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Abstract：
BACKGROUND: Nocardia species can affect both immunocompetent and immunocompromised people.
METHODS: This retrospective study, from 2009 to 2022, aims to compare the survival analyses of pulmonary nocardiosis in AIDS and non-AIDS patients in northeastern Thailand.
RESULTS: A total of 215 culture-confirmed cases of pulmonary nocardiosis: 97 with AIDS and 118 without AIDS. The median CD4 count of AIDS patients was 11 cells/µL (range: 1-198), and 33% had concurrent opportunistic infections. 63.6% of 118 non-AIDS patients received immunosuppressive medications, 28.8% had comorbidities, and 7.6% had no coexisting conditions. Disseminated nocardiosis and pleural effusion were more prevalent among AIDS patients, whereas non-AIDS patients revealed more shock and respiratory failure. One hundred-fifty patients underwent brain imaging; 15 (10%) had brain abscesses. Patients with pulmonary nocardiosis have overall 30-day and 1-year mortality rates of 38.5% (95% CI: 32.3%, 45.4%) and 52.1% (95% CI: 45.6%, 58.9%), respectively. The Cox survival analysis showed that AIDS patients with disseminated nocardiosis had a 7.93-fold (95% CI: 2.61-24.02, p < 0.001) increased risk of death within 30 days compared to non-AIDS patients when considering variables such as age, Charlson comorbidity index, concurrent opportunistic infections, duration of illness, shock, respiratory failure, multi-lobar pneumonia, lung abscesses, and combination antibiotic therapy. While AIDS and pulmonary nocardiosis had a tendency to die within 30 days (2.09 (95% CI, 0.74-5.87, p = 0.162)).
CONCLUSIONS: AIDS with pulmonary nocardiosis, particularly disseminated disease, is a serious opportunistic infection. Early diagnosis and empiric treatment with a multidrug regimen may be the most appropriate approach in a resource-limited setting.
METHODS: This retrospective study, from 2009 to 2022, aims to compare the survival analyses of pulmonary nocardiosis in AIDS and non-AIDS patients in northeastern Thailand.
RESULTS: A total of 215 culture-confirmed cases of pulmonary nocardiosis: 97 with AIDS and 118 without AIDS. The median CD4 count of AIDS patients was 11 cells/µL (range: 1-198), and 33% had concurrent opportunistic infections. 63.6% of 118 non-AIDS patients received immunosuppressive medications, 28.8% had comorbidities, and 7.6% had no coexisting conditions. Disseminated nocardiosis and pleural effusion were more prevalent among AIDS patients, whereas non-AIDS patients revealed more shock and respiratory failure. One hundred-fifty patients underwent brain imaging; 15 (10%) had brain abscesses. Patients with pulmonary nocardiosis have overall 30-day and 1-year mortality rates of 38.5% (95% CI: 32.3%, 45.4%) and 52.1% (95% CI: 45.6%, 58.9%), respectively. The Cox survival analysis showed that AIDS patients with disseminated nocardiosis had a 7.93-fold (95% CI: 2.61-24.02, p < 0.001) increased risk of death within 30 days compared to non-AIDS patients when considering variables such as age, Charlson comorbidity index, concurrent opportunistic infections, duration of illness, shock, respiratory failure, multi-lobar pneumonia, lung abscesses, and combination antibiotic therapy. While AIDS and pulmonary nocardiosis had a tendency to die within 30 days (2.09 (95% CI, 0.74-5.87, p = 0.162)).
CONCLUSIONS: AIDS with pulmonary nocardiosis, particularly disseminated disease, is a serious opportunistic infection. Early diagnosis and empiric treatment with a multidrug regimen may be the most appropriate approach in a resource-limited setting.
摘要：
背景：诺卡氏菌可以影响免疫活性和免疫功能低下的人。
方法：本回顾性研究，从2009年到2022年，旨在比较泰国东北部艾滋病和非艾滋病患者肺诺卡病的生存分析。
结果：共215例经培养证实的肺诺卡病例：97例患有AIDS，118例无AIDS。艾滋病患者的CD4计数中位数为11个细胞/微升（范围：1-198），33%并发机会性感染。118名非艾滋病患者中有63.6%接受了免疫抑制药物治疗,28.8%有合并症，7.6%没有共存条件。播散性诺卡尼病和胸腔积液在艾滋病患者中更为普遍，而非艾滋病患者表现出更多的休克和呼吸衰竭。150例患者接受了脑成像；15例（10％）患有脑脓肿。肺诺卡特病患者的总体30天和1年死亡率为38.5％（95％CI：32.3％，45.4%)和52.1%(95%CI：45.6%，58.9%），分别。Cox生存分析表明，与非AIDS患者相比，患有播散性诺卡尼病的AIDS患者在30天内死亡风险增加了7.93倍（95％CI：2.61-24.02，p<0.001），Charlson合并症指数,并发机会性感染，疾病的持续时间,震惊,呼吸衰竭,多叶性肺炎,肺脓肿,和联合抗生素治疗。而AIDS和肺诺卡心症有在30天内死亡的趋势（2.09（95％CI，0.74-5.87，p=0.162））。
结论：艾滋病合并肺诺卡病，特别是传播疾病，是一种严重的机会性感染.在资源有限的情况下，采用多药方案的早期诊断和经验性治疗可能是最合适的方法。
方法：本回顾性研究，从2009年到2022年，旨在比较泰国东北部艾滋病和非艾滋病患者肺诺卡病的生存分析。
结果：共215例经培养证实的肺诺卡病例：97例患有AIDS，118例无AIDS。艾滋病患者的CD4计数中位数为11个细胞/微升（范围：1-198），33%并发机会性感染。118名非艾滋病患者中有63.6%接受了免疫抑制药物治疗,28.8%有合并症，7.6%没有共存条件。播散性诺卡尼病和胸腔积液在艾滋病患者中更为普遍，而非艾滋病患者表现出更多的休克和呼吸衰竭。150例患者接受了脑成像；15例（10％）患有脑脓肿。肺诺卡特病患者的总体30天和1年死亡率为38.5％（95％CI：32.3％，45.4%)和52.1%(95%CI：45.6%，58.9%），分别。Cox生存分析表明，与非AIDS患者相比，患有播散性诺卡尼病的AIDS患者在30天内死亡风险增加了7.93倍（95％CI：2.61-24.02，p<0.001），Charlson合并症指数,并发机会性感染，疾病的持续时间,震惊,呼吸衰竭,多叶性肺炎,肺脓肿,和联合抗生素治疗。而AIDS和肺诺卡心症有在30天内死亡的趋势（2.09（95％CI，0.74-5.87，p=0.162））。
结论：艾滋病合并肺诺卡病，特别是传播疾病，是一种严重的机会性感染.在资源有限的情况下，采用多药方案的早期诊断和经验性治疗可能是最合适的方法。
