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Volume 29, Number 12—December 2023
CME ACTIVITY - Synopsis

Invasive Nocardia Infections across Distinct Geographic Regions, United States

Simran Gupta1, Leah M. Grant, Harry R. Powers, Kathryn E. Kimes2, Ahmed Hamdi3, Richard J. Butterfield, Juan Gea-Banacloche4, Prakhar Vijayvargiya5, D. Jane Hata, Diana M. Meza Villegas, Adrian C. Dumitrascu, Dana M. Harris, Razvan M. Chirila, Nan Zhang, Raymund R. Razonable, Shimon Kusne, Salvador Alvarez, and Holenarasipur R. VikramComments to Author 
Author affiliations: Mayo Clinic Arizona, Phoenix, Arizona, USA (S. Gupta, L.M. Grant, K.E. Kimes, R.J. Butterfield, J. Gea-Banacloche, N. Zhang, S. Kusne, H.R. Vikram); Mayo Clinic Jacksonville, Jacksonville, Florida, USA (H.R. Powers, D.J. Hata, D.M. Meza Villegas, A.C. Dumitrascu, D.M. Harris, R.M. Chirila, S. Alvarez); Mayo Clinic Rochester, Rochester, Minnesota, USA (A. Hamdi, P. Vijayvargiya, R.R. Razonable)

Main Article

Table 1

Patient demographics and coexisting conditions by site of diagnosis and transplant status in study of invasive Nocardia infections across 3 distinct geographic regions, United States*

Category
Site of diagnosis
Transplant recipient
Total, n = 268
MN, n = 129 AZ, n = 87
FL, n = 52 No, n = 186 Yes, n = 82
Demographics
Age, mean (SD) 63.4 (16.3) 65.9 (15.0) 61.2 (11.7) 66.1 (15.7) 58.6 (12.4) 63.8 (15.1)
Sex
M 61 (47.3) 41 (47.1) 37 (71.2) 83 (44.6) 56 (68.3) 139 (51.9)
F 68 (52.7) 46 (52.9) 15 (28.8) 103 (55.4) 26 (31.7) 129 (48.1)
White 121 (97.6) 71 (84.5) 39 (76.5) 173 (96.6) 58 (72.5) 231 (89.2)
Hispanic
0 (0.0)
12 (14.0)
3 (5.9)
4 (2.2)
11 (13.4)
15 (5.7)
Coexisting conditions
Diabetes 7 (5.4) 18 (20.7) 23 (44.2) 12 (6.5) 36 (43.9) 48 (17.9)
Liver failure 4 (3.1) 1 (1.1) 2 (3.8) 1 (0.5) 6 (7.3) 7 (2.6)
Renal failure/dialysis 6 (4.7) 4 (4.6) 17 (32.7) 2 (1.1) 25 (30.5) 27 (10.1)
Active malignancy 16 (12.5) 12 (13.8) 13 (25.0) 26 (14.0) 15 (18.5) 41 (15.4)
Rheumatologic conditions 21 (16.4) 5 (5.7) 7 (13.5) 28 (15.1) 5 (6.2) 33 (12.4)
Chronic lung disease 95 (74.8) 34 (39.1) 27 (51.9) 130 (69.9) 26 (32.5) 156 (58.6)
Transplant recipient
14 (10.9)
35 (40.2)
33 (63.5)
NA
NA
82 (30.6)
Transplanted organs
Kidney 2 (14.3) 18 (51.4) 13 (39.4) NA 33 (40.2) 33 (40.2)
Liver 2 (14.3) 2 (5.7) 1 (3.0) NA 5 (6.1) 5 (6.1)
Pancreas 1 (7.1) 0 0 NA 1 (1.2) 1 (1.2)
Lung 1 (7.1) 0† 12 (36.4) NA 13 (15.9) 13 (15.9)
Heart 2 (14.3) 9 (25.7) 2 (6.1) NA 13 (15.9) 13 (15.9)
Kidney and liver 1 (7.1) 0 1 (3.0) NA 2 (2.4) 2 (2.4)
Kidney and pancreas 0 0 3 (9.1) NA 3 (3.7) 3 (3.7)
HSCT
5 (35.7) 6 (17.1)
1 (3.0) NA 12 (14.6) 12 (14.6)

*Values are no. (%) patients except at indicated. AZ, Mayo Clinic Arizona, Phoenix/Scottsdale, Arizona, USA; FL, Mayo Clinic Florida, Jacksonville, Florida, USA; HSCT, hematopoietic stem cell transplant; MN, Mayo Clinic Rochester, Rochester, Minnesota, USA; NA, not applicable. †Lung transplantations not performed at Mayo Clinic Arizona during study period.

Main Article

1Current affiliation: Simran Gupta, Massachusetts General Hospital & Brigham and Women’s Hospital, Boston, Massachusetts, USA.

2Current affiliation: Kathryn E. Kimes, Honor Health, Phoenix, Arizona, USA.

3Current affiliation: Ahmed Hamdi, Baylor College of Medicine, Houston, Texas, USA.

4Current affiliation: Juan Gea-Banacloche, National Institute for Allergy and Infectious Diseases, Bethesda, Maryland, USA.

5Current affiliation: Prakhar Vijayvargiya, University of Mississippi Medical Center, Jackson, Mississippi, USA.

Page created: September 26, 2023
Page updated: November 17, 2023
Page reviewed: November 17, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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