{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:51:26Z","timestamp":1791258686770,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Nocardia<\/jats:italic>\n                      infection is a rare but severe complication in kidney transplant (KT) recipients, with high morbidity and mortality. Data on antibiotic tolerability in this population are scarce.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective, multicentric study across six Spanish transplant units to analyze clinical characteristics, treatment strategies, and antibiotic tolerability in KT patients diagnosed with\n                      <jats:italic>Nocardia<\/jats:italic>\n                      infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010six cases of\n                      <jats:italic>Nocardia<\/jats:italic>\n                      infection were identified, predominantly in elderly male patients with significant comorbidities and a high immunosuppressive burden. Pulmonary involvement was the most common presentation, although extrapulmonary manifestations also occurred. Only 36% of infections occurred within the first posttransplant year. Most patients received initial combination therapy, followed by prolonged treatment\u2014primarily with trimethoprim\u2013sulfamethoxazole (TMP\u2010SMX) or linezolid. However, antibiotic tolerability was poor: TMP\u2010SMX was discontinued in 80% of cases due to adverse effects, mainly hyperkalemia, metabolic acidosis, and acute kidney injury. Linezolid was withdrawn in 90% of patients because of myelotoxicity. Tedizolid, used in 38.4% of cases, showed better tolerability, with only 20% of treatment discontinuation and no relapses reported during follow\u2010up. Overall, mortality during treatment reached 30.8%, mainly due to infectious causes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This is the largest series of\n                      <jats:italic>Nocardia<\/jats:italic>\n                      infection in KT recipients in Spain and the first to specifically evaluate antibiotic tolerability. TMP\u2010SMX and linezolid were poorly tolerated, reinforcing the need for alternative strategies. Tedizolid showed a favorable safety profile and may be considered a promising first\u2010line option in high\u2010risk patients. Further prospective studies are needed to confirm these findings and support guideline development.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70239","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T15:01:21Z","timestamp":1778943681000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antibiotic Tolerability in\n                    <i>Nocardia<\/i>\n                    Infection Among Kidney Transplant Recipients: A Multicenter Cohort Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6820-2448","authenticated-orcid":false,"given":"M.","family":"P\u00e9rez\u2010Mir","sequence":"first","affiliation":[{"name":"Transplant Nephrology Unit Department of Nephrology Fundaci\u00f3 Puigvert  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Canal Girol","sequence":"additional","affiliation":[{"name":"Transplant Nephrology Unit Department of Nephrology Fundaci\u00f3 Puigvert  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Escol\u00e0\u2010Verg\u00e9","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases; Department of Medicine Hospital de la Santa Creu i Sant Pau; Universitat Aut\u00f2noma de Barcelona Institut D'investigaci\u00f3 Biom\u00e8dica Sant Pau Barcelona Spain"},{"name":"CIBERINFEC ISCIII\u2010CIBER de Enfermedades Infecciosas Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Codina S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Transplant Nephrology Unit Department of Nephrology Bellvitge University Hospital  L'Hospitalet de Llobregat Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. O.","family":"Chamoun","sequence":"additional","affiliation":[{"name":"Transplant Nephrology Unit Department of Nephrology Hospital Del Mar  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.","family":"Casta\u00f1eda","sequence":"additional","affiliation":[{"name":"Transplant Nephrology Unit Department of Nephrology Vall d'Hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Gonzalez Rojas","sequence":"additional","affiliation":[{"name":"Transplant Nephrology Unit Department of Nephrology Hospital Cl\u00ednic of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngela Isabel","family":"Casas Parra","sequence":"additional","affiliation":[{"name":"Transplant Nephrology Unit Department of Nephrology Germans Trias i Pujol University Hospital  Badalona 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