ArticleBMC infectious diseases2026
Multi-year population-based study of the clinical and epidemiological risk factors for mortality in nocardiosis: survival analysis from a large regional Canadian healthcare region.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNocardiae are ubiquitous environmental soil pathogens that primarily cause invasive infections by inhalation or direct skin inoculation in immunocompromised patients. This multi-year population-based study compared epidemiological and clinical features of all cases diagnosed in our region.
methodsPatients were enrolled in our large integrated healthcare region with culture-proven nocardiosis between 2010 and 2021. Clinical chart reviews were conducted to determine the clinical manifestations, risk factors, treatment and mortality including survival analysis.
resultsNinety-four adults had a mean age of 61 ± 17 years. More cases occurred in males (57%) than females (43%). 96% of cases had underlying co-morbidities including diabetes, liver or renal failure, malignancy, transplant recipients, chronic lung disease, rheumatologic disease, or other inflammatory conditions. Pulmonary (53%) or skin and soft tissue infections (SSTIs) (30%) commonly occurred with infrequent diagnoses of central nervous system infection (CNS) (7%), bloodstream infection (BSI) (6%), and septic arthritis or intra-abdominal infection (IAI) (6%). Diverse Nocardia spp. were isolated, but 3 species complexes caused most cases [56/94 (60%)] including Nocardia farcinica (n = 21, 22.3%), Nocardia cyriacigeorgica (n = 16, 17%) and Nocardia nova (n = 19, 20.2%). Clinical presentation was not unique for individual Nocardia spp. INFECTIONS: Overall mortality was 17.6% with a 1-year mortality of 13.2%. Delayed diagnosis (≥ 30 d) from symptom onset had higher mortality. A trend towards increased mortality occurred for N. farcinica > N. cyriacigeorgica > N. nova complex infections.
conclusionsPrompt diagnosis of nocardiosis improves patient outcomes. Nocardia species-level identification predicts mortality for major species complexes causing nocardiosis in our region. CLINICA TRIAL NUMBER: Not applicable.
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