Acquired resistance of Nocardia brasiliensis to clavulanic acid related to a change in beta-lactamase following therapy with amoxicillin-clavulanic acid

Steingrube, Vincent A.; Wallace, Richard J.; Brown, Barbara A.; Pang, Yanbo; Zeluff, Barry; Steele, Lorraine C.; Zhang, Yansheng

doi:10.1128/aac.35.3.524

Cited by 35 publications

(25 citation statements)

References 21 publications

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“…This in vitro finding has been reported previously (33), and on the basis of these data, amoxicillin-clavulanic acid has successfully been used as treatment for a few cases of cutaneous N. brasiliensis infection (9,26,39). However, more extensive clinical trials should be carried out since the combination amoxicillin-clavulanic acid is not active in vitro against 100% of strains, and secondary resistance has seldom been reported to occur (28).…”

Section: Discussionmentioning

confidence: 81%

In Vitro and In Vivo Activities of Antimicrobials against Nocardia brasiliensis

Gomez-Flores

Welsh

Said‐Fernández³

et al. 2004

Antimicrob Agents Chemother

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In Mexico mycetomas are mostly produced by Nocardia brasiliensis, which can be isolated from about 86% of cases. In the present work, we determined the sensitivities of 30 N. brasiliensis strains isolated from patients with mycetoma to several groups of antimicrobials. As a first screening step we carried out disk diffusion assays with 44 antimicrobials, including aminoglycosides, cephalosporins, penicillins, quinolones, macrolides, and some others. In these assays we observed that some antimicrobials have an effect on more than 66% of the strains: linezolid, amikacin, gentamicin, isepamicin, netilmicin, tobramycin, minocycline, amoxicillin-clavulanic acid, piperacillin-tazobactam, nitroxolin, and spiramycin. Drug activity was confirmed quantitatively by the broth microdilution method. Amoxicillin-clavulanic acid, linezolid, and amikacin, which have been used to treat patients, were tested in an experimental model of mycetoma in BALB/c mice in order to validate the in vitro results. Linezolid showed the highest activity in vivo, followed by the combination amoxicillin-clavulanic acid and amikacin.

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Section: Discussionmentioning

confidence: 81%

In Vitro and In Vivo Activities of Antimicrobials against Nocardia brasiliensis

Gomez-Flores

Welsh

Said‐Fernández³

et al. 2004

Antimicrob Agents Chemother

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“…However, isolates of N. brasiliensis are usually susceptible to amoxicillinclavulanic acid, and it is the preferred oral agent for this species for patients who cannot tolerate a sulfonamide (208,215). A case of acquired resistance to ␤-lactam and ␤-lactamase inhibitor antibiotics was previously described by Steingrube and colleagues (182). Other species with susceptibility to amoxicillin-clavulanic acid include N. abscessus and N. farcinica, while isolates of the N. nova complex are ampicillin susceptible/intermediate but resistant to amoxicillin-clavulanic acid.…”

Section: Downloaded Frommentioning

confidence: 99%

Clinical and Laboratory Features of theNocardiaspp. Based on Current Molecular Taxonomy

et al. 2006

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SUMMARY The recent explosion of newly described species of Nocardia results from the impact in the last decade of newer molecular technology, including PCR restriction enzyme analysis and 16S rRNA sequencing. These molecular techniques have revolutionized the identification of the nocardiae by providing rapid and accurate identification of recognized nocardiae and, at the same time, revealing new species and a number of yet-to-be-described species. There are currently more than 30 species of nocardiae of human clinical significance, with the majority of isolates being N. nova complex, N. abscessus, N. transvalensis complex, N. farcinica, N. asteroides type VI (N. cyriacigeorgica), and N. brasiliensis. These species cause a wide variety of diseases and have variable drug susceptibilities. Accurate identification often requires referral to a reference laboratory with molecular capabilities, as many newer species are genetically distinct from established species yet have few or no distinguishing phenotypic characteristics. Correct identification is important in deciding the clinical relevance of a species and in the clinical management and treatment of patients with nocardial disease. This review characterizes the currently known pathogenic species of Nocardia, including clinical disease, drug susceptibility, and methods of identification.

