Invasive <i>Nocardia</i> Infections across Distinct Geographic Regions, United States
Simran Gupta, Leah Grant, H. R. Powers, Kathryn E. Kimes, Ahmed Hamdi, Richard Butterfield, Juan Gea‐Banacloche, Prakhar Vijayvargiya, D. Jane Hata, Diana M. Meza Villegas, Adrian C. Dumitrascu, Dana M. Harris, Răzvan M. Chirilă, Nan Zhang, Raymund R. Razonable, Shimon Kusne, Salvador Álvarez, Holenarasipur R. Vikram
Abstract
We reviewed invasive Nocardia infections in 3 noncontiguous geographic areas in the United States during 2011–2018. Among 268 patients with invasive nocardiosis, 48.2% were from Minnesota, 32.4% from Arizona, and 19.4% from Florida. Predominant species were N. nova complex in Minnesota (33.4%), N. cyriacigeorgica in Arizona (41.4%), and N. brasiliensis in Florida (17.3%). Transplant recipients accounted for 82/268 (30.6%) patients overall: 14 (10.9%) in Minnesota, 35 (40.2%) in Arizona, and 33 (63.5%) in Florida. Manifestations included isolated pulmonary nocardiosis among 73.2% of transplant and 84.4% of non–transplant patients and central nervous system involvement among 12.2% of transplant and 3.2% of non–transplant patients. N. farcinica (20.7%) and N. cyriacigeorgica (19.5%) were the most common isolates among transplant recipients and N. cyriacigeorgica (38.0%), N. nova complex (23.7%), and N. farcinica (16.1%) among non–transplant patients. Overall antimicrobial susceptibilities were similar across the 3 study sites.