Revisiting nocardiosis at a tertiary care institution: Any change in recent years?

ObjectiveTo analyse relevant changes in incidence, clinical and microbiological characteristics of nocardiosis over the last 24 years at current institution.Materials methodsThe records patients with (2006–2018) were reviewed then compared a previous cohort (1995–2006). Nocardia isolates identified by 5’-end-16S-rRNA-gene-PCR targeting first 500 bp gene sequencing. Susceptibility tests determined broth microdilution (CLSI guidelines).ResultsForty-two (64.3% male) evaluated recent cohort: 51.2% had COPD, 43.9% on corticosteroid therapy 31.7% cancer. The incidence varied from 6.3 to 7.1/100,000 admissions (p = 0.62). There was decrease HIV (27% vs. 4.9%, p 0.01) solid organ transplantation (SOT) recipients (18.9% 2 .4%, 0.01). Cases pulmonary involvement increased (70.3% 90.5%, 0.04). species similar but most common N. cyriacigeorgica (32.4% 40.5%, 0.49) farcinica (24.3% 14.3%, 0.39). Antibiotic resistance remained stable: cotrimoxazole (10.8% 5.7%, 0.68), imipenem (5.4% 5.6%, 1.0); amikacin linezolid 100% active. No differences found breakthrough (21.6% 9.8%, 0.21) or related mortality 21.4%, 1.0). multivariate analysis confirmed that caused is risk factor for poor outcome 0.045).ConclusionsNocardiosis has stable. It mainly affected elderly chronic respiratory conditions those treatment. Infections SOT have practically disappeared. Pulmonary remains area be affected. Nocardiosis apparently outcome.