Journal of Microbiology and Biotechnology

The Korean Society for Microbiology and Biotechnology (한국미생물·생명공학회)
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The Clinical Characteristic and Management of Patients with Nocardiosis in a Tertiary Hospital in China

  • Peilin Liu (Department of Clinical Laboratory, Xiangya Hospital, Central South University) ;
  • Zhiqian Wang (Department of Clinical Laboratory, Xiangya Hospital, Central South University) ;
  • Zijuan Jian (Department of Clinical Laboratory, Xiangya Hospital, Central South University) ;
  • Xuan Liu (Department of Clinical Laboratory, Xiangya Hospital, Central South University) ;
  • Yanming Li (Department of Clinical Laboratory, Xiangya Hospital, Central South University) ;
  • Qun Yan (Department of Clinical Laboratory, Xiangya Hospital, Central South University) ;
  • Baiyun Zhong (Department of Clinical Laboratory, Xiangya Hospital, Central South University) ;
  • Mengting Liao (Department of Clinical Laboratory, Xiangya Hospital, Central South University) ;
  • Xianghui Liang (Department of Clinical Laboratory, Xiangya Hospital, Central South University) ;
  • Wenen Liu (Department of Clinical Laboratory, Xiangya Hospital, Central South University)
  • Received : 2022.09.22
  • Accepted : 2022.12.20
  • Published : 2023.05.28
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Abstract

Nocardiosis is an uncommon opportunistic bacterial infection which becomes a significant health problem due to its increasing incidence and high mortality rate. However, many nocardiosis patients are underdiagnosed by physicians. To summarize the clinical characteristics and management of nocardiosis would help with better diagnosis and prognosis of nocardiosis. This retrospective study was conducted based on the medical records of nocardiosis patients between January 2015 and December 2021 in a tertiary hospital in China. Overall, 44 nocardiosis patients with 54 specimens were included. The patients consisted of 26 males and 18 females with a mean age of 50.4 ± 13.2 years. Among 44 patients, 26 (59.1%) were previously given immunosuppressive therapy. Connective tissue diseases (CTDs) were the most common underlying disease (16/44). The most frequent infection sites were the lungs (17/44) and skin or soft tissues (8/44). Common symptoms included cough (23/44), expectoration (18/44), fever (15/44), and subcutaneous abscesses (15/44). Forty-five out of 54 specimens (83.3%) required over 48 hours of culture time for nocardiosis detection. Thirty-six patients were cured or improved, 5 patients were discharged from the hospital due to poor prognosis, and 1 patient died. The average diagnosis time of poor prognosis cases was 19.7 days, which was significantly longer than those of improved or cured patients (7.3 days). Immunosuppressed patients comprise a large part of nocardiosis cases, which is worth attention in clinical practice. Early diagnosis, specifically through prolonged cultivation time of specimen, could help achieve better prognosis of nocardiosis patients.

Keywords

Acknowledgement

We thank all the staff in the Microbiology Department of Xiangya Hospital for their kind help. This work was supported by the National Natural Science Foundation of China (grant number 81672066).

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