Characteristics of nocardiosis patients with different immune status from a Chinese tertiary general hospital during 8-year period

Huang, Lei; Sun, Li‐Ying; Yan, Yan

doi:10.1097/md.0000000000017913

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…The reason might be the small sample of our case series. Coinfections with other microorganisms have been found to attribute to mortality in nocardiosis (28). Our patients and the other two patients (16,20) with nocardia and aspergillus coinfections had bad outcomes.…”

Section: Discussionmentioning

confidence: 53%

Cushing’s Syndrome With Nocardiosis: A Case Report and a Systematic Review of the Literature

et al. 2021

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ObjectiveTo analyze and summarize the clinical characteristics, treatments, and prognosis of Cushing’s syndrome (CS) with nocardiosis.MethodsA patient in our hospital and additional 17 patients of CS with nocardiosis in the English literature were included in this study. Clinical characteristics, laboratory data, imaging studies, treatments, and prognosis were evaluated.ResultsA 41-year-old man with CS was diagnosed and treated in our hospital. He had co-infections of nocardiosis and aspergillosis. Together with 17 patients of CS with nocardiosis in the English literature, 2 patients (11.1%) were diagnosed as Cushing’s disease (CD) while 16 (88.9%) were diagnosed or suspected as ectopic ACTH syndrome (EAS). The average 24hrUFC was 7,587.1 ± 2,772.0 μg/d. The average serum total cortisol and ACTH (8 AM) was 80.2 ± 18.7 μg/dl and 441.8 ± 131.8 pg/ml, respectively. The most common pulmonary radiologic findings in CT scan were cavitary lesions (10/18) and nodules (8/18). Co-infections were found in 33.3% (6/18) patients. The CS patients with co-infections had higher levels of ACTH (671.5 ± 398.2 vs 245.5 ± 217.1 pg/ml, P = 0.047), and 38.9% (7/18) patients survived through the antibiotic therapy and the treatment of CS. Patients with lower level of ACTH (survival vs mortality: 213.1 ± 159.0 vs 554.7 ± 401.0 pg/ml, P = 0.04), no co-infection, underwent CS surgery, and received antibiotic therapy for more than 6 months, had more possibilities to survive.ConclusionsNocardia infection should be cautioned when a patient of CS presented with abnormal chest radiographs. The mortality risk factors for CS with nocardiosis are high level of ACTH and co-infections. We should endeavor to make early etiological diagnosis, apply long-term sensitive antibiotics and aggressive treatments of CS.

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Section: Discussionmentioning

confidence: 53%

Cushing’s Syndrome With Nocardiosis: A Case Report and a Systematic Review of the Literature

et al. 2021

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“…Spine and joint infections are rare but not completely unknown. The characteristics of nocardiosis include abscess formation, extensive neutrophil infiltration, and significant necrosis ( 6 ). These pathological changes are similar to those of tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Nocardiosis: A two-center analysis of clinical characteristics

Chen

Jiang

et al. 2022

Front. Med.

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ObjectiveThe objective of the present study was to describe and analyze the clinical characteristics of nocardiosis.Materials and methodsWe described and analyzed the clinical characteristics of nocardiosis cases from two centers over the past 5 years from the following aspects: age and sex, Nocardia species, sites of Nocardia infection, test specimens, detection methods, concurrent pathogens, symptoms, imaging features, co-conditions, drug susceptibility tests, antibiotic therapy/duration, outcomes, and follow-up.ResultsThe median age of the 19 cases was 64 years, with an interquartile range (IQR) of 56–68 years. Eight cases (42.1%) were immunocompromised [those who had been on corticosteroid use (62.5%), those who had used immunosuppressants (50.0%), or those who had suffered from chronic nephrosis (37.5%) or diabetes mellitus (DM) (25.0%)]. The plethora of comorbidities of these cases included diabetes (10.5%), chronic kidney disease (CDK) (15.8%), chronic lung disease (36.8%), and rheumatic diseases (10.5%). Cough and expectoration (73.7%) was the most common symptom of nocardiosis. The respiratory tract (89.5%) was the most common site of the clinical disease. Nearly half (9 cases, 47.3%) of these patients had concurrent infections. The most common Nocardia isolation site was the respiratory tract (73.7%). All patients were given antibiotic therapies, out of whom as many as 63.6% of patients were treated with two concurrent antimicrobial agents, 15.8% of patients were treated under monotherapy and 21.1% of patients were treated with three or more concurrent antimicrobial agents.ConclusionsAn uncommon life-threatening infection, nocardiosis, affects those patients with structural lung disease or immunosuppression. Although nocardiosis is capable of progressing into a serious and metastatic disease, early recognition and prompt treatment usually result in successful outcomes benefitting the patient.

