Maria Ercibengoa1, Jordi Càmara2, Fe Tubau2, Dolores García-Somoza2, Alicia Galar3, Pablo Martín-Rabadán4, Mercedes Marin4, Lourdes Mateu5, Ignasi García-Olivé6, Cristina Prat7, Catia Cilloniz8, Antonio Torres8, Maria-Luisa Pedro-Botet5, Carmen Ardanuy9, Patricia Muñoz4, Jose María Marimón10. 1. Biodonostia, Infectious Diseases Area, Respiratory Infection and Antimicrobial Resistance Group, Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Microbiology Department, 20014 San Sebastian, Spain. 2. CIBER Enfermedades Respiratorias - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Hospital de Bellvitge-IDIBELL, L'Hospitalet de LLobregat, Spain. 3. Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain. 4. CIBER Enfermedades Respiratorias - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain. 5. CIBER Enfermedades Respiratorias - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Infectious Diseases Unit - Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. 6. CIBER Enfermedades Respiratorias - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Department of Pneumology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. 7. CIBER Enfermedades Respiratorias - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Microbiology Department - Fundació Institut d'Investigació Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. 8. CIBER Enfermedades Respiratorias - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Department of Pneumology, Hospital Clinic of Barcelona - August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain. 9. CIBER Enfermedades Respiratorias - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Hospital de Bellvitge-IDIBELL, L'Hospitalet de LLobregat, Spain; Department of Pathology and Experimental Therapeutics, School of Medicine, University of Barcelona, Barcelona, Spain. 10. Biodonostia, Infectious Diseases Area, Respiratory Infection and Antimicrobial Resistance Group, Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Microbiology Department, 20014 San Sebastian, Spain. Electronic address: josemaria.marimonortizdez@osakidetza.eus.
Abstract
OBJECTIVE: To analyse all cases of Nocardia pneumonia occurring between 2010 and 2016 in five Spanish hospitals. METHODS: This was a retrospective observational analysis of clinical and microbiological data collected from 55 cases of Nocardia pneumonia. RESULTS: There were one to 20 cases per hospital and six to nine cases per year. Chronic obstructive pulmonary disease, bronchiectasis, and asthma were the main predisposing underlying respiratory conditions. Thirty-four patients were receiving systemic and/or inhaled corticosteroids prior to infection, eight had neoplasia, and six had haematological malignancies. Clinical and radiological findings were common to pneumonia of other infectious aetiologies, except for the frequent presence of nodules and cavitation. Overall, the 1-year mortality was high (38.2%), and mortality was directly related to the pulmonary disease in 15 patients (27.3%). The most frequently identified species were N. cyriacigeorgica (n=21), N. abscessus (n=8), and N. farcinica (n=5). All Nocardia isolates were susceptible to linezolid and all but two were susceptible to amikacin and trimethoprim-sulfamethoxazole. CONCLUSIONS: Nocardia pneumonia-associated mortality remains high, probably because of the debilitated status of patients in whom this pathogen is able to cause pulmonary infection.
OBJECTIVE: To analyse all cases of Nocardia pneumonia occurring between 2010 and 2016 in five Spanish hospitals. METHODS: This was a retrospective observational analysis of clinical and microbiological data collected from 55 cases of Nocardia pneumonia. RESULTS: There were one to 20 cases per hospital and six to nine cases per year. Chronic obstructive pulmonary disease, bronchiectasis, and asthma were the main predisposing underlying respiratory conditions. Thirty-four patients were receiving systemic and/or inhaled corticosteroids prior to infection, eight had neoplasia, and six had haematological malignancies. Clinical and radiological findings were common to pneumonia of other infectious aetiologies, except for the frequent presence of nodules and cavitation. Overall, the 1-year mortality was high (38.2%), and mortality was directly related to the pulmonary disease in 15 patients (27.3%). The most frequently identified species were N. cyriacigeorgica (n=21), N. abscessus (n=8), and N. farcinica (n=5). All Nocardia isolates were susceptible to linezolid and all but two were susceptible to amikacin and trimethoprim-sulfamethoxazole. CONCLUSIONS:Nocardia pneumonia-associated mortality remains high, probably because of the debilitated status of patients in whom this pathogen is able to cause pulmonary infection.
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