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Volume 17, Number 9—September 2011

Research

Central Venous Catheter–associated Nocardia Bacteremia in Cancer Patients

Fadi Al Akhrass, Ray Hachem, Jamal A. Mohamed, Jeffrey Tarrand, Dimitrios P. Kontoyiannis, Jyotsna Chandra, Mahmoud Ghannoum, Souha Haydoura, Ann Marie Chaftari, and Issam RaadComments to Author 
Author affiliations: Author affiliations: The University of Texas MD Anderson Cancer Center, Houston, Texas, USA (F. Al Akhrass, R. Hachem, J.A. Mohamed, J. Tarrand, D.P. Kontoyiannis, A.M. Chaftari, I. Raad); Case Western Reserve University, Cleveland, Ohio, USA (J. Chandra, M. Ghannoum); University Hospitals Case Medical Center, Cleveland (J. Chandra, M. Ghannoum); Kansas University School of Medicine, Wichita, Kansas, USA (S. Haydoura)

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Table 1

Characteristics and outcomes of 17 cancer patients with Nocardia bacteremia, The University of Texas MD Anderson Cancer Center, January 1998–March 2010*

Characteristic Disseminated bacteremia (n = 7), no. (%) patients CLABSI (n = 10), no. (%) patients p value
Male sex
3 (43)
4 (40)
>0.99
Cancer type 0.044
Hematologic 7 (100) 5 (50)
Solid tumor
0
5 (50)

Concomitant infection 7 (100) 5 (50) 0.044
Cytomegalovirus 4 (57) 1 (10) 0.1
Invasive fungus
3 (42)
1 (10)
0.25
Nocardia type† 0.74
N. nova complex 3 (43) 3 (30)
N. asteroides complex 1 (14 ) 4 (40)
N. veterana 1 (17) 1 (11)
N. brasiliensis 1 (17) 0
N. puris
0
1 (11)

Antimicrobial drug treatment outcome
Response to therapy 5 (71) 9 (90) 0.54
Response within 72 h 0 9 (90) <0.001
Response within 7 d
2 (29)
9 (90)
0.035
Death within 3 mo
3 (43)
1 (10)
0.25
Nocardia bacteremia breakthrough despite trimethoprim/sulfamethoxazole prophylaxis 1 2 >0.99

*CLABSI, central line–associated bloodstream infection. Patient median age (range) for those with disseminated infection 56 y (32–73 y), for those with CLABSI 44 y (11–77 y); p = 0.31. Median hospital stay (range) for those with disseminated infection 24 d (8–53 d), for those with CLABSI 5 d (2–18 d); p = 0.01. Median antimicrobial drug treatment duration (range) for those with disseminated infection 50 d (21–105 d), for those with CLABSI 82 d (14–120 d); p = 0.56.
†Species were not determined for 2 isolates.

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