Outcome and Treatment of Nocardiosis After Solid Organ Transplantation : New Insights From a European Study
© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com.
BACKGROUND: Solid organ transplant (SOT) recipients are at risk of nocardiosis, a rare opportunistic bacterial infection, but prognosis and outcome of these patients are poorly defined. Our objectives were to identify factors associated with 1-year mortality after nocardiosis and describe the outcome of patients receiving short-course antibiotics (≤120 days).
METHODS: We analyzed data from a multicenter European case-control study that included 117 SOT recipients with nocardiosis diagnosed between 2000 and 2014. Factors associated with 1-year all-cause mortality were identified using multivariable conditional logistic regression.
RESULTS: One-year mortality was 10-fold higher in patients with nocardiosis (16.2%, 19/117) than in control transplant recipients (1.3%, 3/233, P < .001). A history of tumor (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.8), invasive fungal infection (OR, 1.3; 95% CI, 1.1-1.5), and donor age (OR, 1.0046; 95% CI, 1.0007-1.0083) were independently associated with 1-year mortality. Acute rejection in the year before nocardiosis was associated with improved survival (OR, 0.85; 95% CI, 0.73-0.98). Seventeen patients received short-course antibiotics (median duration 56 [24-120] days) with a 1-year success rate (cured and surviving) of 88% and a 5.9% risk of relapse (median follow-up 49 [6-136] months).
CONCLUSIONS: One-year mortality was 10-fold higher in SOT patients with nocardiosis than in those without. Four factors, largely reflecting general medical condition rather than severity and/or management of nocardiosis, were independently associated with 1-year mortality. Patients who received short-course antibiotic treatment had good outcomes, suggesting that this may be a strategy for further study.
| Errataetall: |
ErratumIn: Clin Infect Dis. 2017 Oct 15;65(8):1431-1433. - PMID 29017252 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:64 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 64(2017), 10 vom: 15. Mai, Seite 1396-1405 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lebeaux, David [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Bacterial Agents |
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| Anmerkungen: |
Date Completed 23.01.2018 Date Revised 17.03.2024 published: Print ErratumIn: Clin Infect Dis. 2017 Oct 15;65(8):1431-1433. - PMID 29017252 Citation Status MEDLINE |
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| doi: |
10.1093/cid/cix124 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM270186751 |
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| 245 | 1 | 0 | |a Outcome and Treatment of Nocardiosis After Solid Organ Transplantation |b New Insights From a European Study |
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| 500 | |a published: Print | ||
| 500 | |a ErratumIn: Clin Infect Dis. 2017 Oct 15;65(8):1431-1433. - PMID 29017252 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com | ||
| 520 | |a BACKGROUND: Solid organ transplant (SOT) recipients are at risk of nocardiosis, a rare opportunistic bacterial infection, but prognosis and outcome of these patients are poorly defined. Our objectives were to identify factors associated with 1-year mortality after nocardiosis and describe the outcome of patients receiving short-course antibiotics (≤120 days) | ||
| 520 | |a METHODS: We analyzed data from a multicenter European case-control study that included 117 SOT recipients with nocardiosis diagnosed between 2000 and 2014. Factors associated with 1-year all-cause mortality were identified using multivariable conditional logistic regression | ||
| 520 | |a RESULTS: One-year mortality was 10-fold higher in patients with nocardiosis (16.2%, 19/117) than in control transplant recipients (1.3%, 3/233, P < .001). A history of tumor (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.8), invasive fungal infection (OR, 1.3; 95% CI, 1.1-1.5), and donor age (OR, 1.0046; 95% CI, 1.0007-1.0083) were independently associated with 1-year mortality. Acute rejection in the year before nocardiosis was associated with improved survival (OR, 0.85; 95% CI, 0.73-0.98). Seventeen patients received short-course antibiotics (median duration 56 [24-120] days) with a 1-year success rate (cured and surviving) of 88% and a 5.9% risk of relapse (median follow-up 49 [6-136] months) | ||
