hounnou A, Peacock C, Beaumel A, Kadio A, De Cock K . Nocardiosis in HIV-positive patients: an autopsy study in West Africa. Tuber Lung Dis. 1994; 75(4):301-7. DOI: 10.1016/0962-8479(94)90137-6. View

Cattaneo C, Antoniazzi F, Caira M, Castagnola C, DElia M, Tumbarello M . Nocardia spp infections among hematological patients: results of a retrospective multicenter study. Int J Infect Dis. 2013; 17(8):e610-4. DOI: 10.1016/j.ijid.2013.01.013. View

10.

Yasuike M, Nishiki I, Iwasaki Y, Nakamura Y, Fujiwara A, Shimahara Y . Analysis of the complete genome sequence of Nocardia seriolae UTF1, the causative agent of fish nocardiosis: The first reference genome sequence of the fish pathogenic Nocardia species. PLoS One. 2017; 12(3):e0173198. PMC: 5336288. DOI: 10.1371/journal.pone.0173198. View

11.

Dumitrascu A, Rojas C, Stancampiano F, Johnson E, Harris D, Chirila R . Invasive Nocardiosis Versus Colonization at a Tertiary Care Center: Clinical and Radiological Characteristics. Mayo Clin Proc Innov Qual Outcomes. 2023; 7(1):20-30. PMC: 9798119. DOI: 10.1016/j.mayocpiqo.2022.11.002. View

12.

Mehta H, Shamoo Y . Pathogenic Nocardia: A diverse genus of emerging pathogens or just poorly recognized?. PLoS Pathog. 2020; 16(3):e1008280. PMC: 7058287. DOI: 10.1371/journal.ppat.1008280. View

13.

Wang H, Zhu Y, Cui Q, Wu W, Li G, Chen D . Epidemiology and Antimicrobial Resistance Profiles of the Species in China, 2009 to 2021. Microbiol Spectr. 2022; 10(2):e0156021. PMC: 9045199. DOI: 10.1128/spectrum.01560-21. View

14.

Margalit I, Lebeaux D, Tishler O, Goldberg E, Bishara J, Yahav D . How do I manage nocardiosis?. Clin Microbiol Infect. 2021; 27(4):550-558. DOI: 10.1016/j.cmi.2020.12.019. View

15.

Yetmar Z, Challener D, Seville M, Bosch W, Beam E . Outcomes of Nocardiosis and Treatment of Disseminated Infection in Solid Organ Transplant Recipients. Transplantation. 2022; 107(3):782-791. PMC: 9974559. DOI: 10.1097/TP.0000000000004343. View

16.

Burke V, Lopez F . Approach to skin and soft tissue infections in non-HIV immunocompromised hosts. Curr Opin Infect Dis. 2017; 30(4):354-363. DOI: 10.1097/QCO.0000000000000378. View

17.

Soueges S, Bouiller K, Botelho-Nevers E, Gagneux-Brunon A, Chirouze C, Rodriguez-Nava V . Prognosis and factors associated with disseminated nocardiosis: a ten-year multicenter study. J Infect. 2022; 85(2):130-136. DOI: 10.1016/j.jinf.2022.05.029. View

18.

Wilson J . Nocardiosis: updates and clinical overview. Mayo Clin Proc. 2012; 87(4):403-7. PMC: 3498414. DOI: 10.1016/j.mayocp.2011.11.016. View

19.

Budzik J, Hosseini M, Mackinnon Jr A, Taxy J . Disseminated Nocardia farcinica: literature review and fatal outcome in an immunocompetent patient. Surg Infect (Larchmt). 2012; 13(3):163-70. PMC: 3375863. DOI: 10.1089/sur.2011.012. View

20.

Ramos-E-Silva M, Lopes R, Trope B . Cutaneous nocardiosis: A great imitator. Clin Dermatol. 2020; 38(2):152-159. DOI: 10.1016/j.clindermatol.2019.10.009. View