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Volume 29, Number 12—December 2023
CME ACTIVITY - Synopsis

Invasive Nocardia Infections across Distinct Geographic Regions, United States

Simran Gupta1, Leah M. Grant, Harry R. Powers, Kathryn E. Kimes2, Ahmed Hamdi3, Richard J. Butterfield, Juan Gea-Banacloche4, Prakhar Vijayvargiya5, D. Jane Hata, Diana M. Meza Villegas, Adrian C. Dumitrascu, Dana M. Harris, Razvan M. Chirila, Nan Zhang, Raymund R. Razonable, Shimon Kusne, Salvador Alvarez, and Holenarasipur R. VikramComments to Author 
Author affiliations: Mayo Clinic Arizona, Phoenix, Arizona, USA (S. Gupta, L.M. Grant, K.E. Kimes, R.J. Butterfield, J. Gea-Banacloche, N. Zhang, S. Kusne, H.R. Vikram); Mayo Clinic Jacksonville, Jacksonville, Florida, USA (H.R. Powers, D.J. Hata, D.M. Meza Villegas, A.C. Dumitrascu, D.M. Harris, R.M. Chirila, S. Alvarez); Mayo Clinic Rochester, Rochester, Minnesota, USA (A. Hamdi, P. Vijayvargiya, R.R. Razonable)

Main Article

Table 4

Choice of initial/empiric antimicrobials and subsequent antimicrobials after susceptibilities were reported in study of invasive Nocardia infections across 3 distinct geographic regions, United States*

Initial treatment No. (%) Treatment after species confirmation and antimicrobial susceptibility testing results
AM/
CL CEF CTX IMP CIP MOX CLA AMI TOB DOX MIN TMP/
SMX LIN SUL Other†
AM/CL
 7 (2.6)
 57
 0
 0
 14
 14
 14
 14
 0
 0
 0
 0
 57
 0
 0
 0
CEF
 3 (1.1)
 0
 100
 0
 0
 0
 0
 0
 0
 33
 33
 0
 67
 0
 0
 0
CTX
 22 (8.2)
 14
 0
 27
 5
 5
 18
 9
 5
 0
 9
 14
 45
 5
 9
 5
IMP
 49 (18.3)
 16
 0
 8
 22
 0
 22
 8
 2
 0
 4
 31
 69
 0
 4
 2
CIP
 7 (2.6)
 14
 0
 0
 0
 86
 0
 0
 0
 0
 0
 14
 43
 14
 0
 29
MOX
 19 (7.1)
 11
 0
 11
 16
 0
 74
 11
 0
 0
 5
 16
 37
 0
 0
 0
CLA
 10 (3.7)
 0
 0
 0
 0
 10
 20
 80
 10
 0
 0
 10
 20
 0
 0
 10
AMI
 8 (3.0)
 25
 0
 0
 0
 13
 13
 25
 13
 0
 0
 13
 75
 0
 13
 0
TOB
 2 (0.8)
 0
 50
 0
 0
 0
 0
 0
 0
 50
 0
 0
 50
 0
 0
 0
DOX
 15 (5.6)
 20
 7
 0
 20
 7
 13
 0
 0
 0
 33
 0
 73
 0
 7
 0
MIN
 27 (10.1)
 11
 0
 7
 7
 4
 30
 7
 0
 0
 4
 37
 52
 0
 0
 0
TMP/SMX
 153 (57.1)
 6
 1
 7
 5
 5
 5
 17
 3
 1
 4
 10
 82
 2
 3
 3
LIN
 21 (7.8)
 19
 0
 10
 19
 5
 33
 5
 0
 0
 5
 38
 57
 5
 10
 0
SUL
 4 (1.5)
 25
 0
 50
  
 0
 25
 0
 0
 0
 0
 25
 0
 0
 75
 0
Other 15 (5.6) 7 0 7 7 13 0 0 0 0 13 13 60 0 0 13

*Gray shaded cells show percentages of patients in which initial antimicrobial was retained as part of subsequent therapy. AM/CL, amoxicillin/clavulanic acid; CEF, cefepime; CTX, ceftriaxone; IMP, imipenem; CIP, ciprofloxacin; MOX, moxifloxacin; CLA, clarithromycin; AMI, amikacin; TOB, tobramycin; DOX, doxycycline; MIN, minocycline; TMP/SMX, trimethoprim/sulfamethoxazole; LIN, linezolid, SUL, sulfadiazine †Other species (n<5 each): N. amikacinitolerans (1), N. asiatica (1), N. asteroides complex (3), N. beijingensis (3), N. carnea (1), N. cerradoensis (1), N. exalbida (1), N. flavorosea (1), N. kruczakiae (1), N. niwae (2), N. otitidiscaviarum (1), N. pseudobrasiliensis (4), N. puris (1), N. takedensis (3), N. vermiculata (1), N. vinacea (1), and N. yamanashiensis (1); no species identified (9).

Main Article

1Current affiliation: Simran Gupta, Massachusetts General Hospital & Brigham and Women’s Hospital, Boston, Massachusetts, USA.

2Current affiliation: Kathryn E. Kimes, Honor Health, Phoenix, Arizona, USA.

3Current affiliation: Ahmed Hamdi, Baylor College of Medicine, Houston, Texas, USA.

4Current affiliation: Juan Gea-Banacloche, National Institute for Allergy and Infectious Diseases, Bethesda, Maryland, USA.

5Current affiliation: Prakhar Vijayvargiya, University of Mississippi Medical Center, Jackson, Mississippi, USA.

Page created: September 26, 2023
Page updated: November 17, 2023
Page reviewed: November 17, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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