Clinical InvestigationClinical Spectrum and Outcome of Nocardia Infection: Experience of 15-Year Period From a Single Tertiary Medical Center
Section snippets
Patient Population
This study was undertaken at Rambam Health Care Campus, a 1000-bed tertiary care center, university-affiliated hospital. Records of patients who were diagnosed with nocardiosis between January 1, 1996, and December 1, 2010, were reviewed. Patients were identified through a search of computerized data from the microbiology laboratory and clinical records. The following data were gathered for each patient: patient’s age and gender, underlying diseases, immunosuppressive therapies, clinical and
RESULTS
During the 15-year period (1996–2010), Nocardia sp. was isolated from 63 patients. Records of 62 of the 63 cases were available for review. Fifty-three patients had nocardiosis. The remaining 9 patients were colonized with Nocardia sp. without clinical disease, and no further analysis was performed on these patients. The median patients’ age was 59 years (range, 2–32 years), and men represented the majority of cases (38/53, 72%). The incidence rate of the disease calculated per 1,00,000 admissions
DISCUSSION
Previous reports indicate a possible increase in the incidence of nocardial infection.6., 7., 8. In contrast, this study revealed that nocardiosis remained infrequent and at constant incidence rate of about 2 to 6 cases a year during the last decade. Notably, this study was carried out in a 1000-bed tertiary university-affiliated medical center and included significant immunocompromised patient population.
Most patients were men, similar to most published reports.1., 2., 4., 7., 10., 11., 12., 13.
CONCLUSION
Nocardiosis is still a rather rare infection and mainly affects immunocompromised patients. The incidence of the infection remains stable in our hospital during the last decade. Most of the patients survive the infection, when diagnosis is obtained on time. Pulmonary infection in immunocompromised patients is responsible for the subset of patients with the highest mortality.
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