{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T15:28:16Z","timestamp":1793028496021,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lung transplant recipients are at heightened risk for nocardiosis compared to other solid organ transplant recipients, with incidence rates as high as 9% and up to 30% associated mortality. No controlled studies assessing risk factors for nocardiosis in this high\u2010risk population have been reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing lung transplantation at a single center between 2012 and 2018 and diagnosed with nocardiosis post\u2010transplant were matched 1:2 to uninfected control subjects on the basis of age, transplant date, and sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of nocardiosis in this lung transplant population was 3.4% (20\/586), occurring a median of 9.4\u00a0months (range 4.4\u201055.2) post\u2010transplant. In multivariable analysis, consistent use of trimethoprim\/sulfamethoxazole (TMP\/SMX) in the 12\u00a0weeks prior to diagnosis was independently associated with protection against nocardiosis (OR 0.038; 95% CI 0.01\u20100.29; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002). Augmented immunosuppression in the 6\u00a0months prior to diagnosis was independently associated with the development of nocardiosis (OR 9.94; 95% CI 1.62\u2010 61.00; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.013). Six case patients (30%) had disseminated disease; all\u2010cause 6\u2010month mortality was 25%. The most common species was <jats:italic>Nocardia farcinica<\/jats:italic> (7\/17 isolates), which was associated with dissemination and mortality. The most active antibiotics were TMP\/SMX (100%), linezolid (100%), and amikacin (76%). Imipenem was only active against 4\/17 isolates (24% susceptibility), with two isolates becoming non\u2010susceptible later in therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Trimethoprim\/sulfamethoxazole prophylaxis was shown to be protective against nocardiosis in lung transplant recipients, while augmented immunosuppression conferred increased risk. Institutional epidemiologic data are needed to best guide empiric therapy for <jats:italic>Nocardia<\/jats:italic>, as historical in vitro data may not predict local susceptibilities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13478","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T05:40:49Z","timestamp":1601358049000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Nocardia prophylaxis, treatment, and outcomes of infection in lung transplant recipients: A matched case\u2010control study"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9736-0891","authenticated-orcid":false,"given":"Kellie J.","family":"Goodlet","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice College of Pharmacy Midwestern University Glendale AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2821-8776","authenticated-orcid":false,"given":"Sofya","family":"Tokman","sequence":"additional","affiliation":[{"name":"Division of Transplant Pulmonology Norton Thoracic Institute Dignity Health St. Joseph's Hospital and Medical Center Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aasya","family":"Nasar","sequence":"additional","affiliation":[{"name":"Division of Transplant Pulmonology Norton Thoracic Institute Dignity Health St. Joseph's Hospital and Medical Center Phoenix AZ USA"},{"name":"Department of Pharmacy Services Dignity Health St. Joseph's Hospital and Medical Center Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5042-0236","authenticated-orcid":false,"given":"Lauren","family":"Cherrier","sequence":"additional","affiliation":[{"name":"Division of Transplant Pulmonology Norton Thoracic Institute Dignity Health St. Joseph's Hospital and Medical Center Phoenix AZ USA"},{"name":"Department of Pharmacy Services Dignity Health St. Joseph's Hospital and Medical Center Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajat","family":"Walia","sequence":"additional","affiliation":[{"name":"Division of Transplant Pulmonology Norton Thoracic Institute Dignity Health St. Joseph's Hospital and Medical Center Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Nailor","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services Dignity Health St. Joseph's Hospital and Medical Center Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1053-2498(01)00394-1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/318150"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2008.00824.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12904"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2014.08.010"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2017.01.005"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12902"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14068"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2008.00338.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2011.06.065"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000012436"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw241"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/514340"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01419-17"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.10.4497-4501.2003"},{"key":"e_1_2_7_17_1","unstructured":"Valley Fever Center for Excellence.Check for risk factors. 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