[Clinical, microbiological, and therapeutic aspects of Nocardia sp. infections in the Bordeaux hospital from 1993 to 2003].

OBJECTIVE

Our goal was to describe the epidemiological, clinical, and microbiological characteristics of nocardiosis in the Bordeaux teaching hospital, between January 1, 1993 and December 31, 2003.

DESIGNS

The retrospective study included patients examined between January 1, 1993 and December 31, 2003 in whom a Nocardia bacterium had been identified from a biological sample.

RESULTS

Twenty-four out of 30 Nocardia sp. strains identified during the study period were classified as colonizing strains. 19 patients presented with risk factors for nocardiosis. Nocardia asteroïdes were found in 22 samples, mainly from pulmonary samples. 11 cases of infection due to Nocardia sp. were reported during the study period. Immunosuppression was reported in 7 cases. The clinical forms were not specific. The species incriminated belonged to the N. asteroïdes complex in 8 cases. Treatment consisted in a combination of 2 or 3 molecules including cotrimoxazole for an average duration of 9 months. 9 patients recovered.

CONCLUSIONS

The variability of clinical presentation and the lack of standard identification methods delayed the diagnostic. The treatment is not well defined. Clinical strains should be reported to the reference laboratory and prospective studies are necessary.