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Clinical correlates of nocardiosis

Nocardia is an opportunistic pathogen that most frequently affects the lungs. Evidence is limited regarding the risk factors for nocardiosis. The current study assessed clinical correlates of nocardiosis. A retrospective study was conducted based on medical records of consecutive adult patients (N =...

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Autores principales: Margalit, Ili, Goldberg, Elad, Ben Ari, Yaara, Ben-Zvi, Haim, Shostak, Yael, Krause, Ilan, Muhsen, Khitam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459281/
https://www.ncbi.nlm.nih.gov/pubmed/32868850
http://dx.doi.org/10.1038/s41598-020-71214-4
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author Margalit, Ili
Goldberg, Elad
Ben Ari, Yaara
Ben-Zvi, Haim
Shostak, Yael
Krause, Ilan
Muhsen, Khitam
author_facet Margalit, Ili
Goldberg, Elad
Ben Ari, Yaara
Ben-Zvi, Haim
Shostak, Yael
Krause, Ilan
Muhsen, Khitam
author_sort Margalit, Ili
collection PubMed
description Nocardia is an opportunistic pathogen that most frequently affects the lungs. Evidence is limited regarding the risk factors for nocardiosis. The current study assessed clinical correlates of nocardiosis. A retrospective study was conducted based on medical records of consecutive adult patients (N = 60) with nocardiosis hospitalized during 2007–2018 at a tertiary hospital in central Israel. A matched comparison group of 120 patients was randomly selected among hospitalized patients with community-acquired pneumonia. Multivariable conditional logistic regression models were fitted. Immunosuppressive pharmacotherapy was positively associated with nocardiosis (matched odds ratio [OR] 4.40, 95% confidence interval [CI] 2.25–8.62, p < 0.001), particularly corticosteroid therapy (matched OR 4.69, 95% CI 2.45–8.99, p < 0.001). Systemic corticosteroid therapy was strongly associated with pulmonary nocardiosis (matched OR 5.90, 95% CI 2.75–12.66, p < 0.001). The positive association between solid organ transplantation and nocardiosis was attenuated following adjustment for systemic corticosteroids in a multivariable model. The association between corticosteroid therapy and nocardiosis appeared stronger in patients with chronic pulmonary disease (OR 5.74, 95% CI 2.75–12.66, p < 0.001) than in the pooled analysis of all nocardiosis cases. In conclusion, corticosteroid therapy was strongly correlated with nocardiosis, particularly among individuals with chronic pulmonary disease and in pulmonary nocardiosis.
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spelling pubmed-74592812020-09-01 Clinical correlates of nocardiosis Margalit, Ili Goldberg, Elad Ben Ari, Yaara Ben-Zvi, Haim Shostak, Yael Krause, Ilan Muhsen, Khitam Sci Rep Article Nocardia is an opportunistic pathogen that most frequently affects the lungs. Evidence is limited regarding the risk factors for nocardiosis. The current study assessed clinical correlates of nocardiosis. A retrospective study was conducted based on medical records of consecutive adult patients (N = 60) with nocardiosis hospitalized during 2007–2018 at a tertiary hospital in central Israel. A matched comparison group of 120 patients was randomly selected among hospitalized patients with community-acquired pneumonia. Multivariable conditional logistic regression models were fitted. Immunosuppressive pharmacotherapy was positively associated with nocardiosis (matched odds ratio [OR] 4.40, 95% confidence interval [CI] 2.25–8.62, p < 0.001), particularly corticosteroid therapy (matched OR 4.69, 95% CI 2.45–8.99, p < 0.001). Systemic corticosteroid therapy was strongly associated with pulmonary nocardiosis (matched OR 5.90, 95% CI 2.75–12.66, p < 0.001). The positive association between solid organ transplantation and nocardiosis was attenuated following adjustment for systemic corticosteroids in a multivariable model. The association between corticosteroid therapy and nocardiosis appeared stronger in patients with chronic pulmonary disease (OR 5.74, 95% CI 2.75–12.66, p < 0.001) than in the pooled analysis of all nocardiosis cases. In conclusion, corticosteroid therapy was strongly correlated with nocardiosis, particularly among individuals with chronic pulmonary disease and in pulmonary nocardiosis. Nature Publishing Group UK 2020-08-31 /pmc/articles/PMC7459281/ /pubmed/32868850 http://dx.doi.org/10.1038/s41598-020-71214-4 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Margalit, Ili
Goldberg, Elad
Ben Ari, Yaara
Ben-Zvi, Haim
Shostak, Yael
Krause, Ilan
Muhsen, Khitam
Clinical correlates of nocardiosis
title Clinical correlates of nocardiosis
title_full Clinical correlates of nocardiosis
title_fullStr Clinical correlates of nocardiosis
title_full_unstemmed Clinical correlates of nocardiosis
title_short Clinical correlates of nocardiosis
title_sort clinical correlates of nocardiosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459281/
https://www.ncbi.nlm.nih.gov/pubmed/32868850
http://dx.doi.org/10.1038/s41598-020-71214-4
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