Risk Factors of Peleg et al for a Nocardia Infection in an Organ Transplant Recipient

 

Patient selection: solid organ transplant recipient

 

Independent risk factors for nocardiosis in an organ transplant recipient:

(1) therapy with high dose steroid therapy in the preceding 6 months (>= 20 mg per day prednisone for >= 1 month and/or >= 3 intravenous pulses of 1 g methylprednisolone)

(2) history of cytomegalovirus (CMV) infection in the preceding 6 months

(3) high plasma levels of calcineurin inhibitors in the preceding 30 days (> 15 µg/mL for tacrolimus or > 300 ng/mL for cyclosporin)

 

Types of infection:

(1) pneumonia

(2) disseminated disease

 

The risk of infection increases as the number of risk factors increases.

 

The odds ratio for the high-dose steroid therapy is 27, while the odds ratios for the remaining 2 factors is 6-7. In the implementation the first will be assigned 4 points and the remaining 2 factors 1 point apiece.