诺卡菌感染患者的临床特征、病原学特点及预后分析OA

Objective To analyze the clinical characteristics,pathogenic features,and prognosis of patients with Nocardia infection,and provide guidance for the clinical treatment of Nocardia infection.Methods Clinical data of 35 patients with No-cardia infection were collected,including general information,clinical characteristics,imaging,laboratory tests,etiology,treat-ment methods,and prognosis.The resistance rates of different Nocardia species to various antimicrobial agents were calculated.Intergroup comparisons were performed using one-way ANOVA and non-parametric tests for statistical analysis.Results Among 35 patients with Nocardia infection,32 had a history of glucocorticoid and immunosuppressant use;9 had autoimmune diseases,and 29 had respiratory system diseases.Pulmonary infection occurred in 31 cases,mainly manifested as respiratory tract infection symptoms such as fever,cough,sputum production,and shortness of breath.Chest CT examinations frequently showed nodules,patchy opacities,cavities,and pleural effusion.The majority of patients had elevated white blood cell and neutrophil counts,e-rythrocyte sedimentation rate,and procalcitonin to varying degrees.The 35 Nocardia strains included 14 Nocardia cyriacigeorgi-ca,7 Nocardia farcinica,6 Nocardia abscessus,and 5 Nocardia otitidiscaviarum.Drug susceptibility testing results showed that Nocardia otitidiscaviarum had high resistance rates to imipenem,trimethoprim-sulfamethoxazole,cefotaxime,ciprofloxacin,and amoxicillin/clavulanate potassium at 40%,40%,100%,40%,and 40%,respectively;Nocardia farcinica had a high resist-ance rate to cefotaxime at 57.1%;Nocardia cyriacigeorgica had a resistance rate of 100%to amoxicillin/clavulanate potassium;Nocardia brasiliensis had resistance rates of 100%to both cefotaxime and ciprofloxacin;Nocardia wallacei and Nocardia dasson-villei both showed 100%susceptibility rates.Regarding treatment,1 patient received sulfonamide monotherapy,and 21 patients received combination therapy with sulfonamides as the foundation.Four patients experienced disease progression and were dis-charged against medical advice or died,while 31 patients improved and were discharged.Conclusion Nocardia infection is more common in the immunocompromised individuals,mainly affecting the lungs,skin and soft tissues,and blood system.Clinical symptoms,imaging,and laboratory tests lack specificity.Early identification and effective anti-infective treatment are key to im-proving the prognosis of patients with Nocardia nfection.