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“…Although some nocardial ␤-lactamases have been characterized biochemically in N. asteroides (9,17), Nocardia brasiliensis (19,23), and N. farcinica (11,20), the accurate role of ␤-lactamase in the ␤-lactam resistance pattern has scarcely been explored. Sequences of ␤-lactamase genes are available only for N. farcinica and the nonhuman pathogen Nocardia lactamdurans (5,11).…”

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confidence: 99%

Molecular and Biochemical Analysis of AST-1, a Class A β-Lactamase from Nocardia asteroides Sensu Stricto

Poirel

Laurent

Naas

et al. 2001

Antimicrob Agents Chemother

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A ␤-lactamase gene was cloned from a Nocardia asteroides sensu stricto clinical isolate. A recombinant plasmid, pAST-1, expressed the ␤-lactamase AST-1 in Escherichia coli JM109. Its pI was 4.8, and its relative molecular mass was 31 kDa. E. coli JM109(pAST-1) was resistant to penicillins and narrow-spectrum cephalosporins. The ␤-lactamase AST-1 had a restricted hydrolytic activity spectrum. Its activity was partially inhibited by clavulanic acid but not by sulbactam and tazobactam. AST-1 is an Ambler class A ␤-lactamase sharing 65% amino acid identity with ␤-lactamase FAR-1, the most closely related enzyme.The Nocardia genus includes several species that are opportunistic pathogens in immunocompromised patients (3,13). Species of Nocardia asteroides sensu stricto are the predominant human pathogens and are involved in pulmonary and brain abscesses (13). Since nocardiosis requires a long treatment (6 to 12 months or longer) and may cause a high mortality rate, the choice of the optimal antibiotic treatement is crucial (7).␤-Lactams have been used as first-line treatment with little concern for the ␤-lactam susceptibility of Nocardia sp. isolates (13). Knowledge of the mechanisms of ␤-lactam resistance profiles of Nocardia isolates may be critical for assessing the potential clinical efficacy of ␤-lactams. A study of the antimicrobial susceptibility patterns of 78 clinical isolates belonging to the N. asteroides complex found that 95% of the isolates exhibit one of the four major antibiotic resistance patterns (24). Type I (20% of the isolates) is susceptible to ampicillin and carbenicillin but intermediate in susceptibility to imipenem; type III (18%) is susceptible to ampicillin and erythromycin; type V (17%) is resistant to broad-spectrum cephalosporins; and type VI, the most prevalent group (35%), is resistant to ampicillin but susceptible to extended-spectrum cephalosporins and imipenem. Type II and type IV are extremely rare and not well characterized. Wallace et al. show that drug resistance patterns of type III and type V correlate with taxonomic groups and have been reclassified as Nocardia nova and Nocardia farcinica, respectively (21,22). Isolates belonging to types I, IV, and VI are grouped into the same subspecies, named N. asteroides sensu stricto.Although some nocardial ␤-lactamases have been characterized biochemically in N. asteroides (9, 17), Nocardia brasiliensis (19, 23), and N. farcinica (11, 20), the accurate role of ␤-lactamase in the ␤-lactam resistance pattern has scarcely been explored. Sequences of ␤-lactamase genes are available only for N. farcinica and the nonhuman pathogen Nocardia lactamdurans (5, 11).We report on the molecular and biochemical characterization of a class A ␤-lactamase named AST-1 from a clinical isolate belonging to the most prevalent group of N. asteroides sensu stricto species. Hydrolytic activity of ␤-lactamase AST-1 was compared to that of ␤-lactamase FAR-1. MATERIALS AND METHODSBacterial strains and plasmids. The N. asteroides sensu stricto isolate JPL was fro...

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Acquired resistance of Nocardia brasiliensis to clavulanic acid related to a change in beta-lactamase following therapy with amoxicillin-clavulanic acid

Cited by 35 publications

References 21 publications

In Vitro and In Vivo Activities of Antimicrobials against Nocardia brasiliensis

In Vitro and In Vivo Activities of Antimicrobials against Nocardia brasiliensis

Clinical and Laboratory Features of theNocardiaspp. Based on Current Molecular Taxonomy

Molecular and Biochemical Analysis of AST-1, a Class A β-Lactamase from Nocardia asteroides Sensu Stricto

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