A multicentre analysis of Nocardia pneumonia in Spain: 2010–2016

• Main Authors: Maria Ercibengoa, Jordi Càmara, Fe Tubau, Dolores García-Somoza, Alicia Galar, Pablo Martín-Rabadán, Mercedes Marin, Lourdes Mateu, Ignasi García-Olivé, Cristina Prat, Catia Cilloniz, Antonio Torres, Maria-Luisa Pedro-Botet, Carmen Ardanuy, Patricia Muñoz, Jose María Marimón
• Format: Article
• Language: English
• Published: Elsevier 2020-01-01
• Series: International Journal of Infectious Diseases
• Online Access: http://www.sciencedirect.com/science/article/pii/S1201971219304266

Objective: To analyse all cases of Nocardia pneumonia occurring between 2010 and 2016 in five Spanish hospitals. Methods: This was a retrospective observational analysis of clinical and microbiological data collected from 55 cases of Nocardia pneumonia. Results: There were one to 20 cases per hospital and six to nine cases per year. Chronic obstructive pulmonary disease, bronchiectasis, and asthma were the main predisposing underlying respiratory conditions. Thirty-four patients were receiving systemic and/or inhaled corticosteroids prior to infection, eight had neoplasia, and six had haematological malignancies. Clinical and radiological findings were common to pneumonia of other infectious aetiologies, except for the frequent presence of nodules and cavitation. Overall, the 1-year mortality was high (38.2%), and mortality was directly related to the pulmonary disease in 15 patients (27.3%). The most frequently identified species were N. cyriacigeorgica (n = 21), N. abscessus (n = 8), and N. farcinica (n = 5). All Nocardia isolates were susceptible to linezolid and all but two were susceptible to amikacin and trimethoprim–sulfamethoxazole. Conclusions: Nocardia pneumonia-associated mortality remains high, probably because of the debilitated status of patients in whom this pathogen is able to cause pulmonary infection. Keywords: Nocardia, Pneumonia, Multicentre study, Nocardia cyriacigeorgica, Spain, Respiratory infection