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“…Bronchiectasis was the most common (54.9%) among the patients with pulmonary nocardiosis combined with the underlying disease in our study. In a study by Huang et al [ 25 ]. bronchiectasis was most common (30.4%) among the underlying diseases.In a study by Yang et al bronchiectasis was comorbid in 6 out of 12 (50%) patients diagnosed with nocardiosis [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and drug resistance of Nocardia in Henan, China, 2017–2023

Han,

Cheng,

et al. 2024

Ann Clin Microbiol Antimicrob

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Background The aim of this study was to investigate the clinical features of Nocardia infections, antibiotic resistance profile, choice of antibiotics and treatment outcome, among others. In addition, the study compared the clinical and microbiological characteristics of nocardiosis in bronchiectasis patients and non-bronchiectasis patients. Methods Detailed clinical data were collected from the medical records of 71 non-duplicate nocardiosis patients from 2017 to 2023 at a tertiary hospital in Zhengzhou, China. Nocardia isolates were identified to the species level using MALDI-TOF MS and 16S rRNA PCR sequencing. Clinical data were collected from medical records, and drug susceptibility was determined using the broth microdilution method. Results Of the 71 cases of nocardiosis, 70 (98.6%) were diagnosed as pulmonary infections with common underlying diseases including bronchiectasis, tuberculosis, diabetes mellitus and chronic obstructive pulmonary disease (COPD). Thirteen different strains were found in 71 isolates, the most common of which were N. farcinica (26.8%) and N. cyriacigeorgica (18.3%). All Nocardia strains were 100% susceptible to both TMP-SMX and linezolid, and different Nocardia species showed different patterns of drug susceptibility in vitro. Pulmonary nocardiosis is prone to comorbidities such as bronchiectasis, diabetes mellitus, COPD, etc., and Nocardia is also frequently accompanied by co-infection of the body with pathogens such as Mycobacterium and Aspergillus spp. Sixty-one patients underwent a detailed treatment regimen, of whom 32 (52.5%) received single or multi-drug therapy based on TMP-SMX. Bronchiectasis was associated with a higher frequency of Nocardia infections, and there were significant differences between the bronchiectasis and non-bronchiectasis groups in terms of age distribution, clinical characteristics, identification of Nocardia species, and antibiotic susceptibility (P < 0.05). Conclusions Our study contributes to the understanding of the species diversity of Nocardia isolates in Henan, China, and the clinical characteristics of patients with pulmonary nocardiosis infections. Clinical and microbiologic differences between patients with and without bronchiectasis. These findings will contribute to the early diagnosis and treatment of patients.

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Characteristics of nocardiosis patients with different immune status from a Chinese tertiary general hospital during 8-year period

Cited by 8 publications

References 25 publications

Cushing’s Syndrome With Nocardiosis: A Case Report and a Systematic Review of the Literature

Cushing’s Syndrome With Nocardiosis: A Case Report and a Systematic Review of the Literature

Nocardiosis: A two-center analysis of clinical characteristics

Clinical characteristics and drug resistance of Nocardia in Henan, China, 2017–2023

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