PDF(Pubmed)
Abstract：
BACKGROUND: Nocardia species can cause local or disseminated infection. Prompt diagnosis and appropriate treatment of nocardiosis are required, because it can cause significant morbidity and mortality. Knowledge of local species distribution and susceptibility patterns is important to appropriate empiric therapy. However, knowledge on the epidemiology and antimicrobial susceptibility profiles of clinical Nocardia species remains limited in China.
METHODS: The data of isolation of Nocardia species were collected from databases such as Pubmed, Web of Science, Embase as well as Chinese databases (CNKI, Wanfang and VIP). Meta-analysis was performed using RevMan 5.3 software. Random effect models were used and tested with Cochran\'s Q and I2 statistics taking into account the possibility of heterogeneity between studies.
RESULTS: In total, 791 Nocardia isolates were identified to 19 species levels among all the recruited studies. The most common species were N. farcinica (29.1%, 230/791), followed by N. cyriacigeorgica (25.3%, 200/791), N. brasiliensis (11.8%, 93/791) and N. otitidiscaviarum (7.8%, 62/791). N. farcinica and N. cyriacigeorgica were widely distributed, N. brasiliensis mainly prevalent in the south, N. otitidiscaviarum mainly distributed in the eastern coastal provinces of China. Totally, 70.4% (223/317) Nocardia were cultured from respiratory tract specimens, 16.4% (52/317) from extra-pulmonary specimens, and 13.3% (42/317) from disseminated infection. The proportion of susceptible isolates as follows: linezolid 99.5% (197/198), amikacin 96.0% (190/198), trimethoprim-sulfamethoxazole 92.9% (184/198), imipenem 64.7% (128/198). Susceptibility varied by species of Nocardia.
CONCLUSIONS: N. farcinica and N. cyriacigeorgica are the most frequently isolated species, which are widely distributed in China. Pulmonary nocardiosis is the most common type of infection. Trimethoprim-sulfamethoxazole can still be the preferred agent for initial Nocardia infection therapy due to the low resistance rate, linezolid and amikacin could be an alternative to treat nocardiosis or a choice in a combination regimen.
METHODS: The data of isolation of Nocardia species were collected from databases such as Pubmed, Web of Science, Embase as well as Chinese databases (CNKI, Wanfang and VIP). Meta-analysis was performed using RevMan 5.3 software. Random effect models were used and tested with Cochran\'s Q and I2 statistics taking into account the possibility of heterogeneity between studies.
RESULTS: In total, 791 Nocardia isolates were identified to 19 species levels among all the recruited studies. The most common species were N. farcinica (29.1%, 230/791), followed by N. cyriacigeorgica (25.3%, 200/791), N. brasiliensis (11.8%, 93/791) and N. otitidiscaviarum (7.8%, 62/791). N. farcinica and N. cyriacigeorgica were widely distributed, N. brasiliensis mainly prevalent in the south, N. otitidiscaviarum mainly distributed in the eastern coastal provinces of China. Totally, 70.4% (223/317) Nocardia were cultured from respiratory tract specimens, 16.4% (52/317) from extra-pulmonary specimens, and 13.3% (42/317) from disseminated infection. The proportion of susceptible isolates as follows: linezolid 99.5% (197/198), amikacin 96.0% (190/198), trimethoprim-sulfamethoxazole 92.9% (184/198), imipenem 64.7% (128/198). Susceptibility varied by species of Nocardia.
CONCLUSIONS: N. farcinica and N. cyriacigeorgica are the most frequently isolated species, which are widely distributed in China. Pulmonary nocardiosis is the most common type of infection. Trimethoprim-sulfamethoxazole can still be the preferred agent for initial Nocardia infection therapy due to the low resistance rate, linezolid and amikacin could be an alternative to treat nocardiosis or a choice in a combination regimen.
摘要：
背景：诺卡氏菌可引起局部或播散性感染。需要迅速诊断和适当治疗诺卡心症，因为它可以导致显著的发病率和死亡率。了解当地物种分布和易感性模式对于适当的经验性治疗很重要。然而,在中国，关于临床诺卡氏菌属物种的流行病学和抗菌药物敏感性的知识仍然有限。
方法：从Pubmed、WebofScience,Embase以及中文数据库(CNKI，万方和VIP）。采用RevMan5.3软件进行Meta分析。使用随机效应模型，并使用Cochran的Q和I2统计进行测试，同时考虑到研究之间异质性的可能性。
结果：总计，在所有招募的研究中，791个诺卡氏菌分离株被鉴定为19个物种水平。最常见的物种是N.farcinica（29.1％，230/791），其次是N.cyriacigeorgica(25.3%，200/791),巴西N.(11.8%，93/791)和耳炎奈瑟菌(7.8%，62/791)。N.farcinica和N.cyriacigeorgica分布广泛，巴西奈瑟氏菌主要在南部流行，N.otidiscaviarum主要分布在中国东部沿海省份。完全正确,70.4%(223/317)的诺卡氏菌来自呼吸道标本，16.4%（52/317）来自肺外标本，传播感染占13.3%(42/317)。敏感分离株比例如下：利奈唑胺99.5%(197/198)，阿米卡星96.0%（190/198），甲氧苄啶-磺胺甲恶唑92.9%(184/198)，亚胺培南64.7%(128/198)。易感性因诺卡氏菌的种类而异。
结论：N.farcinica和N.cyriacigeorgica是最常见的孤立物种，在中国广泛分布。肺诺卡病是最常见的感染类型。甲氧苄啶-磺胺甲恶唑由于耐药率低，仍然可以作为初始诺卡氏菌感染治疗的首选药物，利奈唑胺和阿米卡星可以作为治疗诺卡心症的替代方案或联合治疗方案的选择。
方法：从Pubmed、WebofScience,Embase以及中文数据库(CNKI，万方和VIP）。采用RevMan5.3软件进行Meta分析。使用随机效应模型，并使用Cochran的Q和I2统计进行测试，同时考虑到研究之间异质性的可能性。
结果：总计，在所有招募的研究中，791个诺卡氏菌分离株被鉴定为19个物种水平。最常见的物种是N.farcinica（29.1％，230/791），其次是N.cyriacigeorgica(25.3%，200/791),巴西N.(11.8%，93/791)和耳炎奈瑟菌(7.8%，62/791)。N.farcinica和N.cyriacigeorgica分布广泛，巴西奈瑟氏菌主要在南部流行，N.otidiscaviarum主要分布在中国东部沿海省份。完全正确,70.4%(223/317)的诺卡氏菌来自呼吸道标本，16.4%（52/317）来自肺外标本，传播感染占13.3%(42/317)。敏感分离株比例如下：利奈唑胺99.5%(197/198)，阿米卡星96.0%（190/198），甲氧苄啶-磺胺甲恶唑92.9%(184/198)，亚胺培南64.7%(128/198)。易感性因诺卡氏菌的种类而异。
结论：N.farcinica和N.cyriacigeorgica是最常见的孤立物种，在中国广泛分布。肺诺卡病是最常见的感染类型。甲氧苄啶-磺胺甲恶唑由于耐药率低，仍然可以作为初始诺卡氏菌感染治疗的首选药物，利奈唑胺和阿米卡星可以作为治疗诺卡心症的替代方案或联合治疗方案的选择。
