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Journal Articles Clinical Infectious Diseases Year : 2017

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

David Lebeaux , Romain Freund , Christian Van Delden , Hélène Guillot , Sierk D. Marbus , Marie Matignon , Eric van Wijngaerden , Benoit Douvry , Julien de Greef , Fanny Vuotto , Leïla Tricot , Mario Fernández-Ruiz , Jacques Dantal , Cédric Hirzel , Jean-Philippe Jais , Veronica Rodriguez-Nava (1) , Frédérique Jacobs , Olivier Lortholary , Julien Coussement , James R. Anstey , Martine Antoine , Nathalie Ausselet , Asmae Belhaj , Jerina Boelens , Hans De Beenhouwer , Catherine Denis , Erwin Ho , Margareta Ieven , Stijn Jonckheere , Christiane Knoop , Alain Le Moine , Hector Rodriguez-Villalobos , Judith Racapé , Sandrine Roisin , Bernard Vandercam , Marie-Laure Vander Zwalmen , Gaëlle Vanfraechem , Steven van Laecke , Jan Verhaegen , Benoit Barrou , Pascal Battistella , Emmanuelle Bergeron , Nicolas Bouvier , Sophie Caillard , Eric Caumes , Hélène Chaussade , Cécile Chauvet , Romain Crochette , Eric Epailly , Marie Essig , Sébastien Gallien , Romain Guillemain , Canan Herel , Bruno Hoen , Nassim Kamar , Thierry Le Gall , Charlene Levi , Arnaud Lionet , Hélène Longuet , Giovanna Melica , Anaick Miel , Hélène Morel , Salima Ould Ammar , Sabine Pattier , Marie-Noelle Peraldi , Johnny Sayegh , Anne Scemla , Agathe Senechal , Jérome Tourret , Katia Boggian , Adrian Egli , Christian Garzoni , Matthias Hoffman , Hans H. Hirsch , Nina Khanna , Oriol Manuel , Pascal Meylan , Nicolas J. Mueller , Klara M. Posfay-Barbe , Diem-Lan Vu , Maja Weisser , Albert M. Vollaard , Herman F. Wunderink
David Lebeaux
  • Function : Author
Romain Freund
  • Function : Author
Christian Van Delden
  • Function : Author
Hélène Guillot
  • Function : Author
Sierk D. Marbus
  • Function : Author
Marie Matignon
Eric van Wijngaerden
  • Function : Author
Benoit Douvry
  • Function : Author
Julien de Greef
  • Function : Author
Fanny Vuotto
  • Function : Author
Leïla Tricot
  • Function : Author
Mario Fernández-Ruiz
  • Function : Author
Jacques Dantal
  • Function : Author
Cédric Hirzel
  • Function : Author
Jean-Philippe Jais
  • Function : Author
Frédérique Jacobs
  • Function : Author
Olivier Lortholary
  • Function : Author
Julien Coussement
  • Function : Author
James R. Anstey
  • Function : Author
Martine Antoine
  • Function : Author
Nathalie Ausselet
  • Function : Author
Asmae Belhaj
  • Function : Author
Jerina Boelens
  • Function : Author
Hans De Beenhouwer
  • Function : Author
Catherine Denis
  • Function : Author
Erwin Ho
  • Function : Author
Margareta Ieven
  • Function : Author
Stijn Jonckheere
  • Function : Author
Christiane Knoop
  • Function : Author
Alain Le Moine
  • Function : Author
Hector Rodriguez-Villalobos
  • Function : Author
Judith Racapé
  • Function : Author
Sandrine Roisin
  • Function : Author
Bernard Vandercam
  • Function : Author
Marie-Laure Vander Zwalmen
  • Function : Author
Gaëlle Vanfraechem
  • Function : Author
Steven van Laecke
  • Function : Author
Jan Verhaegen
  • Function : Author
Benoit Barrou
  • Function : Author
Pascal Battistella
  • Function : Author
Emmanuelle Bergeron
  • Function : Author
Nicolas Bouvier
  • Function : Author
Sophie Caillard
  • Function : Author
Eric Caumes
  • Function : Author
Hélène Chaussade
  • Function : Author
Cécile Chauvet
  • Function : Author
Romain Crochette
  • Function : Author
Eric Epailly
  • Function : Author
Marie Essig
  • Function : Author
Sébastien Gallien
Romain Guillemain
  • Function : Author
Canan Herel
  • Function : Author
Bruno Hoen
Nassim Kamar
Thierry Le Gall
  • Function : Author
Charlene Levi
  • Function : Author
Arnaud Lionet
  • Function : Author
Hélène Longuet
  • Function : Author
Giovanna Melica
  • Function : Author
Anaick Miel
  • Function : Author
Hélène Morel
  • Function : Author
Salima Ould Ammar
  • Function : Author
Sabine Pattier
  • Function : Author
Marie-Noelle Peraldi
  • Function : Author
Johnny Sayegh
  • Function : Author
Anne Scemla
  • Function : Author
Agathe Senechal
  • Function : Author
Jérome Tourret
  • Function : Author
Katia Boggian
  • Function : Author
Adrian Egli
  • Function : Author
Christian Garzoni
  • Function : Author
Matthias Hoffman
  • Function : Author
Hans H. Hirsch
  • Function : Author
Nina Khanna
Oriol Manuel
  • Function : Author
Pascal Meylan
  • Function : Author
Nicolas J. Mueller
  • Function : Author
Klara M. Posfay-Barbe
  • Function : Author
Diem-Lan Vu
  • Function : Author
Maja Weisser
  • Function : Author
Albert M. Vollaard
  • Function : Author
Herman F. Wunderink
  • Function : Author

Abstract

Background.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).Methods.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.Results.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], 1.11.8), invasive fungal infection (OR, 1.3; 95% CI, 1.11.5), and donor age (OR, 1.0046; 95% CI, 1.00071.0083) were independently associated with 1-year mortality. Acute rejection in the year before nocardiosis was associated with improved survival (OR, 0.85; 95% CI, 0.730.98). Seventeen patients received short-course antibiotics (median duration 56 [24120] days) with a 1-year success rate (cured and surviving) of 88% and a 5.-% risk of relapse (median follow-up 49 [6136] months).Conclusions.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.

Dates and versions

hal-02487192 , version 1 (21-02-2020)

Identifiers

Cite

David Lebeaux, Romain Freund, Christian Van Delden, Hélène Guillot, Sierk D. Marbus, et al.. Outcome and Treatment of Nocardiosis After Solid Organ Transplantation: New Insights From a European Study. Clinical Infectious Diseases, 2017, 64 (10), pp.1396-1405. ⟨10.1093/cid/cix124⟩. ⟨hal-02487192⟩
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