TY  - JOUR
A1  - Ott, Sebastian Robert
A1  - Meier, Niklaus
A1  - Kolditz, Martin
A1  - Bauer, Torsten Thomas
A1  - Rohde, Gernot Gerhard Ulrich
A1  - Presterl, Elisabeth
A1  - Schürmann, Dirk
A1  - Lepper, Philipp Moritz
A1  - Ringshausen, Felix Christian
A1  - Flick, Holger
A1  - Leib, Stephen L.
A1  - Pletz, Mathias Wilhelm Rudolf
T1  - Pulmonary nocardiosis in Western Europe − clinical evaluation of 43 patients and population-based estimates of hospitalization rates
T2  - International journal of infectious diseases
N2  - Background: Pulmonary nocardiosis (PN) is an uncommon but potentially life-threatening infection. Most of our knowledge is derived from case reports or smaller case series. Recently, increasing PN incidence rates have been reported. We aim to describe the clinical course of and risk factors for PN in four Western European countries and to estimate population-based annual hospitalization rates.
Methods: Retrospective evaluation (1995 to 2011) of the clinical course of and risk factors for PN in patients from 11 hospitals in four European countries (Germany, Austria, Switzerland and The Netherlands). Calculation of population-based estimates of hospitalization rates of PN in Germany (2005 to 2011) using official German nationwide diagnosis-related groups (DRG) hospital statistics.
Results: Forty-three patients fulfilled stringent criteria for proven (n = 8) and probable (n = 35) PN; seven with extrapulmonary dissemination. Within the 43 patients, major PN risk factors were immunocompromising (83.7%) and/or pulmonary (58.1%; in 27.9% as only comorbidity) comorbidities. Median duration of PN targeted therapy was 12 weeks. Distinguished patterns of resistance were observed (imipenem susceptibility: N. farcinica 33.3%; N. asteroides 66.7%). Overall mortality rate was 18.9%; in disseminated PN 50%. Over time, annual PN hospitalization rates remained unchanged at around 0.04/100′000 with the highest rate among men aged 75–84 years (0.24/100′000).
Conclusion: PN is rare, but potentially life-threatening, and mainly affects immunocompromised elder males. Overall annual hospitalization rates remained stable between 2005 and 2011.
KW  - nocardia
KW  - nocardiosis
KW  - pulmonary nocardiosis
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/48845
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-488453
SN  - 1878-3511
SN  - 1201-9712
N1  - © 2019 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
VL  - 81
SP  - 140
EP  - 148
PB  - Elsevier
CY  - Amsterdam [u.a.]
ER  -