Outcome and Treatment of Nocardiosis After Solid Organ Transplantation: New Insights From a European Study.

Details

Serval ID
serval:BIB_9E6DAD557486
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Outcome and Treatment of Nocardiosis After Solid Organ Transplantation: New Insights From a European Study.
Journal
Clinical infectious diseases
Author(s)
Lebeaux D., Freund R., van Delden C., Guillot H., Marbus S.D., Matignon M., Van Wijngaerden E., Douvry B., De Greef J., Vuotto F., Tricot L., Fernández-Ruiz M., Dantal J., Hirzel C., Jais J.P., Rodriguez-Nava V., Jacobs F., Lortholary O., Coussement J., Manuel O.
Working group(s)
European Study Group for Nocardia in Solid Organ Transplantation , European Study Group for Nocardia in Solid Organ Transplantation
Contributor(s)
Anstey J.R., Antoine M., Ausselet N., Belhaj A., Boelens J., de Beenhouwer H., Denis C., Ho E., Ieven M., Jonckheere S., Knoop C., le Moine A., Rodriguez-Villalobos H., Racapé J., Roisin S., Vandercam B., Vander Zwalmen M.L., Vanfraechem G., Van Laecke S., Verhaegen J., Barrou B., Battistella P., Bergeron E., Bouvier N., Caillard S., Caumes E., Chaussade H., Chauvet C., Crochette R., Epailly E., Essig M., Gallien S., Guillemain R., Herel C., Hoen B., Kamar N., le Gall T., Levi C., Lionet A., Longuet H., Melica G., Miel A., Morel H., Ammar S.O., Pattier S., Peraldi M.N., Sayegh J., Scemla A., Senechal A., Tourret J., Boggian K., Egli A., Garzoni C., Hoffman M., Hirsch H.H., Khanna N., Meylan P., Mueller N.J., Posfay-Barbe K.M., Vu D.L., Weisser M., Vollaard A.M., Wunderink H.F.
ISSN
1537-6591 (Electronic)
ISSN-L
1058-4838
Publication state
Published
Issued date
15/05/2017
Peer-reviewed
Oui
Volume
64
Number
10
Pages
1396-1405
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
Solid organ transplant (SOT) recipients are at risk of nocardiosis, a rare opportunistic bacterial infection, but prognosis and outcome of these patients are poorly defined. Our objectives were to identify factors associated with 1-year mortality after nocardiosis and describe the outcome of patients receiving short-course antibiotics (≤120 days).
We analyzed data from a multicenter European case-control study that included 117 SOT recipients with nocardiosis diagnosed between 2000 and 2014. Factors associated with 1-year all-cause mortality were identified using multivariable conditional logistic regression.
One-year mortality was 10-fold higher in patients with nocardiosis (16.2%, 19/117) than in control transplant recipients (1.3%, 3/233, P < .001). A history of tumor (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.8), invasive fungal infection (OR, 1.3; 95% CI, 1.1-1.5), and donor age (OR, 1.0046; 95% CI, 1.0007-1.0083) were independently associated with 1-year mortality. Acute rejection in the year before nocardiosis was associated with improved survival (OR, 0.85; 95% CI, 0.73-0.98). Seventeen patients received short-course antibiotics (median duration 56 [24-120] days) with a 1-year success rate (cured and surviving) of 88% and a 5.9% risk of relapse (median follow-up 49 [6-136] months).
One-year mortality was 10-fold higher in SOT patients with nocardiosis than in those without. Four factors, largely reflecting general medical condition rather than severity and/or management of nocardiosis, were independently associated with 1-year mortality. Patients who received short-course antibiotic treatment had good outcomes, suggesting that this may be a strategy for further study.
Keywords
Aged, Anti-Bacterial Agents/administration & dosage, Anti-Bacterial Agents/therapeutic use, Case-Control Studies, Europe/epidemiology, Female, Humans, Invasive Fungal Infections/complications, Invasive Fungal Infections/drug therapy, Invasive Fungal Infections/microbiology, Logistic Models, Male, Middle Aged, Nocardia Infections/complications, Nocardia Infections/drug therapy, Nocardia Infections/epidemiology, Nocardia Infections/mortality, Odds Ratio, Opportunistic Infections/drug therapy, Opportunistic Infections/microbiology, Organ Transplantation/adverse effects, Prognosis, Retrospective Studies, Risk Factors, Treatment Outcome, Nocardia, mortality, opportunistic infections., organ transplantation, prognosis
Pubmed
Web of science
Open Access
Yes
Create date
31/07/2019 8:07
Last modification date
21/08/2019 6:34
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