"Pulmonary Nocardiosis in Western Europe-Clinical evaluation of 43 patients and population-based estimates of hospitalization rates".

Ott, Sebastian Robert; Meier, N; Kolditz, Martin; Bauer, Torsten T; Rohde, Gernot; Presterl, Elisabeth; Schürmann, Dirk; Lepper, Philipp M; Ringshausen, Felix C; Flick, Holger; Leib, Stephen; Pletz, Mathias W (2019). "Pulmonary Nocardiosis in Western Europe-Clinical evaluation of 43 patients and population-based estimates of hospitalization rates". International journal of infectious diseases, 81, pp. 140-148. Elsevier 10.1016/j.ijid.2018.12.010

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BACKGROUND Pulmonary nocardiosis (PN) is an uncommon but potentially life-threatening infection. Most of our knowledge is derived from case reports or smaller case series. Recently, increasing PN incidence rates have been reported. We aim to describe the clinical course of and risk factors for PN in four Western European countries and to estimate population-based annual hospitalization rates. METHODS Retrospective evaluation (1995 to 2011) of the clinical course of and risk factors for PN in patients from 11 hospitals in four European countries (Germany, Austria, Switzerland and The Netherlands). Calculation of population-based estimates of hospitalization rates of PN in Germany (2005 to 2011) using official German nationwide diagnosis-related groups (DRG) hospital statistics. RESULTS Forty-three patients fulfilled stringent criteria for proven (n=8) and probable (n=35) PN; seven with extrapulmonary dissemination. Within the 43 patients, major PN risk factors were immunocompromising (83.7%) and/or pulmonary (58.1%; in 27.9% as only comorbidity) comorbidities. Median duration of PN targeted therapy was 12 weeks. Distinguished patterns of resistance were observed (imipenem susceptibility: N. farcinica 33.3%; N. asteroides 66.7%). Overall mortality rate was 18.9%; in disseminated PN 50%. Over time, annual PN hospitalization rates remained unchanged at around 0.04/100'000 with the highest rate among men aged 75-84 years (0.24/100'000). CONCLUSION PN is rare, but potentially life-threatening, and mainly affects immunocompromised elder males. Overall annual hospitalization rates remained stable between 2005 and 2011.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Research

UniBE Contributor:

Ott, Sebastian Robert and Leib, Stephen

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1201-9712

Publisher:

Elsevier

Language:

English

Submitter:

Stephen Leib

Date Deposited:

09 May 2019 15:15

Last Modified:

18 Jul 2019 15:56

Publisher DOI:

10.1016/j.ijid.2018.12.010

PubMed ID:

30658169

Uncontrolled Keywords:

nocardia nocardiosis pulmonary nocardiosis

BORIS DOI:

10.7892/boris.127110

URI:

https://boris.unibe.ch/id/eprint/127110

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