Central venous catheter-associated Nocardia bacteremia in cancer patients

Abstract

Central venous catheters, often needed by cancer patients, can be the source of Nocardia bacteremia. We evaluated the clinical characteristics and outcomes of 17 cancer patients with Nocardia bacteremia. For 10 patients, the bacteremia was associated with the catheter; for the other 7, it was a disseminated infection. N. nova complex was the leading cause of bacteremia. Nocardia promoted heavy biofi lm formation on the surface of central venous catheter segments tested in an in vitro biofi lm model. Trimethoprimand minocycline-based lock solutions had potent in vitro activity against biofi lm growth. Patients with Nocardia central venous catheter-associated bloodstream infections responded well to catheter removal and antimicrobial drug therapy, whereas those with disseminated bacteremia had poor prognoses.