Clinical features, identification, antimicrobial resistance patterns of Nocardia species in China: 2009–2017

Huang, Lei; Chen, Xingchun; Xu, Huanji; Sun, Li‐Ying; Li, Chen; Guo, Wenchen; Xiang, Lili; Luo, Guolan; Cui, Yancao; Lu, Binghuai

doi:10.1016/j.diagmicrobio.2018.12.007

Cited by 68 publications

(74 citation statements)

References 29 publications

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“…However, resistance to sulphonamides is being increasingly reported; thus, it should ideally be provided in combination with two or more different kinds of antibiotics. In vitro drug sensitivity tests show that the multi-drug resistant Nocardia is sensitive to linezolid and is therefore recommended for treatment of patients with severe or disseminated disease, allergy to sulphonamides, or poor response to other drugs [ 10 , 11 ]. Meropenem was also recommended as the disease has a tendency to progress.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Nocardia infection with a lesion occupying the intracranial space complicated with coma: a case report

Chen

et al. 2020

BMC Infect Dis

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Background Disseminated Nocardia infection is a disease that is easily overlooked in patients with lesions occupying the intracranial space complicated with coma. Early diagnosis and treatment are crucial. Case presentation A 65-year-old man was admitted to the First Affiliated Hospital of Zhejiang University in October 2018 with weakness in the right limbs for 3 days and altered consciousness for 1 day. Five months earlier, he had been diagnosed with membranous kidney disease and had received cyclophosphamide and prednisone. At admission, the white blood cell count was 1.37 × 1010/L (with 86.4% neutrophils), and C-reactive protein was 115.60 mg/L. Imaging examinations revealed a lesion occupying the intracranial space, lung infection, and multiple abscesses in the rhomboid muscle. The abscesses were drained. Pus culture confirmed Nocardia cyriacigeorgica infection. With antibiotics and vacuum-sealed drainage of the back wound, the patient improved and was discharged from the hospital. Conclusions This case report shows that infection should be considered during the differential diagnosis of lesions in the intracranial space, especially in patients receiving immunosuppressive treatment. In patients with disseminated N. cyriacigeorgica infection, combination antibiotic therapy and surgical drainage of localised abscesses can be effective.

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Section: Discussionmentioning

confidence: 99%

Disseminated Nocardia infection with a lesion occupying the intracranial space complicated with coma: a case report

Chen

et al. 2020

BMC Infect Dis

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“…The lung is the most frequently involved site in nocardiosis (>50%). 5,[19][20][21]49,89,160 Symptoms are nonspecific and may include cough, dyspnea, malaise, fatigue, and rarely hemoptysis. 19 As noted above, nocardiosis usually occurs in IS patients, but may occur in IC patients, particularly in those with chronic lung disease or the elderly.…”

Section: Clinical Features Pulmonarymentioning

confidence: 99%

“…include third-and fourth-generation cephalosporins (e.g., ceftriaxone, cefotaxime, and cefepime), 248 amoxicillin-clavulanate, 248 carbapenems (imipenem and meropenem), 5,20 and amikacin. 20,50,55,244 Susceptibility rates are lower with macrolides, minocycline or doxycycline, and fluoroquinolones, although these antimicrobials may have activity against some species. 50,55 Regarding the carbapenems, meropenem has been used successfully in the treatment of nocardiosis, though usually in combination with other antimicrobials.…”

Section: Antimicrobial Susceptibilitymentioning

confidence: 99%

“…55 In China, 53 clinical isolates from 2009 to 2017 were uniformly S to linezolid; 92.5% were S to imipenem and amikacin. 20 In Karachi, Pakistan from November 2014 to June 2016, S rates among 52 clinical isolates were: linezolid (100%), amikacin (94.2%), TMP-SMX (90.4%), and imipenem (38.5%). 250 In Spain from 1998 to 2009, 186 clinical isolates were tested for in vitro susceptibility to 20 antimicrobials.…”

Section: Antimicrobial Susceptibilitymentioning

confidence: 99%

“…16,18 Pulmonary nocardiosis may mimic communityacquired pneumonia, and this may be more common among individuals with agricultural or outdoor occupations in developing countries. 10,12,16 Nocardiosis primarily involves the lungs, 5,[19][20][21] but skin and soft tissue infections (SSTIs), [21][22][23][24][25][26][27][28][29] central nervous system (CNS) infection (brain abscesses, meningitis), 7,[30][31][32][33][34] and dissemination 4,11,12,21,35 may occur. Given the rarity of the disease, the diagnosis and initiation of appropriate antimicrobial therapy are often delayed.…”

mentioning

confidence: 99%

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Nocardia spp.: A Rare Cause of Pneumonia Globally

Lynch

Reid

Clark

2020

Semin Respir Crit Care Med

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AbstractMembers of the Nocardia genus are ubiquitous in the environment. These aerobic, gram-positive organisms can lead to life-threatening infection, typically in immunocompromised hosts such as solid organ transplant recipients or those receiving immunosuppressive medications for other reasons. This current review discusses the microbiology of nocardiosis, risk factors for infection, clinical manifestations, methods for diagnosis, and treatment. Nocardiosis primarily affects the lung but may also cause skin and soft tissue infection, cerebral abscess, bloodstream infection, or infection involving other organs. Although rare as a cause of community-acquired pneumonia, Nocardia can have severe morbidity and mortality, particularly in patients with comorbidities or compromised immunity. Early diagnosis and timely initiation of therapy are critical to optimizing patient outcomes. Species identification is important in determining treatment, as is in vitro susceptibility testing. Sulfonamide therapy is usually indicated, although a variety of other antimicrobials may be useful, depending on the species and susceptibility testing. Prolonged therapy is usually indicated, for 6 to 12 months, and in some cases surgical debridement may be required to resolve infection.

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Other Gram-Positive Infections

Tatara

2023

The Infectious Diseases Consult Handbook

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Clinical features, identification, antimicrobial resistance patterns of Nocardia species in China: 2009–2017

Cited by 68 publications

References 29 publications

Disseminated Nocardia infection with a lesion occupying the intracranial space complicated with coma: a case report

Disseminated Nocardia infection with a lesion occupying the intracranial space complicated with coma: a case report

Nocardia spp.: A Rare Cause of Pneumonia Globally

Other Gram-Positive Infections

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