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

BMC Infect Dis. 2024 Sep 30;24(1):1073. doi: 10.1186/s12879-024-09933-6.

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.

Keywords: Bronchiectasis; Neutrophil-to-lymphocyte ratio; Prognosis; Pulmonary nocardiosis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bronchiectasis / drug therapy
  • Bronchiectasis / microbiology
  • Carbapenems / therapeutic use
  • China / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nocardia Infections* / diagnosis
  • Nocardia Infections* / drug therapy
  • Nocardia Infections* / epidemiology
  • Nocardia Infections* / microbiology
  • Nocardia* / isolation & purification
  • Prognosis
  • Retrospective Studies
  • Sputum / microbiology
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Carbapenems

Supplementary concepts

  • Nocardia farcinica