{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T16:59:19Z","timestamp":1773939559959,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,5,7]],"date-time":"2018-05-07T00:00:00Z","timestamp":1525651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["5T32AI100851"],"award-info":[{"award-number":["5T32AI100851"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Nocardia<\/jats:italic> are uncommon pathogens that disproportionately afflict the immunocompromised host. Epidemiology and outcome data of <jats:italic>Nocardia<\/jats:italic> infections in transplant recipients are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective chart review of all patients at Duke University Hospital with a history of solid organ transplant (SOT) or hematopoietic cell transplant (HCT) and at least one positive culture for <jats:italic>Nocardia<\/jats:italic> between 1996 and 2013. Our aim was to describe the epidemiology and outcomes of <jats:italic>Nocardia<\/jats:italic> infections in the transplanted host.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the 18\u2010year study period, 51 patients (14 HCT and 37 SOT recipients) had <jats:italic>Nocardia<\/jats:italic> infection. <jats:italic>Nocardia<\/jats:italic> incidence was stable during the study period in all populations except heart transplants, whose incidence declined. Infection occurred earlier in the HCT group than the SOT group (median time to diagnosis of 153 and 370\u00a0days, respectively). In both groups, the most common site involved was the lung. Outcomes were overall poor, especially in the HCT group with a cure rate of 29%. Heart transplant recipients had significantly better overall survival (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05) than other patients. Trimethoprim\u2010sulfamethoxazole (TMP\u2010SMX) prophylaxis did not provide complete protection from <jats:italic>Nocardia<\/jats:italic> infections, nor did it appear to select for resistant <jats:italic>Nocardia<\/jats:italic> isolates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Infections with <jats:italic>Nocardia<\/jats:italic> are typically a late post\u2010transplant complication. The use of TMP\u2010SMX prophylaxis was not associated with TMP\u2010SMX\u2010resistant <jats:italic>Nocardia<\/jats:italic>. Overall outcomes remain poor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12902","type":"journal-article","created":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T16:09:24Z","timestamp":1524067764000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["<i>Nocardia<\/i> infections in the transplanted host"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-6815","authenticated-orcid":false,"given":"Marion","family":"Hemmersbach\u2010Miller","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and International Health Department of Medicine Duke University Medical Center  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason E.","family":"Stout","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health Department of Medicine Duke University Medical Center  Durham NC 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