Pulmonary Nocardiosis in Renal Transplant Recipients From Pakistan: Risk Factors, Clinical Presentation, and Mortality.
Exp Clin Transplant
; 22(8): 607-612, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-39254072
ABSTRACT
OBJECTIVES:
Nocardia is an opportunistic infection among renal transplant recipients with an incidence of <1% but high mortality. Data from Pakistan are scarce. Our aim was to find the risk factors, clinical and radiographic findings, antimicrobial sensitivity, and outcomes of Nocardia infection among renal transplant recipients in Pakistan. MATERIALS ANDMETHODS:
All adult renal transplant recipients diagnosed with nocardiosis between 2013 and 2020 were included. The cases were matched 12 with controls based on sex, age (±1 year), and transplant date (±1 year). Risk factors, clinical features, antibiotic sensitivities and outcomes were analyzed.RESULTS:
A total of 48 patients developed nocardiosis. Around 25% of patients presented with disseminated disease. Median time from transplant to disease development was 2.68 years. High-dose methylprednisolone and presence of cytomegalovirus infection within 90 days of disease development were independent risk factors for Nocardia infection. The mortality rate was 20%. Central nervous system disease and cytomegalovirus infection within 90 days were significantly associated with mortality. The most susceptible drugs were co-trimoxazole and linezolid. Imipenem susceptibility was only 20%.CONCLUSIONS:
High-dose methylprednisolone and cytomegalovirus infection were independent risk factors for Nocardia infection. Central nervous system disease was associated with mortality. Nocardia species were highly resistant to ceftriaxone and imipenem in our patient population.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones Oportunistas
/
Trasplante de Riñón
/
Huésped Inmunocomprometido
/
Antibacterianos
/
Nocardiosis
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Exp Clin Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2024
Tipo del documento:
Article
País de afiliación:
Pakistán
Pais de publicación:
Turquía