BACKGROUND: Nocardia are uncommon pathogens that disproportionately afflict the immunocompromised host. Epidemiology and outcome data of Nocardia infections in transplant recipients are limited. METHODS: We performed a retrospective chart review of all patients at Duke University Hospital with a history of solid organ transplant (SOT) or hematopoietic cell transplant (HCT) and at least one positive culture for Nocardia between 1996 and 2013. Our aim was to describe the epidemiology and outcomes of Nocardia infections in the transplanted host. RESULTS: During the 18-year study period, 51 patients (14 HCT and 37 SOT recipients) had Nocardia infection. Nocardia incidence was stable during the study period in all populations except heart transplants, whose incidence declined. Infection occurred earlier in the HCT group than the SOT group (median time to diagnosis of 153 and 370 days, respectively). In both groups, the most common site involved was the lung. Outcomes were overall poor, especially in the HCT group with a cure rate of 29%. Heart transplant recipients had significantly better overall survival (P < .05) than other patients. Trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis did not provide complete protection from Nocardia infections, nor did it appear to select for resistant Nocardia isolates. CONCLUSIONS: Infections with Nocardia are typically a late post-transplant complication. The use of TMP-SMX prophylaxis was not associated with TMP-SMX-resistant Nocardia. Overall outcomes remain poor.
BACKGROUND:Nocardia are uncommon pathogens that disproportionately afflict the immunocompromised host. Epidemiology and outcome data of Nocardia infections in transplant recipients are limited. METHODS: We performed a retrospective chart review of all patients at Duke University Hospital with a history of solid organ transplant (SOT) or hematopoietic cell transplant (HCT) and at least one positive culture for Nocardia between 1996 and 2013. Our aim was to describe the epidemiology and outcomes of Nocardia infections in the transplanted host. RESULTS: During the 18-year study period, 51 patients (14 HCT and 37 SOT recipients) had Nocardia infection. Nocardia incidence was stable during the study period in all populations except heart transplants, whose incidence declined. Infection occurred earlier in the HCT group than the SOT group (median time to diagnosis of 153 and 370 days, respectively). In both groups, the most common site involved was the lung. Outcomes were overall poor, especially in the HCT group with a cure rate of 29%. Heart transplant recipients had significantly better overall survival (P < .05) than other patients. Trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis did not provide complete protection from Nocardia infections, nor did it appear to select for resistant Nocardia isolates. CONCLUSIONS: Infections with Nocardia are typically a late post-transplant complication. The use of TMP-SMX prophylaxis was not associated with TMP-SMX-resistant Nocardia. Overall outcomes remain poor.
Authors: Michael M Koerner; Aly El-Banayosy; Uwe Schulz; Mohamad Zeriouh; Reiner Koerfer; Gero Tenderich; Ali Ghodsizad Journal: Heart Surg Forum Date: 2015-12-14 Impact factor: 0.676
Authors: M-F Tripodi; E Durante-Mangoni; R Fortunato; S Cuccurullo; Y Mikami; C Farina; R Utili Journal: Transpl Infect Dis Date: 2010-12-13 Impact factor: 2.228
Authors: Monica M Horvath; Shelley A Rusincovitch; Stephanie Brinson; Howard C Shang; Steve Evans; Jeffrey M Ferranti Journal: J Biomed Inform Date: 2014-07-19 Impact factor: 6.317
Authors: L Mansi; E Daguindau; P Saas; F Pouthier; C Ferrand; A Dormoy; I Patry; F Garnache; P-S Rohrlich; E Deconinck; F Larosa Journal: Pathol Biol (Paris) Date: 2014-05-27
Authors: Ben De Pauw; Thomas J Walsh; J Peter Donnelly; David A Stevens; John E Edwards; Thierry Calandra; Peter G Pappas; Johan Maertens; Olivier Lortholary; Carol A Kauffman; David W Denning; Thomas F Patterson; Georg Maschmeyer; Jacques Bille; William E Dismukes; Raoul Herbrecht; William W Hope; Christopher C Kibbler; Bart Jan Kullberg; Kieren A Marr; Patricia Muñoz; Frank C Odds; John R Perfect; Angela Restrepo; Markus Ruhnke; Brahm H Segal; Jack D Sobel; Tania C Sorrell; Claudio Viscoli; John R Wingard; Theoklis Zaoutis; John E Bennett Journal: Clin Infect Dis Date: 2008-06-15 Impact factor: 9.079
Authors: V Freites; A Sumoza; R Bisotti; M Mujica; A Cabrera; M Costa; R Anguilo; K Rolston Journal: Bone Marrow Transplant Date: 1995-01 Impact factor: 5.483
Authors: Emanuele Palomba; Arianna Liparoti; Anna Tonizzo; Valeria Castelli; Laura Alagna; Giorgio Bozzi; Riccardo Ungaro; Antonio Muscatello; Andrea Gori; Alessandra Bandera Journal: Microorganisms Date: 2022-05-29
Authors: Dana M Harris; Adrian G Dumitrascu; Razvan M Chirila; Mohamed Omer; Fernando F Stancampiano; D Jane Hata; Diana M Meza Villegas; Michael G Heckman; Jordan J Cochuyt; Salvador Alvarez Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2021-01-19
Authors: Natalie Davidson; Matthew J Grigg; Sarah L Mcguinness; Robert J Baird; Nicholas M Anstey Journal: Open Forum Infect Dis Date: 2020-03-16 Impact factor: 3.835