| Institution: | 1. Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan;2. Department of Clinical Pharmacology and Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan;3. Laboratory of Clinical Pharmacogenomics, Shizuoka General Hospital, Shizuoka, Japan;1. Department of Respiratory Medicine, Hosoya Hospital, Ibara, 715-0014, Japan;2. Department of Internal Medicine 4, Kawasaki Medical School, Okayama, 700-8505, Japan;1. Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan;2. Department of Respiratory Medicine, Kosumosu Hospital, 1131-1 Nagatani, Tomuro, Usuki 875-0051, Japan;3. The Center for Nursing Education, Research and Collaboration, College of Nursing, Oita University of Nursing and Healt Sciences, 2944-9 Megusuno, Oita, Oita, 870-1201, Japan;4. Mental Health and Psychiatric Division, College of Nursing, Oita University of Nursing and Healt Sciences, 2944-9 Megusuno, Oita, Oita, 870-1201, Japan;1. Department of Surgery, National Hospital Organization Ehime Medical Center, 366 Yokogawara, Toon, Ehime, 791-0281, Japan;2. Department of Respiratory Medicine, National Hospital Organization Ehime Medical Center, 366 Yokogawara, Toon, Ehime, 791-0281, Japan;3. Department of Minimally Invasive Gastroenterology, Ehime University Medical School, Shitsukawa, Toon, Ehime, 791-0295, Japan;4. Department of Cardiovascular and Thoracic Surgery, Ehime University Medical School, Toon, Ehime, 791-0295, Japan |
| Abstract: | BackgroundPulmonary nocardiosis is a rare pulmonary infection with high morbidity and mortality. Limited real-world data on pulmonary nocardiosis patients are available from developing countries like Pakistan.MethodsThis retrospective observational study was conducted at the Aga Khan University Hospital, Karachi, Pakistan, from August 2003 to June 2020. Demographics, immune status, underlying diseases, laboratory data, treatment, and outcomes of all nocardiosis patients were recorded in predesigned proforma.ResultsSixty-six patients with smear/culture-proven pulmonary nocardiosis were identified. Most patients (83.3%) were treated with trimethoprim-sulfamethoxazole alone or in combination with other medicines. The overall mortality rate in our study was 33.3% (n = 22/66). Factors significantly associated with mortality were respiratory failure (p < 0.001), raised procalcitonin levels (p = 0.01), concomitant fungal infections (p = 0.01), concomitant TB (p = 0.03), and patients on combination therapy (p < 0.001).Respiratory failure (odds ratio OR] 46.94 95% confidence intervals CI]: 5.01–439.03] p < 0.001), concomitant fungal infection (OR 17.09 95% CI: 1.47–197.88] p- = 0.02) and patients on combination therapy (OR 6.90 95% CI: 1.23–38.61] p = 0.02) were also identified as independent risk factors for mortality on multivariate analysis.ConclusionsThis study provides essential information on the clinical characteristics and risk factors, outcomes, and factors associated with mortality for pulmonary nocardial infections. |
