Cargando…
1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States
BACKGROUND: Nocardia species can cause localized or disseminated disease in humans. Infection results from direct inoculation or inhalation. In recent years, several new species have been identified via molecular methods. Further speciation is crucial as each organism has its own spectrum of disease...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809132/ http://dx.doi.org/10.1093/ofid/ofz360.1218 |
_version_ | 1783461909856518144 |
---|---|
author | Moore-Pardo, Shylah M Asquith, Johonna Aslam, Sadaf Mayer, Cynthia Greene, John Alrabaa, Sally |
author_facet | Moore-Pardo, Shylah M Asquith, Johonna Aslam, Sadaf Mayer, Cynthia Greene, John Alrabaa, Sally |
author_sort | Moore-Pardo, Shylah M |
collection | PubMed |
description | BACKGROUND: Nocardia species can cause localized or disseminated disease in humans. Infection results from direct inoculation or inhalation. In recent years, several new species have been identified via molecular methods. Further speciation is crucial as each organism has its own spectrum of disease and unique antibiotic susceptibility patterns. Immunosuppression, alcoholism, and certain lung diseases are well-established risk factors for nocardiosis. In fact, cases have incremented in association with increasing population of immunocompromised hosts as well as improved methods for detection and identification. Thus, Nocardia species may be considered opportunistic pathogens. Nocardia bejingensis was first isolated in 2001 by Wang et al from sewage soil in China. The first human infections were reported in Asia. Subsequently, cases were reported in Europe and a few cases have been described in the United States but it has been infrequently cited in the literature. Thus, not much is known about its spectrum of disease. METHODS: The primary objective of this study was to determine the risk factors and clinical manifestations of Nocardia bejingensis infection via retrospective chart review of 6 cases identified in Tampa General Hospital and Moffitt Cancer Center within a 5-year period. We aimed to evaluate the treatment used and the antibiotic susceptibility patterns of the isolates. RESULTS: All patients were immunocompromised (1/3 HIV/AIDS, 1/3 hematologic malignancy, 1/3 solid-organ transplant). Most were male (67%) and mean age of 48. The majority had lung involvement (67%). Thecal sac infection and femur osteomyelitis (OM) were atypical manifestations. Localized disease predominated. Combination therapy was preferred. Trimethoprim-sulfamethoxazole (TMP-SMX), Ceftriaxone, and carbapenems were mostly used. All isolates were susceptible to TMP-SMX. See Table 1. CONCLUSION: This case series depicts clinical features, risk factors, and epidemiology of Nocardia bejingensis infections. Our observations suggest that it is a novel pathogen in the United States, affecting mainly immunocompromised hosts. Early detection, appropriate antibiotics, and surgery were keys in successful management. However, further studies are needed to further elucidate its pathogenesis. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6809132 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-68091322019-10-28 1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States Moore-Pardo, Shylah M Asquith, Johonna Aslam, Sadaf Mayer, Cynthia Greene, John Alrabaa, Sally Open Forum Infect Dis Abstracts BACKGROUND: Nocardia species can cause localized or disseminated disease in humans. Infection results from direct inoculation or inhalation. In recent years, several new species have been identified via molecular methods. Further speciation is crucial as each organism has its own spectrum of disease and unique antibiotic susceptibility patterns. Immunosuppression, alcoholism, and certain lung diseases are well-established risk factors for nocardiosis. In fact, cases have incremented in association with increasing population of immunocompromised hosts as well as improved methods for detection and identification. Thus, Nocardia species may be considered opportunistic pathogens. Nocardia bejingensis was first isolated in 2001 by Wang et al from sewage soil in China. The first human infections were reported in Asia. Subsequently, cases were reported in Europe and a few cases have been described in the United States but it has been infrequently cited in the literature. Thus, not much is known about its spectrum of disease. METHODS: The primary objective of this study was to determine the risk factors and clinical manifestations of Nocardia bejingensis infection via retrospective chart review of 6 cases identified in Tampa General Hospital and Moffitt Cancer Center within a 5-year period. We aimed to evaluate the treatment used and the antibiotic susceptibility patterns of the isolates. RESULTS: All patients were immunocompromised (1/3 HIV/AIDS, 1/3 hematologic malignancy, 1/3 solid-organ transplant). Most were male (67%) and mean age of 48. The majority had lung involvement (67%). Thecal sac infection and femur osteomyelitis (OM) were atypical manifestations. Localized disease predominated. Combination therapy was preferred. Trimethoprim-sulfamethoxazole (TMP-SMX), Ceftriaxone, and carbapenems were mostly used. All isolates were susceptible to TMP-SMX. See Table 1. CONCLUSION: This case series depicts clinical features, risk factors, and epidemiology of Nocardia bejingensis infections. Our observations suggest that it is a novel pathogen in the United States, affecting mainly immunocompromised hosts. Early detection, appropriate antibiotics, and surgery were keys in successful management. However, further studies are needed to further elucidate its pathogenesis. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809132/ http://dx.doi.org/10.1093/ofid/ofz360.1218 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Moore-Pardo, Shylah M Asquith, Johonna Aslam, Sadaf Mayer, Cynthia Greene, John Alrabaa, Sally 1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States |
title | 1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States |
title_full | 1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States |
title_fullStr | 1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States |
title_full_unstemmed | 1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States |
title_short | 1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States |
title_sort | 1354. nocardia bejingensis: a novel isolate affecting immunocompromised patients in the united states |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809132/ http://dx.doi.org/10.1093/ofid/ofz360.1218 |
work_keys_str_mv | AT moorepardoshylahm 1354nocardiabejingensisanovelisolateaffectingimmunocompromisedpatientsintheunitedstates AT asquithjohonna 1354nocardiabejingensisanovelisolateaffectingimmunocompromisedpatientsintheunitedstates AT aslamsadaf 1354nocardiabejingensisanovelisolateaffectingimmunocompromisedpatientsintheunitedstates AT mayercynthia 1354nocardiabejingensisanovelisolateaffectingimmunocompromisedpatientsintheunitedstates AT greenejohn 1354nocardiabejingensisanovelisolateaffectingimmunocompromisedpatientsintheunitedstates AT alrabaasally 1354nocardiabejingensisanovelisolateaffectingimmunocompromisedpatientsintheunitedstates |