Clinical and microbiological characteristics of Nocardiosis including those caused by emerging Nocardia species in Taiwan, 1998–2008

Tan, Che-Kim; Lai, Chih‐Cheng; Lin, Sheng Hsiang; Liao, Chun-Hsing; Chou, Chien‐Hong; Hsu, Han Lin; Huang, Yu-Tsung; Hsueh, Po-Ren

doi:10.1111/j.1469-0691.2009.02950.x

Cited by 78 publications

(80 citation statements)

References 22 publications

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“…Nocardia species, soilborne aerobic actinomycetes with worldwide distribution, can cause local or disseminated infection in humans, especially in immunocompromised individuals (3,15,17,20). Pulmonary nocardial infection can be caused by N. abscessus, N. cyriacigeorgica, N. farcinica, and N. nova; in contrast, N. brasiliensis was the most common pathogen associated with primary skin infection (mycetoma) (3,20).…”

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Multicenter Study in Taiwan of the In Vitro Activities of Nemonoxacin, Tigecycline, Doripenem, and Other Antimicrobial Agents against Clinical Isolates of Various Nocardia Species

Lai

Liu

et al. 2011

Antimicrob Agents Chemother

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The aim of this study was to assess the in vitro activities of nemonoxacin (a novel nonfluorinated quinolone), doripenem, tigecycline, and 16 other antimicrobial agents against Nocardia species. The MICs of the 19 agents against 151 clinical isolates of Nocardia species were determined by the broth microdilution method. The isolates were identified to the species level using 16S rRNA gene sequencing analysis. The results showed that N. brasiliensis (n ‫؍‬ 60; 40%) was the most common species, followed by N. cyriacigeorgica (n ‫؍‬ 24; 16%), N. farcinica (n ‫؍‬ 12; 8%), N. beijingensis (n ‫؍‬ 9), N. otitidiscaviarum (n ‫؍‬ 8), N. nova (n ‫؍‬ 8), N. asiatica (n ‫؍‬ 7), N. puris (n ‫؍‬ 6), N. flavorosea (n ‫؍‬ 5), N. abscessus (n ‫؍‬ 3), N. carnea (2), and one each of N. alba, N. asteroides complex, N. rhamnosiphila, N. elegans, N. jinanensis, N. takedensis, and N. transvalensis. The MIC 90 s of the tested quinolones against the N. brasiliensis isolates were in the order nemonoxacin ‫؍‬ gemifloxacin < moxifloxacin < levofloxacin ‫؍‬ ciprofloxacin, and the MIC 90 s of the tested carbapenems were in the order doripenem ‫؍‬ meropenem < ertapenem < imipenem. Tigecycline had a lower MIC 90 (1 g/ml) than linezolid (8 g/ml). The MIC 90 s of the tested quinolones against N. cyriacigeorgica isolates were in the order nemonoxacin < gemifloxacin < moxifloxacin < levofloxacin < ciprofloxacin, and the MIC 90 s of the tested carbapenems were in the order imipenem < doripenem ‫؍‬ meropenem < ertapenem. Nemonoxacin had the lowest MIC 90 values among the tested quinolones against the other 17 Nocardia isolates. Among the four tested carbapenems, imipenem had the lowest MIC 90 s. All of the clinical isolates of N. beijingensis, N. otitidiscaviarum, N. nova, and N. puris and more than half of the N. brasiliensis and N. cyriacigeorgica isolates were resistant to at least one antimicrobial agent. The results of this in vitro study suggest that nemonoxacin, linezolid, and tigecycline are promising treatment options for nocardiosis. Further investigation of their clinical role is warranted.

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“…Pulmonary nocardial infection can be caused by N. abscessus, N. cyriacigeorgica, N. farcinica, and N. nova; in contrast, N. brasiliensis was the most common pathogen associated with primary skin infection (mycetoma) (3,20). This group of organisms is rapidly expanding and now comprises at least 80 species (http://www.bacterio.cict.fr/n/nocardia.html).…”

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confidence: 99%

Multicenter Study in Taiwan of the In Vitro Activities of Nemonoxacin, Tigecycline, Doripenem, and Other Antimicrobial Agents against Clinical Isolates of Various Nocardia Species

Lai

Liu

et al. 2011

Antimicrob Agents Chemother

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“…In 2001, a new species of Nocardia, N. beijingensis, was described by Wang et al, which had been isolated from a soil sample from a sewage ditch at Xishan Mountain in Beijing (17). Strains have been isolated in Asia between 2004 and 2010 from patients with nocardiosis (5,9,10,15,16), mainly from pulmonary samples (80%) and in immunocompromised patients. To our knowledge, this is the first infectious case reported outside Asia, although some strains have been isolated in Europe, but without strong evidence of their involvement in pathology (6).…”

