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Medical Microbiology and Immunology

, Volume 204, Issue 4, pp 493–504 | Cite as

A French multicentric study and review of pulmonary Nocardia spp. in cystic fibrosis patients

  • Verónica Rodriguez-Nava
  • Stéphane Durupt
  • Sandra Chyderiotis
  • Anne-Marie Freydière
  • Judith Karsenty
  • Michèle de Montclos
  • Philippe Reix
  • Isabelle Durieu
  • Raphaele Nove-Josserand
  • Raphael Chiron
  • François Bremont
  • Laurent Têtu
  • Marlène Murris
  • Dominique Terru
  • Sylvain Godreuil
  • Emmanuelle Bergeron
  • Jean Freney
  • Patrick Boiron
  • François Vandenesch
  • Hélène Marchandin
  • Christine Segonds
  • Anne Doléans-Jordheim
Original Investigation

Abstract

Some bacterial species recovered from the airways of cystic fibrosis (CF) patients are indisputably associated with lung infections, whereas the clinical relevance of others, such as Nocardia spp., remains unclear. Sixteen French CF cases of colonization/infection with Nocardia spp. were reviewed in order to evaluate the epidemiology, the clinical impact and the potential treatment of these bacteria, and results were compared to those of the literature. Five Nocardia species were identified, Nocardia cyriacigeorgica being the major species (50 % of cases). At first isolation, Nocardia was the sole pathogen recovered in six patients. Seven patients presented pulmonary exacerbation. For 12 patients, antimicrobial treatment against Nocardia was started immediately, mainly based on cotrimoxazole (6 of the 12 cases). In this study, we highlight the heterogeneity of the clinical management of Nocardia spp. in CF. Guidelines for the clinical management of Nocardia infections in CF patients are proposed.

Keywords

Nocardia Cystic fibrosis Lung infections Antimicrobial therapy Guidelines 

Notes

Acknowledgments

The authors would like to thank Margaux Burguière for her help in collecting data from the CF Center of the University Hospital of Montpellier and the technician team of the different microbiological laboratories (Lyon, Montpellier and Toulouse) and of the FON for their excellent technical assistance.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Verónica Rodriguez-Nava
    • 1
    • 2
    • 3
    • 4
  • Stéphane Durupt
    • 5
  • Sandra Chyderiotis
    • 6
  • Anne-Marie Freydière
    • 6
  • Judith Karsenty
    • 5
  • Michèle de Montclos
    • 7
  • Philippe Reix
    • 8
  • Isabelle Durieu
    • 5
  • Raphaele Nove-Josserand
    • 5
  • Raphael Chiron
    • 9
  • François Bremont
    • 10
  • Laurent Têtu
    • 11
  • Marlène Murris
    • 11
  • Dominique Terru
    • 12
  • Sylvain Godreuil
    • 12
  • Emmanuelle Bergeron
    • 1
    • 2
    • 3
    • 4
  • Jean Freney
    • 1
    • 2
    • 3
    • 6
  • Patrick Boiron
    • 1
    • 2
    • 3
    • 4
  • François Vandenesch
    • 1
    • 2
    • 6
    • 13
    • 14
  • Hélène Marchandin
    • 12
    • 15
  • Christine Segonds
    • 16
  • Anne Doléans-Jordheim
    • 1
    • 2
    • 3
    • 6
    • 17
  1. 1.Université de LyonLyonFrance
  2. 2.Université Claude Bernard Lyon 1LyonFrance
  3. 3.Groupe de recherche «Bactérie Pathogènes Opportunistes et Environnement», UMR CNRS 5557 Ecologie MicrobienneUniversité Claude Bernard Lyon1, CNRS, VetAgro Sup, ISPBVilleurbanneFrance
  4. 4.Observatoire Français des NocardiosesISPBLyonFrance
  5. 5.Département de médecine interne, Centre de Ressources et de Compétences pour la Mucoviscidose Adultes, Centre Hospitalier Lyon-SudHospices Civils de LyonPierre-BéniteFrance
  6. 6.Laboratoire de Bactériologie, Centre de Biologie EstHospices Civils de LyonBronFrance
  7. 7.Laboratoire de Bactériologie, Centre Hospitalier Lyon-SudHospices Civils de LyonPierre-BéniteFrance
  8. 8.Service de Pneumologie et Allergologie Pédiatriques, Centre Ressources et de Compétences pour la Mucoviscidose EnfantsHôpital Femme Mère Enfant-Groupement Hospitalier EstBronFrance
  9. 9.Centre Ressources et de Compétences pour la Mucoviscidose Adultes et Enfants, Pédiatrie et pneumologieHôpital Arnaud de VilleneuveMontpellierFrance
  10. 10.Centre Ressources et de Compétences pour la Mucoviscidose Enfants, Pédiatrie-Pneumologie, Allergologie, Pôle EnfantsHôpital des EnfantsToulouseFrance
  11. 11.Service de Pneumologie-Allergologie, Centre Ressources et de Compétences pour la Mucoviscidose AdultesHôpital LarreyToulouseFrance
  12. 12.Laboratoire de Bactériologie, Hôpital Arnaud de VilleneuveCHRU de MontpellierMontpellierFrance
  13. 13.U851 INSERMLyonFrance
  14. 14.Centre National de référence des Staphylocoques, Faculté de Médecine Lyon EstUniversité de LyonLyonFrance
  15. 15.UMR5119 ECOSYM, Equipe Pathogènes et EnvironnementsUniversité Montpellier 1MontpellierFrance
  16. 16.Laboratoire de Bactériologie-Hygiène, Hôpital PurpanCHU ToulouseToulouseFrance
  17. 17.Laboratoire de Microbiologie, UMR CNRS 5557 Ecologie MicrobienneISPBLyon Cedex 08France

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