Clinical characteristics and outcome analysis of pulmonary nocardiosis in southern China: a two-center retrospective study.

BMC Infect Dis

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, No 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian Province, People's Republic of China.

Published: September 2024

AI Article Synopsis

  • Pulmonary nocardiosis (PN) is a rare opportunistic infection studied in southern China, focusing on clinical, radiological, and microbiological aspects along with treatment outcomes.
  • The research included 67 PN patients, revealing that bronchiectasis was the most common respiratory condition, with cough and sputum as the major symptoms, while Nocardia farcinica was identified as the most prevalent pathogen.
  • Factors linked to poor prognosis included a higher neutrophil-to-lymphocyte ratio, concurrent bacterial infections, and the use of carbapenems.

Article Abstract

Background: Pulmonary nocardiosis (PN) is a rare and opportunistic infection. This study aimed to analyze clinical, radiological, and microbiological features, treatment and outcome of PN in southern china.

Methods: Clinical, laboratory, imaging, treatment and outcome data of PN patients at two tertiary hospitals from January 1, 2018, to January 1, 2024 were collected. Factors associated with clinical outcomes were determined by multivariate logistic regression analysis.

Results: 67 PN patients including 53 with clinical improvement and 14 with treatment failure were enrolled. Bronchiectasis was the most common respiratory disease in patients with PN (31.3%). The major symptoms of PN were cough (89.6%) and sputum (79.1%). Lung nodules, bronchiectasis, consolidation, pleural involvement, mass, cavity, and lymph node enlargement were the frequent computed tomography findings of PN. Among the Nocardia species detected, N. farcinica was the most common pathogen. Neutrophil-to-lymphocyte ratio (OR = 1.052, p = 0.010), concurrent bacterial infection (OR = 7.706, p = 0.016), and the use of carbapenems (OR = 9.345, p = 0.023) were independently associated with poor prognosis in patients with PN.

Conclusions: This study provides important insights into the clinical features of PN in southern china. neutrophil-to-lymphocyte ratio, concurrent bacterial infection, and the use of carbapenems were independently associated with poor prognosis in patients with PN.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441091PMC
http://dx.doi.org/10.1186/s12879-024-09933-6DOI Listing

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