Publication:
Outcome and treatment of nocardiosis after solid organ transplantation: new insights from a European study.

cris.virtual.author-orcid0000-0002-7870-912X
cris.virtualsource.author-orcid007a455c-6f7d-4906-a0db-2a2c547fca83
datacite.rightsopen.access
dc.contributor.authorLebeaux, David
dc.contributor.authorFreund, Romain
dc.contributor.authorvan Delden, Christian
dc.contributor.authorGuillot, Hélène
dc.contributor.authorMarbus, Sierk D
dc.contributor.authorMatignon, Marie
dc.contributor.authorVan Wijngaerden, Eric
dc.contributor.authorDouvry, Benoit
dc.contributor.authorDe Greef, Julien
dc.contributor.authorVuotto, Fanny
dc.contributor.authorTricot, Leïla
dc.contributor.authorFernández-Ruiz, Mario
dc.contributor.authorDantal, Jacques
dc.contributor.authorHirzel, Cédric
dc.contributor.authorJais, Jean-Philippe
dc.contributor.authorRodriguez-Nava, Veronica
dc.contributor.authorJacobs, Frédérique
dc.contributor.authorLortholary, Olivier
dc.contributor.authorCoussement, Julien
dc.date.accessioned2024-10-25T05:35:17Z
dc.date.available2024-10-25T05:35:17Z
dc.date.issued2017-05-15
dc.description.abstractBackground 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 one-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 one-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<0.001). A history of tumor (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.1-1.8), invasive fungal infection in the six months before nocardiosis (OR 1.3; 95%CI 1.1-1.5) and donor age (OR 1.0046; 95%CI 1.0007-1.0083) were independently associated with one-year mortality. Acute rejection in the year before nocardiosis was associated with improved survival (OR 0.85; 95%CI 0.73-0.98). Seventeen patients received short-course antibiotics (median duration 56 [24-120] days) with a one-year success rate (cured and surviving) of 88% and a 5.9% risk of relapse (median follow-up 49 [6-136] month). 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 one-year mortality. Patients receiving short-course antibiotic treatment had good outcomes, suggesting this may be a strategy for further study.
dc.description.numberOfPages10
dc.description.sponsorshipUniversitätsklinik für Infektiologie
dc.identifier.doi10.7892/boris.98331
dc.identifier.pmid28329348
dc.identifier.publisherDOI10.1093/cid/cix124
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/151644
dc.language.isoen
dc.publisherOxford University Press
dc.relation.ispartofClinical infectious diseases
dc.relation.issn1058-4838
dc.relation.organizationDCD5A442BB13E17DE0405C82790C4DE2
dc.subjectNocardia
dc.subjectmortality
dc.subjectopportunistic infections.
dc.subjectorgan transplantation
dc.subjectprognosis
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titleOutcome and treatment of nocardiosis after solid organ transplantation: new insights from a European study.
dc.typearticle
dspace.entity.typePublication
dspace.file.typetext
oaire.citation.endPage1405
oaire.citation.issue10
oaire.citation.startPage1396
oaire.citation.volume64
oairecerif.author.affiliationUniversitätsklinik für Infektiologie
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unibe.date.embargoChanged2018-05-16 00:30:08
unibe.description.ispublishedpub
unibe.eprints.legacyId98331
unibe.journal.abbrevTitleCLIN INFECT DIS
unibe.refereedtrue
unibe.subtype.articlejournal

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