Risk factors for Nocardia infection among allogeneic hematopoietic cell transplant recipients: A case-control study of the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation

De Greef, J; Averbuch, D; Tondeur, L; Dur&#233;ault, A; Zuckerman, T; Roussel, X; Robin, C; Xhaard, A; Pagliuca, S; Beguin, Y; Botella-Garcia, C; Khanna, N; Le Bourgeois, A; Van Praet, J; Ho, A; Kr&#246;ger, N; Ducastelle Lepr&#234;tre, S; Roos-Weil, D; Aljurf, M; Blijlevens, N; Blau, IW; Carlson, K; Collin, M; Ganser, A; Villate, A; Lakner, J; Martin, S; Nagler, A; Ram, R; Torrent, A; Stamouli, M; Mikulska, M; Gil, L; Wendel, L; Tridello, G; Knelange, N; de la Camara, R; Lortholary, O; Fontanet, A; Styczynski, J; Maertens, J; Coussement, J; Lebeaux, D

Author(s): De Greef, J; Averbuch, D; Tondeur, L; Duréault, A; Zuckerman, T; Roussel, X; Robin, C; Xhaard, A; Pagliuca, S; Beguin, Y; Botella-Garcia, C; Khanna, N; Le Bourgeois, A; Van Praet, J; Ho, A; Kröger, N; Ducastelle Leprêtre, S; Roos-Weil, D; Aljurf, M; Blijlevens, N; Blau, IW; Carlson, K; Collin, M; Ganser, A; Villate, A; Lakner, J; Martin, S; Nagler, A; Ram, R; Torrent, A; Stamouli, M; Mikulska, M; Gil, L; Wendel, L; Tridello, G; Knelange, N; de la Camara, R; Lortholary, O; Fontanet, A; Styczynski, J; Maertens, J; Coussement, J; Lebeaux, D;
Details: Publication Year 2024-04-23,Volume 88,Issue #6,Page 106162
Journal Title: Journal of Infection
Publication Type: Research article
Abstract: OBJECTIVES: Nocardiosis is a rare but life-threatening infection after hematopoietic cell transplantation (HCT). We aimed at identifying risk factors for nocardiosis after allogeneic HCT and clarifying the effect of trimethoprim-sulfamethoxazole prophylaxis on its occurrence. METHODS: We performed a retrospective multicenter case-control study of patients diagnosed with nocardiosis after allogeneic HCT between January 2000 and December 2018. For each case, two controls were matched by center, transplant date, and age group. Multivariable analysis was conducted using conditional logistic regression to identify potential risk factors for nocardiosis. Kaplan-Meier survival curves of cases and controls were compared using log-rank tests. RESULTS: Sixty-four cases and 128 controls were included. Nocardiosis occurred at a median of 9 months after allogeneic HCT (interquartile range: 5-18). After adjustment for potential confounders in a multivariable model, Nocardia infection was associated with tacrolimus use (adjusted odds ratio [aOR] 9.9, 95 % confidence interval [95 % CI]: 1.6-62.7), lymphocyte count < 500/µL (aOR 8.9, 95 % CI: 2.3-34.7), male sex (aOR 8.1, 95 % CI: 2.1-31.5), recent use of systemic corticosteroids (aOR 7.9, 95 % CI: 2.2-28.2), and recent CMV infection (aOR 4.3, 95 % CI: 1.2-15.9). Conversely, use of trimethoprim-sulfamethoxazole prophylaxis was associated with a significantly decreased risk of nocardiosis (aOR 0.2, 95 % CI: 0.1-0.8). HCT recipients who developed nocardiosis had a significantly decreased survival, as compared with controls (12-month survival: 58 % and 90 %, respectively; p < 0.0001). CONCLUSIONS: We identified six factors independently associated with the occurrence of nocardiosis among allogeneic HCT recipients. In particular, trimethoprim-sulfamethoxazole prophylaxis was found to protect against nocardiosis.
Publisher: Elsevier
Keywords: Hsct; Hematopoietic stem cell transplantation; Nocardiosis
Department(s): Infectious Diseases
Publisher's Version: https://doi.org/10.1016/j.jinf.2024.106162
Open Access at Publisher's Site: https://doi.org/10.1016/j.jinf.2024.106162
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-07-04 04:37:41

Last Modified: 2024-07-04 04:49:35