{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T04:41:25Z","timestamp":1759898485359,"version":"build-2065373602"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To comprehensively analyze the relevant factors influencing the treatment efficacy of <jats:italic>Nocardia farcinica<\/jats:italic> pneumonia, construct and validate a prediction model to provide a scientific basis for clinical treatment, and realize visual prediction using a nomogram.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical data of 150 patients with <jats:italic>Nocardia farcinica<\/jats:italic> pneumonia collected from January 2020 to December 2024 were selected and divided into a training set (<jats:italic>n<\/jats:italic> = 105) and a validation set (<jats:italic>n<\/jats:italic> = 45) at a ratio of 7:3. The data covered patients\u2019 basic information, laboratory examination indicators, imaging features, and treatment regimens. Risk factors were screened by univariate and multivariate logistic regression in the training set to construct a nomogram model. The receiver operating characteristic curve (ROC) and calibration curve were plotted to evaluate the model\u2019s efficacy and were validated in the validation set. Decision curve analysis (DCA) was used to evaluate the clinical value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the training set, 26 cases (24.32%) exhibited poor treatment response, while 11 cases (25.25%) were identified in the validation set. Multivariate analysis identified serum albumin levels, empyema, cavitary lesions, and antibiotic regimens (sulfonamides\/cephalosporins\/carbapenems) as independent factors influencing the therapeutic efficacy of <jats:italic>Nocardia farcinica<\/jats:italic> pneumonia. In the training and validation sets, the model achieved C-index values of 0.849 and 0.831, with areas under the ROC curve (AUC) of 0.849 (95% <jats:italic>CI:<\/jats:italic> 0.764\u20130.935) and 0.831 (95% <jats:italic>CI<\/jats:italic>: 0.580\u20131.000), respectively. The sensitivity and specificity were 0.772 and 0.895 in the training set, and 0.773 and 0.857 in the validation set, indicating predictive capability for treatment outcomes. The nomogram model exhibited excellent predictive accuracy upon calibration curve analysis. Decision curve analysis (DCA) further confirmed its high clinical utility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Beyond confirming the role of host immunity and inflammation, this study develops and validates the first nomogram that integrates baseline albumin, empyema, cavitation, and antibiotic choice to quantitatively predict individual treatment failure risk in <jats:italic>Nocardia farcinica<\/jats:italic> pneumonia. This tool provides an immediately applicable visual guide for early risk stratification and personalized therapy selection, addressing a significant gap in the management of this complex infection.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1651397","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T04:17:02Z","timestamp":1759897022000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Influencing factors and nomogram model for predicting treatment efficacy in Nocardia farcinica pneumonia"],"prefix":"10.3389","volume":"12","author":[{"given":"Hongyan","family":"Ren","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoju","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Mu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijie","family":"Kou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yafei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1186\/s13054-023-04608-1","article-title":"Pneumocystis jirovecii pneumonia in intensive care units: a multicenter study by ESGCIP and EFISG.","volume":"27","author":"Giacobbe","year":"2023","journal-title":"Crit Care"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1016\/j.chest.2024.01.015","article-title":"Characteristics and prognosis factors of Pneumocystis jirovecii pneumonia according to underlying disease: a retrospective multicenter study.","volume":"165","author":"L\u00e9cuyer","year":"2024","journal-title":"Chest"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1016\/j.chest.2021.11.007","article-title":"Primary prophylaxis for Pneumocystis jirovecii pneumonia in patients receiving rituximab.","volume":"161","author":"Park","year":"2022","journal-title":"Chest"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1016\/j.chest.2022.12.044","article-title":"Guided bronchoscopy for the evaluation of pulmonary lesions: an updated meta-analysis.","volume":"163","author":"Nadig","year":"2023","journal-title":"Chest"},{"key":"B5","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1016\/j.cmi.2024.03.037","article-title":"Comparative efficacy and safety of Pneumocystis jirovecii pneumonia prophylaxis regimens for people living with HIV: a systematic review and network meta-analysis of randomized controlled trials.","volume":"30","author":"Prosty","year":"2024","journal-title":"Clin Microbiol Infect"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e0010122","DOI":"10.1128\/cmr.00101-22","article-title":"Pneumocystis jirovecii pneumonia in people living with HIV: a review.","volume":"37","author":"McDonald","year":"2024","journal-title":"Clin Microbiol Rev"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.3390\/pathogens12101265","article-title":"Pneumocystis jirovecii Pneumonia after heart transplantation: two case reports and a review of the literature.","volume":"12","author":"Burzio","year":"2023","journal-title":"Pathogens"},{"key":"B8","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1002\/phar.2733","article-title":"Prophylaxis for Pneumocystis jirovecii pneumonia in patients with inflammatory bowel disease: a systematic review.","volume":"42","author":"Sierra","year":"2022","journal-title":"Pharmacotherapy"},{"key":"B9","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.biopsych.2023.06.008","article-title":"Genetic overlap between global cortical brain structure, C-reactive protein, and white blood cell counts.","volume":"95","author":"Parker","year":"2024","journal-title":"Biol Psychiatry"},{"key":"B10","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.rxeng.2022.08.002","article-title":"Organizing pneumonia.","volume":"64","author":"Arenas-Jim\u00e9nez","year":"2022","journal-title":"Radiologia"},{"key":"B11","first-page":"756","article-title":"C- reactive protein in the early diagnosis of pneumonia complicating severe blunt chest trauma.","volume":"101","author":"Trabelsi","year":"2023","journal-title":"Tunis Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"106894","DOI":"10.1016\/j.rmed.2022.106894","article-title":"Serum C-reactive protein-to-albumin ratio is a potential risk indicator for pneumonia: findings from a prospective cohort study.","volume":"199","author":"Kunutsor","year":"2022","journal-title":"Respir Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.3390\/jcm12031049","article-title":"Pleural effusion in COVID-19 pneumonia: clinical and prognostic implications-An observational, retrospective study.","volume":"12","author":"Cappelli","year":"2023","journal-title":"J Clin Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"15738","DOI":"10.3390\/ijms232415738","article-title":"Nanomaterials for delivering antibiotics in the therapy of pneumonia.","volume":"23","author":"Tang","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B15","doi-asserted-by":"publisher","first-page":"51","DOI":"10.3390\/molecules28010051","article-title":"Sulfonamides with heterocyclic periphery as antiviral agents.","volume":"28","author":"Moskalik","year":"2022","journal-title":"Molecules"},{"key":"B16","doi-asserted-by":"publisher","first-page":"239","DOI":"10.5935\/2965-2774.20230404-en","article-title":"Sulfonamide-induced acute eosinophilic pneumonia requiring extracorporeal membrane oxygenation support: a case report.","volume":"35","author":"Silva","year":"2023","journal-title":"Crit Care Sci"},{"key":"B17","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/S2213-2600(23)00418-6","article-title":"Individualised, short-course antibiotic treatment versus usual long-course treatment for ventilator-associated pneumonia (REGARD-VAP): a multicentre, individually randomised, open-label, non-inferiority trial.","volume":"12","author":"Mo","year":"2024","journal-title":"Lancet Respir Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"241","DOI":"10.2478\/rjim-2024-0013","article-title":"Inflammatory biomarker-based clinical practice in patients with pneumonia: a systematic review of randomized controlled trials.","volume":"62","author":"Dimitropoulos","year":"2024","journal-title":"Rom J Intern Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1651397\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T04:17:03Z","timestamp":1759897023000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1651397\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":18,"alternative-id":["10.3389\/fmed.2025.1651397"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1651397","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]},"article-number":"1651397"}}