Increasing Nocardia Incidence Associated with Bronchiectasis at a Tertiary Care Center

  title={Increasing Nocardia Incidence Associated with Bronchiectasis at a Tertiary Care Center},
  author={Michael H. Woodworth and Jennifer L. Saullo and Paul M. Lantos and Gary M. Cox and Jason E. Stout},
  journal={Annals of the American Thoracic Society},
Rationale: Nocardia is a genus of pathogens that most commonly afflict immunocompromised hosts but may be an emerging infection among persons with bronchiectasis. Objectives: To examine the epidemiology and clinical presentation of adult patients with Nocardia and bronchiectasis relative to other patient groups. Methods: We examined a retrospectively assembled cohort of adults at Duke University Hospital in Durham, North Carolina with at least one positive culture from a bodily fluid or tissue… 

Figures and Tables from this paper

Manifestations and outcomes of nocardia infections
Investigation at a tertiary care hospital from 1994 to 2015 found immunocompromised patients with nocardiosis had more severe disease and significantly higher mortality than nonimmunocompromising patients, but clinical presentations did not differ.
Clinical correlates of nocardiosis
In conclusion, corticosteroid therapy was strongly correlated with nocardiosis, particularly among individuals with chronic pulmonary disease and in pulmonary nocardia, and the positive association between solid organ transplantation and nocardiotic was attenuated following adjustment for systemic cortic Fosteroids in a multivariable model.
Imaging Findings of Pulmonary Nocardiosis Mimicking Bronchiectasis.
Two patients with pulmonary nocardiasis in immunocompetent individuals, whose chest computed tomography (CT) findings mimicked bronchiectasis responded well to treatment with the combination of sulfamethoxazole and linezolid.
Characteristics of nocardiosis patients with different immune status from a Chinese tertiary general hospital during 8-year period
There were no significant differences in other clinical characteristics, Nocardia species’ identification, and antibiotic susceptibility between ISPs and ICPs, but chronic kidney diseases and co-infection with aspergillosis occurred more frequently in ISPs.
How do I manage nocardiosis?
  • I. Margalit, D. Lebeaux, J. Coussement
  • Medicine, Biology
    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
  • 2021
Nocardia spp.: A Rare Cause of Pneumonia Globally.
Prolonged therapy is usually indicated, for 6 to 12 months, and in some cases surgical debridement may be required to resolve infection, and a variety of other antimicrobials may be useful, depending on the species and susceptibility testing.
Pulmonary nocardiosis in Western Europe-Clinical evaluation of 43 patients and population-based estimates of hospitalization rates.
  • S. Ott, N. Meier, Mathias W Pletz
  • Medicine
    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
  • 2019
Pulmonary Reinfection by Nocardia in an Immunocompetent Patient with Bronchiectasis
An 82-year-old immunocompetent woman with bronchiectasis presented with exacerbation of cough, and Nocardia species were cultured from the sputum and bronchial washing specimens grew N. beijingensis, which was identified with 16S ribosomal RNA gene sequencing.
Invasive Nocardiosis: Disease Presentation, Diagnosis and Treatment – Old Questions, New Answers?
Although treatment duration has historically been set to at least 6 months in the absence of central nervous system involvement, shorter durations seem to be associated with a favourable outcome.
Nocardiosis in glomerular disease patients with immunosuppressive therapy
It was shown that multisite abscesses, including subcutaneous, pulmonary and cerebral abscesse were the common manifestations of nocardiosis in glomerular disease patients, and Sulfonamide was the first-line antibiotic therapy for nocardia, and combinations of other antibiotics were also needed in some serious cases.


Pulmonary nocardiosis in southern Taiwan.
Nocardiosis: a 15-year experience in a tertiary medical center in Israel.
Nocardiosis in Quebec, Canada, 1988-2008.
In regions such as the authors', where a substantial proportion of invasive isolates are non-susceptible in vitro to trimethoprim-sulphamethoxazole, the latter may no longer be the empirical treatment of choice in immunosuppressed and severely ill patients with nocardiosis.
Infection with Nocardia Species: Clinical Spectrum of Disease and Species Distribution in Madrid, Spain, 1978–2001
Although most patients develop active disease, pulmonary colonization might not be as rare as has generally been assumed and many patients may remain free of nocardial disease for a prolonged period.
Nocardiosis at the Turn of the Century
It is concluded that HIV infection has become the most common underlying condition for invasive nocardiosis in a general hospital over the last 12 years and new species and new types of immunosuppressed patients are identified.
Clinical characteristics of pulmonary nocardiosis in immunocompetent patients.
Review of nocardial infections in France 1987 to 1990
Nocardiosis caused by Nocardia farcinica may be a growing problem because of the relatively high incidence in AIDS patients and the resistance of this species to most antimicrobial agents.
Nocardiosis in 132 patients with cancer: microbiological and clinical analyses.
Diverse Nocardia species can cause secondary infections in patients with cancer and timely species identification and antimicrobial susceptibility tests may guide treatment.