Details

Autor(en) / Beteiligte

• Kurosawa, Shuhei
• Sekiya, Noritaka
• Doki, Noriko
• Yaguchi, Takashi
• Kishida, Yuya
• Nagata, Akihito
• Yamada, Yuta
• Konishi, Tatsuya
• Kaito, Satoshi
• Yoshifuji, Kota
• Shirane, Shuichi
• Uchida, Tomoyuki
• Inamoto, Kyoko
• Toya, Takashi
• Igarashi, Aiko
• Najima, Yuho
• Muto, Hideharu
• Kobayashi, Takeshi
• Kakihana, Kazuhiko
• Sakamaki, Hisashi
• Ohashi, Kazuteru

Titel

The emergence of rare nocardiosis following allogeneic hematopoietic stem cell transplantation in the era of molecular taxonomy

Ist Teil von

• International journal of infectious diseases, 2019-12, Vol.89, p.154-162

Ort / Verlag

Canada: Elsevier Ltd

Erscheinungsjahr

2019

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• •We reviewed rare nocardiosis in allogeneic stem cell transplant recipients.•Five newly identified Nocardia species were focused on in the present study.•The cases of N. abscessus and N. aobensis have not been reported in the past.•New Nocardia species had various antimicrobial susceptibility patterns.•Maintenance therapy was changed in half of the cases due to adverse drug events. The purpose of this study was to describe the clinical features of nocardiosis after allogeneic hematopoietic stem cell transplantation (allo-HSCT), focusing on new Nocardia species. We retrospectively reviewed data from patients with nocardiosis after allo-HSCT treated at our hospital and documented cases in the medical literature. Fifty-seven cases were identified from our institution and the literature review. Although 51 patients (89.5%) responded to initial treatment, 28 (49.1%) patients were switched over to other treatment regimens due to the recurrence of nocardiosis or adverse events of antimicrobials. Nocardiosis-attributed mortality occurred in ten patients (17.5%). Antimicrobial susceptibilities varied among intra- and inter-species except linezolid (LZD). In the present study, five species were newly discovered after 2000, including N. cyriacigeorgica, N. veterana, N. abscessus, N. aobensis, and N. mexicana. All isolates of N. cyriacigeorgica, N. veterana, N. abscessus, and N. aobensis were sensitive to trimethoprim/sulfamethoxazole, amikacin (AMK), imipenem (IPM), and LZD; however, N. mexicana was resistant to AMK and IPM. Newly identified Nocardia species have various antimicrobial susceptibility patterns. Long-term maintenance therapy could be challenging due to the adverse events of antimicrobials, especially in the allo-HSCT setting. Prudent evaluation is crucial for selecting a second-line or further treatment options.