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Isolation of Nocardia beijingensis from a Pulmonary Abscess Reveals Human Immunodeficiency Virus Infection

et al. 2011

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A strain of Nocardia was isolated from a pulmonary abscess of a human immunodeficiency virus-infected patient in France. Comparative 16S rRNA gene sequence analysis revealed that the isolate represented a strain of Nocardia beijingensis. Antimicrobial susceptibility testing was essential to guide the clinicians to successfully treat this infection. CASE REPORTA strain of Nocardia beijingensis was isolated from a 47-yearold male who was admitted to our unit on 23 December 2010 for chest pain and a history of amoxicillin-resistant pneumonia. His main medical history was chronic sinusitis. On examination, he appeared asthenic, without fever. Physical examination concluded there was deteriorated general status, with a weight loss of 5 kg in 8 weeks. Laboratory test results were as follows: hemoglobin, 11.9 g/dl; neutrophils, 13 ϫ 10 9 /liter; lymphocytes, 1.2 ϫ 10 9 /liter; platelets, 357 ϫ 10 9 /liter; and C-reactive protein level, 241 mg/liter (normal range, Ͻ6 mg/liter). A chest radiograph disclosed mediastinal widening with a left paraaortic mass. A computed tomography (CT) scan of the chest revealed an abscess (Fig. 1). Blood cultures were negative.A bronchoalveolar lavage and a lung biopsy of the abscess were performed. In the laboratory, sputum was processed for mycobacterial study: the strain was also isolated from the mycobacterial culture medium. In a modified Ziehl-Neelsen stain, the strain was partially acid fast. The samples were tested for tuberculosis by PCR on the MTB/RIF test platform (GeneXpert; Cepheid) and were negative, except for, interestingly, one of the five probes that target the rpoB gene. Gram-stained smears revealed Gram-positive short filaments, coccoid forms, and branching rods. Primary cultures from the pulmonary abscess and a bronchoalveolar lavage on blood and chocolate agar plates, incubated at 37°C in 5% CO 2 , yielded within 3 days small, chalky white, dome-shaped rough colonies. On Coletsos medium, the colonies appeared irregular and orange colored (Fig. 2). They were Gram-positive rod-shaped organisms producing aerial hyphae. They were partially acid fast and were considered most likely to represent Nocardia spp.Antibiotic susceptibility among isolates within the genus Nocardia is unpredictable (15); therefore, we assessed susceptibility according to the guidelines of the French Society for Microbiology, using the disk diffusion method or the Etest (AB Biodisk, Solna, Sweden) on Mueller-Hinton plates. Although broth microdilution is now recommended by the Clinical and Laboratory Standards Institute (CLSI), two reports suggest that MIC determination by broth microdilution and the Etest give similar results (1, 2), making the Etest suitable and more convenient for routine work. The results were recorded after 48 h (or after 72 h if growth was insufficient after 48 h) and interpreted according to the MIC breakpoints published by the CLSI. However, the Etest method was not available for every antibiotic in our laboratory. Therefore, the agar disk diffusion method on Mueller-Hinton ...

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“…Some of them, such as Listeria monocytogenes and Nocardia, Kocuria, Rhodococcus, Gordonia, and Tsukamurella species, are associated with severe community-acquired infections, including meningitis, bacteremia, pneumonia, brain abscesses, and skin and soft tissue infections (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). These organisms also cause various health care-associated infections, including catheter-related bacteremia (5,9,(12)(13)(14).…”

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Bruker Biotyper Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry System for Identification of Nocardia, Rhodococcus, Kocuria, Gordonia, Tsukamurella, and Listeria Species

Hsueh

Lee

et al. 2014

J Clin Microbiol

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fWe evaluated whether the Bruker Biotyper matrix-associated laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system provides accurate species-level identifications of 147 isolates of aerobically growing Gram-positive rods (GPRs). The bacterial isolates included Nocardia (n ‫؍‬ 74), Listeria (n ‫؍‬ 39), Kocuria (n ‫؍‬ 15), Rhodococcus (n ‫؍‬ 10), Gordonia (n ‫؍‬ 7), and Tsukamurella (n ‫؍‬ 2) species, which had all been identified by conventional methods, molecular methods, or both. In total, 89.7% of Listeria monocytogenes, 80% of Rhodococcus species, 26.7% of Kocuria species, and 14.9% of Nocardia species (n ‫؍‬ 11, all N. nova and N. otitidiscaviarum) were correctly identified to the species level (score values, >2.0). A clustering analysis of spectra generated by the Bruker Biotyper identified six clusters of Nocardia species, i.e., cluster 1 (N.

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Clinical and microbiological characteristics of Nocardiosis including those caused by emerging Nocardia species in Taiwan, 1998–2008

Cited by 78 publications

References 22 publications

Multicenter Study in Taiwan of the In Vitro Activities of Nemonoxacin, Tigecycline, Doripenem, and Other Antimicrobial Agents against Clinical Isolates of Various Nocardia Species

Multicenter Study in Taiwan of the In Vitro Activities of Nemonoxacin, Tigecycline, Doripenem, and Other Antimicrobial Agents against Clinical Isolates of Various Nocardia Species

Isolation of Nocardia beijingensis from a Pulmonary Abscess Reveals Human Immunodeficiency Virus Infection

Bruker Biotyper Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry System for Identification of Nocardia, Rhodococcus, Kocuria, Gordonia, Tsukamurella, and Listeria Species

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