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Infections in Solid Organ Transplant Recipients Admitted to the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Almudena Burillo, Patricia Muñoz, Emilio Bouza
Nocardiosis is usually observed between 1 and 6 months post-transplantation. Risk factors are high calcineurin inhibitor trough levels in the month before diagnosis (OR, 6.11), use of tacrolimus (OR, 2.65) and corticosteroid dose (OR, 1.12) at the time of diagnosis, patient age (OR, 1.04), and length of CCU stay after SOT (OR, 1.04) [140]. The clinical presentation of nocardiosis includes pneumonia, focal CNS lesions, and skin involvement [116,141–145]. Brain abscesses due to Nocardia spp. are multiple in 40% of cases and may show ring enhancement.
Unexplained Fever in Infectious Diseases Section 1: Viruses, Chlamydia, Mycoplasma, Rickettsiae, Higher Bacteria, Cell-Wall Deficient Bacteria, And Fungi
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Nocardia asteroides is an aerobic Gram-positive filamentous bacteria widely distributed as a soil and vegetation saprophyte which can be inhalated and, mainly in immunodeficient patients, can create a primary necrotizing pneumonia, with a possible hematogenous spread to viscera, mainly to central nervous system.
Nocardiosis *
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
Nocardia species are soil saprophytes that tend to cause infection in immunocompromised humans.2 Although otherwise healthy individuals may acquire the infection, the disease is predominantly one of patients with underlying diseases such as cancer, congenital and acquired immune deficiency disorders, organ transplant recipients, and chronic lung disease. The organism is usually acquired by the respiratory route, although in some cases gastrointestinal, oral mucosal, or cutaneous sites may be the portal of entry. The organism usually causes a suppurative lesion with acute necrosis and abscess formation. Extension of the infection to the pleura or chest wall may occur. Dissemination from the site of the primary infection may occur to involve almost any organ of the body. These hematogenously spread lesions tend to be of a purulent nature, containing centers composed of polymorphonuclear neutrophils and myeloid fragments. Miliary-type lesions may be apparent.
Emerging antibiotics for community-acquired pneumonia
Published in Expert Opinion on Emerging Drugs, 2019
Adamantia Liapikou, Catia Cilloniz, Andrea Palomeque, Toni Torres
Nemonoxacin is a novel C-8-methoxy non-fluorinated quinolone that targets DNA gyrase and topoisomerase IV, having a broader profile of activity and reduced resistance profile compared with other fluoroquinolones. TaiGen in-licensed nemonoxacin from Procter & Gamble Healthcare in 2011, when it obtained worldwide rights [69]. The drug benefits from a broad spectrum of activity against gram-positive, gram-negative, and atypical pathogens, including activity against MRSA (MIC90 = 1 μg/mL) and vancomycin-resistant pathogens, with similar activity to levofloxacin and moxifloxacin against most gram-negative bacteria [70]. It has also been shown to exhibit the best in vitro activity against Nocardia spp. among all tested antibiotics, including fluoroquinolones, carbapenems, tigecycline, and linezolid [71]. However, it exhibits poor activity against both MDR and non-MDR strains of Mycobacterium tuberculosis.
Infective endocarditis by Nocardia species: a systematic review
Published in Journal of Chemotherapy, 2023
Antonios Velidakis, Fotios Degaitis, George Tsorbatzoglou, Petros Ioannou
Nocardia species are aerobic actinomycetes that can cause localized or disseminated infections in humans and animals. They are Gram-positive, branching, filamentous bacteria able to form aerial hyphae and grow in media containing lysozyme and also grow at 50oC [1]. Nocardia spp. are saprophytes found ubiquitously in the environment, such as in the soil, in organic matter and waste-water systems [1]. With development of newer methods for pathogen identification, such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and genotypic methods such as comparative 16S ribosomal RNA (rRNA), several taxonomic changes and species reassignment have occurred within the genus [2–4]. For example, there are several isolates identified that were formerly known to comprise the N. asteroides spp. complex – a term that is no longer used, as it encompasses a quite heterogeneous group of microorganisms [1,2,5,6]. Infection in humans usually occurs in the context of direct inoculation of the skin and the soft tissues or by inhalation. N. brasiliensis is the most common cause of mycetoma as a result of nocardial infection in immunocompetent hosts in specific tropical areas, such as the southern United States, Mexico, South America and Australia. On the other hand, nocardial disease of the respiratory tract and disseminated disease occur predominantly in immunocompromised individuals with a species distribution that varies depending on the geographic region; however, the most commonly implicated species are N. cyriacigeorgica, N, abscessus, N. nova, N. brasiliensis, and N. farcinica [2,7,8].
Clinical features and prognosis of nocardiosis in patients with connective tissue diseases
Published in Modern Rheumatology, 2021
Mizuki Yagishita, Hiroto Tsuboi, Daiki Tabuchi, Toshiki Sugita, Taihei Nishiyama, Shota Okamoto, Toshihiko Terasaki, Masaru Shimizu, Fumika Honda, Ayako Ohyama, Izumi Kurata, Saori Abe, Hiroyuki Takahashi, Atsumu Osada, Shinya Hagiwara, Yuya Kondo, Isao Matsumoto, Takayuki Sumida
We performed a retrospective chart review of patients with CTDs who were diagnosed with nocardiosis from January 2004 to December 2019 at the University of Tsukuba Hospital (Ibaraki, Japan). A definite diagnosis of nocardiosis was made based on positive culture specimens for Nocardia species associated with clinical symptoms of infection. We defined a dissemination of nocardiosis as multiple organ infection and/or a positive blood culture. We retrospectively investigated patient characteristics and therapeutic outcomes of nocardiosis. Additionally, we performed comparisons between survivors and non-survivors, who were defined as patients who died from nocardiosis while under treatment.