Nocardiosis: a single-center experience and literature review
Introduction: Nocardiosis is a rare bacterial infection caused by Nocardia spp. However, an increasing incidence has been described whereby data about epidemiology and prognosis are essential. Methods: A retrospective descriptive study was conducted among patients with positive Nocardia spp. culture...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-09-01
|
| Series: | Brazilian Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867023000661 |
| _version_ | 1827794324172046336 |
|---|---|
| author | Bruno Besteiro Daniel Coutinho Joana Fragoso Cristóvão Figueiredo Sofia Nunes Carlos Azevedo Tiago Teixeira Aurélia Selaru Gabriela Abreu Luís Malheiro |
| author_facet | Bruno Besteiro Daniel Coutinho Joana Fragoso Cristóvão Figueiredo Sofia Nunes Carlos Azevedo Tiago Teixeira Aurélia Selaru Gabriela Abreu Luís Malheiro |
| author_sort | Bruno Besteiro |
| collection | DOAJ |
| description | Introduction: Nocardiosis is a rare bacterial infection caused by Nocardia spp. However, an increasing incidence has been described whereby data about epidemiology and prognosis 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 Disseminated 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 antibiotic therapy, of whom as many as 55.6% were treated with monotherapy. The most frequently 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 importance of gaining a better understanding of the microbiology of nocardiosis. Such knowledge can lead to the optimization of antimicrobial therapy and, when necessary, guide appropriate surgical interventions to prevent unfavorable outcomes. |
| first_indexed | 2024-03-11T18:31:03Z |
| format | Article |
| id | doaj.art-82f853c4c36e4adda70f86f3e485dc80 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-03-11T18:31:03Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-82f853c4c36e4adda70f86f3e485dc802023-10-13T11:03:50ZengElsevierBrazilian Journal of Infectious Diseases1413-86702023-09-01275102806Nocardiosis: a single-center experience and literature reviewBruno Besteiro0Daniel Coutinho1Joana Fragoso2Cristóvão Figueiredo3Sofia Nunes4Carlos Azevedo5Tiago Teixeira6Aurélia Selaru7Gabriela Abreu8Luís Malheiro9Centro Hospitalar e Universitário de São João, Internal Medicine Department, Oporto, Portugal; Oporto University, Faculty of Medicine, Centro Hospitalar e Universitário de São João, Oporto, Portugal; Centro Académico Clínico de São João, Oporto, Portugal; Corresponding author.Centro Hospitalar de Vila Nova de Gaia Espinho, Infectious Diseases Department, Vila Nova de Gaia, PortugalCentro Hospitalar de Vila Nova de Gaia Espinho, Infectious Diseases Department, Vila Nova de Gaia, PortugalCentro Hospitalar de Vila Nova de Gaia Espinho, Infectious Diseases Department, Vila Nova de Gaia, PortugalCentro Hospitalar de Vila Nova de Gaia Espinho, Infectious Diseases Department, Vila Nova de Gaia, PortugalCentro Hospitalar de Vila Nova de Gaia Espinho, Infectious Diseases Department, Vila Nova de Gaia, PortugalCentro Hospitalar de Vila Nova de Gaia Espinho, Infectious Diseases Department, Vila Nova de Gaia, PortugalCentro Hospitalar de Vila Nova de Gaia Espinho, Microbiology Department, Vila Nova de Gaia, PortugalCentro Hospitalar de Vila Nova de Gaia Espinho, Microbiology Department, Vila Nova de Gaia, PortugalOporto University, Faculty of Medicine, Centro Hospitalar e Universitário de São João, Oporto, Portugal; Centro Académico Clínico de São João, Oporto, Portugal; Centro Hospitalar de Vila Nova de Gaia Espinho, Infectious Diseases Department, Vila Nova de Gaia, PortugalIntroduction: Nocardiosis is a rare bacterial infection caused by Nocardia spp. However, an increasing incidence has been described whereby data about epidemiology and prognosis 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 Disseminated 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 antibiotic therapy, of whom as many as 55.6% were treated with monotherapy. The most frequently 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 importance of gaining a better understanding of the microbiology of nocardiosis. Such knowledge can lead to the optimization of antimicrobial therapy and, when necessary, guide appropriate surgical interventions to prevent unfavorable outcomes.http://www.sciencedirect.com/science/article/pii/S1413867023000661NocardiosisPrognosisEpidemiologyAntibiotics |
| spellingShingle | Bruno Besteiro Daniel Coutinho Joana Fragoso Cristóvão Figueiredo Sofia Nunes Carlos Azevedo Tiago Teixeira Aurélia Selaru Gabriela Abreu Luís Malheiro Nocardiosis: a single-center experience and literature review Brazilian Journal of Infectious Diseases Nocardiosis Prognosis Epidemiology Antibiotics |
| title | Nocardiosis: a single-center experience and literature review |
| title_full | Nocardiosis: a single-center experience and literature review |
| title_fullStr | Nocardiosis: a single-center experience and literature review |
| title_full_unstemmed | Nocardiosis: a single-center experience and literature review |
| title_short | Nocardiosis: a single-center experience and literature review |
| title_sort | nocardiosis a single center experience and literature review |
| topic | Nocardiosis Prognosis Epidemiology Antibiotics |
| url | http://www.sciencedirect.com/science/article/pii/S1413867023000661 |
| work_keys_str_mv | AT brunobesteiro nocardiosisasinglecenterexperienceandliteraturereview AT danielcoutinho nocardiosisasinglecenterexperienceandliteraturereview AT joanafragoso nocardiosisasinglecenterexperienceandliteraturereview AT cristovaofigueiredo nocardiosisasinglecenterexperienceandliteraturereview AT sofianunes nocardiosisasinglecenterexperienceandliteraturereview AT carlosazevedo nocardiosisasinglecenterexperienceandliteraturereview AT tiagoteixeira nocardiosisasinglecenterexperienceandliteraturereview AT aureliaselaru nocardiosisasinglecenterexperienceandliteraturereview AT gabrielaabreu nocardiosisasinglecenterexperienceandliteraturereview AT luismalheiro nocardiosisasinglecenterexperienceandliteraturereview |