A French multicentric study and review of pulmonary Nocardia spp. in cystic fibrosis patients

Med Microbiol Immunol. 2015 Aug;204(4):493-504. doi: 10.1007/s00430-014-0360-3. Epub 2014 Oct 26.

Abstract

Some bacterial species recovered from the airways of cystic fibrosis (CF) patients are indisputably associated with lung infections, whereas the clinical relevance of others, such as Nocardia spp., remains unclear. Sixteen French CF cases of colonization/infection with Nocardia spp. were reviewed in order to evaluate the epidemiology, the clinical impact and the potential treatment of these bacteria, and results were compared to those of the literature. Five Nocardia species were identified, Nocardia cyriacigeorgica being the major species (50 % of cases). At first isolation, Nocardia was the sole pathogen recovered in six patients. Seven patients presented pulmonary exacerbation. For 12 patients, antimicrobial treatment against Nocardia was started immediately, mainly based on cotrimoxazole (6 of the 12 cases). In this study, we highlight the heterogeneity of the clinical management of Nocardia spp. in CF. Guidelines for the clinical management of Nocardia infections in CF patients are proposed.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Child
  • Child, Preschool
  • Cystic Fibrosis / complications*
  • France / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Nocardia / classification
  • Nocardia / isolation & purification*
  • Nocardia Infections / drug therapy
  • Nocardia Infections / epidemiology*
  • Nocardia Infections / microbiology
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / epidemiology*
  • Pneumonia, Bacterial / microbiology
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination