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Nocardiosis in kidney transplant recipients: A tertiary care center experience.
- Source :
-
Transplant immunology [Transpl Immunol] 2024 Jun; Vol. 84, pp. 102041. Date of Electronic Publication: 2024 Mar 26. - Publication Year :
- 2024
-
Abstract
- Introduction: Kidney transplant recipients are at increased risk of opportunistic infections, including Nocardia. The incidence of nocardiosis in kidney transplant recipients is 0.4-1.3%. The data regarding its epidemiology and outcomes is limited.<br />Methods: This was a 10-year retrospective observational study from January 2012 to December 2021 at a tertiary care center in northern India, in which all kidney transplant recipients with Nocardia infection were included and followed.<br />Results: 12 (1.1%) patients had a Nocardia infection among the 1108 kidney transplant recipients. All were living donor kidney transplant recipients, and the mean age at diagnosis was 48.67 ± 12.60 years. Nocardia infection occurred at a median of 26 months (range 4-235) post-transplantation, with 4 (33.1%) of the cases occurring within a year of transplant. Breakthrough infection occurred in 7 (58.3%) patients on cotrimoxazole prophylaxis. 41.7% (n = 5) cases had an episode of rejection in the preceding year of Nocardia diagnosis. Concurrent cytomegalovirus (CMV) infection was present in one (8.3%) case. The lung was the most frequently involved organ. Microscopy was positive in all the cases; while culture was positive in 10 cases, and antimicrobial susceptibility testing (AST) were performed for these isolates. The majority (60%) of isolates were resistant to cotrimoxazole. All tested isolates remained susceptible to Amikacin, Imipenem, and Linezolid. No patients experienced Nocardia recurrence after completion of antibiotic therapy. The mortality at 12 months was 66.7% (n = 4), and only one death was Nocardia-related.<br />Conclusion: Nocardia may cause a late-manifesting infection beyond the traditional window. The cotrimoxazole prophylaxis may not be sufficient for Nocardia prevention.<br />Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare.<br /> (Copyright © 2024 Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Middle Aged
Male
Female
Retrospective Studies
Adult
India epidemiology
Opportunistic Infections epidemiology
Opportunistic Infections immunology
Opportunistic Infections microbiology
Transplant Recipients
Incidence
Graft Rejection
Nocardia Infections epidemiology
Nocardia Infections drug therapy
Nocardia Infections diagnosis
Kidney Transplantation adverse effects
Tertiary Care Centers
Nocardia
Subjects
Details
- Language :
- English
- ISSN :
- 1878-5492
- Volume :
- 84
- Database :
- MEDLINE
- Journal :
- Transplant immunology
- Publication Type :
- Academic Journal
- Accession number :
- 38537681
- Full Text :
- https://doi.org/10.1016/j.trim.2024.102041