{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:35:13Z","timestamp":1787294113942,"version":"build-2736575974"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nocardiosis primarily affects immunocompromised hosts and those with chronic pulmonary disease but can also occur in immunocompetent patients. Predictors of dissemination and its role in long-term mortality remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adults with nocardiosis diagnosed from January 1, 2010 to December 31, 2023. Patients were categorized into 3 groups: immunocompromised, immunocompetent with chronic lung disease, and immunocompetent without chronic lung disease. We evaluated risk factors associated with dissemination at the time of diagnosis and predictors of 1-year mortality. Multivariable logistic regression identified risk factors for dissemination. Cox regression assessed predictors of 1-year mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 232 patients, 44 (19.0%) had disseminated infection and 36 (15.5%) died within 1-year. Dissemination was more common among patients who were immunocompromised (odds ratio ([OR] 6.26, 95% confidence interval [CI] 2.26\u201320.53) or immunocompetent without chronic lung disease (OR 5.09, 95% CI 1.75\u201317.15). Lymphopenia and infection with Nocardia farcinica were also independently associated with dissemination. Dissemination was not associated with mortality overall (hazard ratio [HR] 1.58, P = .222), though interaction analysis revealed that dissemination was significantly associated with 1-year mortality only in immunocompetent patients with chronic lung disease (HR 9.43, 95% CI 1.73\u201351.52).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immunocompromised patients and those without chronic lung disease are at increased risk for disseminated nocardiosis. While dissemination alone is not predictive of 1-year mortality overall, it is directly associated with mortality among immunocompetent patients with chronic lung disease. These findings highlight the need for tailored prognostic assessment and management in this subgroup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag008","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T12:54:37Z","timestamp":1767963277000},"source":"Crossref","is-referenced-by-count":6,"title":["Risk Factors and Outcomes of Disseminated Nocardiosis Across Host Risk Groups"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6729-0880","authenticated-orcid":false,"given":"Maria","family":"Vega Brizneda","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Cleveland Clinic , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1296-9105","authenticated-orcid":false,"given":"Cyndee","family":"Miranda","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Cleveland Clinic , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Cober","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Cleveland Clinic , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6175-6755","authenticated-orcid":false,"given":"Anisha","family":"Misra","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Cleveland Clinic , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8112-0896","authenticated-orcid":false,"given":"Susan","family":"Harrington","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Cleveland Clinic , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2098-2868","authenticated-orcid":false,"given":"Zachary A","family":"Yetmar","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Cleveland Clinic , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"2026012010313008600_ofag008-B1","doi-asserted-by":"crossref","first-page":"e0002721","DOI":"10.1128\/cmr.00027-21","article-title":"Updated Review on Nocardia Species: 2006\u20132021","volume":"35","author":"Traxler","year":"2022","journal-title":"Clin Microbiol Rev"},{"key":"2026012010313008600_ofag008-B2","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1093\/cid\/ciae643","article-title":"State-of-the-art review: modern approach to Nocardiosis\u2014diagnosis, management, and uncertainties","volume":"80","author":"Yetmar","year":"2025","journal-title":"Clin Infect Dis"},{"key":"2026012010313008600_ofag008-B3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/ctr.13509","article-title":"Nocardia infections in solid organ transplantation: guidelines from the infectious diseases community of practice of the American society of transplantation","volume":"33","author":"Restrepo","year":"2019","journal-title":"Clin Transplant"},{"key":"2026012010313008600_ofag008-B4","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.jinf.2022.05.029","article-title":"Prognosis and factors associated with disseminated nocardiosis: a ten-year multicenter study","volume":"85","author":"Soueges","year":"2022","journal-title":"J Infect"},{"key":"2026012010313008600_ofag008-B5","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1097\/TP.0000000000004343","article-title":"Outcomes of nocardiosis and treatment of disseminated infection in solid organ 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