| 520 | |a CONCLUSIONS: One-year mortality was 10-fold higher in SOT patients with nocardiosis than in those without. Four factors, largely reflecting general medical condition rather than severity and/or management of nocardiosis, were independently associated with 1-year mortality. Patients who received short-course antibiotic treatment had good outcomes, suggesting that this may be a strategy for further study | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Nocardia | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a opportunistic infections. | |
| 650 | 4 | |a organ transplantation | |
| 650 | 4 | |a prognosis | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Freund, Romain |e verfasserin |4 aut | |
| 700 | 1 | |a van Delden, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Guillot, Hélène |e verfasserin |4 aut | |
| 700 | 1 | |a Marbus, Sierk D |e verfasserin |4 aut | |
| 700 | 1 | |a Matignon, Marie |e verfasserin |4 aut | |
| 700 | 1 | |a Van Wijngaerden, Eric |e verfasserin |4 aut | |
| 700 | 1 | |a Douvry, Benoit |e verfasserin |4 aut | |
| 700 | 1 | |a De Greef, Julien |e verfasserin |4 aut | |
| 700 | 1 | |a Vuotto, Fanny |e verfasserin |4 aut | |
| 700 | 1 | |a Tricot, Leïla |e verfasserin |4 aut | |
| 700 | 1 | |a Fernández-Ruiz, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Dantal, Jacques |e verfasserin |4 aut | |
| 700 | 1 | |a Hirzel, Cédric |e verfasserin |4 aut | |
| 700 | 1 | |a Jais, Jean-Philippe |e verfasserin |4 aut | |
| 700 | 1 | |a Rodriguez-Nava, Veronica |e verfasserin |4 aut | |
| 700 | 1 | |a Jacobs, Frédérique |e verfasserin |4 aut | |
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| 700 | 1 | |a Coussement, Julien |e verfasserin |4 aut | |
| 700 | 0 | |a European Study Group for Nocardia in Solid Organ Transplantation |e verfasserin |4 aut | |
| 700 | 0 | |a European Study Group for Nocardia in Solid Organ Transplantation |e verfasserin |4 aut | |
| 700 | 1 | |a Anstey, James R |e investigator |4 oth | |
| 700 | 1 | |a Antoine, Martine |e investigator |4 oth | |
| 700 | 1 | |a Ausselet, Nathalie |e investigator |4 oth | |
| 700 | 1 | |a Belhaj, Asmae |e investigator |4 oth | |
| 700 | 1 | |a Boelens, Jerina |e investigator |4 oth | |
| 700 | 1 | |a de Beenhouwer, Hans |e investigator |4 oth | |
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| 700 | 1 | |a Knoop, Christiane |e investigator |4 oth | |
| 700 | 1 | |a le Moine, Alain |e investigator |4 oth | |
| 700 | 1 | |a Rodriguez-Villalobos, Hector |e investigator |4 oth | |
| 700 | 1 | |a Racapé, Judith |e investigator |4 oth | |
| 700 | 1 | |a Roisin, Sandrine |e investigator |4 oth | |
| 700 | 1 | |a Vandercam, Bernard |e investigator |4 oth | |
| 700 | 1 | |a Vander Zwalmen, Marie-Laure |e investigator |4 oth | |
| 700 | 1 | |a Vanfraechem, Gaëlle |e investigator |4 oth | |
| 700 | 1 | |a Van Laecke, Steven |e investigator |4 oth | |
| 700 | 1 | |a Verhaegen, Jan |e investigator |4 oth | |
| 700 | 1 | |a Barrou, Benoit |e investigator |4 oth | |
| 700 | 1 | |a Battistella, Pascal |e investigator |4 oth | |
| 700 | 1 | |a Bergeron, Emmanuelle |e investigator |4 oth | |
| 700 | 1 | |a Bouvier, Nicolas |e investigator |4 oth | |
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| 700 | 1 | |a Caumes, Eric |e investigator |4 oth | |
| 700 | 1 | |a Chaussade, Hélène |e investigator |4 oth | |
| 700 | 1 | |a Chauvet, Cécile |e investigator |4 oth | |
| 700 | 1 | |a Crochette, Romain |e investigator |4 oth | |
| 700 | 1 | |a Epailly, Eric |e investigator |4 oth | |
| 700 | 1 | |a Essig, Marie |e investigator |4 oth | |
| 700 | 1 | |a Gallien, Sébastien |e investigator |4 oth | |
| 700 | 1 | |a Guillemain, Romain |e investigator |4 oth | |
| 700 | 1 | |a Herel, Canan |e investigator |4 oth | |
| 700 | 1 | |a Hoen, Bruno |e investigator |4 oth | |
| 700 | 1 | |a Kamar, Nassim |e investigator |4 oth | |
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| 700 | 1 | |a Lionet, Arnaud |e investigator |4 oth | |
| 700 | 1 | |a Longuet, Hélène |e investigator |4 oth | |
| 700 | 1 | |a Melica, Giovanna |e investigator |4 oth | |
| 700 | 1 | |a Miel, Anaick |e investigator |4 oth | |
| 700 | 1 | |a Morel, Hélène |e investigator |4 oth | |
| 700 | 1 | |a Ammar, Salima Ould |e investigator |4 oth | |
| 700 | 1 | |a Pattier, Sabine |e investigator |4 oth | |
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