Manifestations and Management of Trimethoprim/Sulfamethoxazole–Resistant <i>Nocardia otitidiscaviarum</i> Infection

Fu, Katherine A.; White, Kyle; Ramaniuk, Aliaksandr; Kollu, Vidya; Urbine, Daniel

doi:10.3201/eid2906.221854

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…In China, N. otitidiscaviarum was mainly reported in the eastern coastal provinces of China (Wang et al, 2023). In more recent years, fatal cases were reported of drugresistant N. otitidiscaviarum infections (Barry et al, 2022;Fu et al, 2023). However, since most clinical and radiological signs of N. otitidiscaviarum resemble that of MTB and NTM (Duggal and Chugh, 2020), it is of capital importance to obtain a microbiological diagnosis for proper treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical utility of metagenomic next-generation sequencing in pathogen detection for lower respiratory tract infections and impact on clinical outcomes in southernmost China

Hao,

Li,

Wang

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundToday, metagenomic next-generation sequencing (mNGS) has emerged as a diagnostic tool for infections. However, since Hainan has a complicated pathogen spectrum, the diagnostic value and impact on patient outcomes of mNGS in Hainan are to be explored.MethodsFrom April 2020 to October 2021, 266 suspected lower respiratory tract infections (LRTIs) patients in Hainan were enrolled, and specimens were collected before antibiotic treatment. Bronchoalveolar lavage fluid (BALF) samples were subjected to mNGS and culture to compare the diagnostic performance. Other conventional microbiological tests (CMT) were also performed. Patients’ treatments and clinical outcomes were recorded, and the antibiotic resistance genes (ARGs) were detected via mNGS workflow.ResultsThe positive rate of mNGS outperformed that of culture (87.55% vs. 39.30%, p<0.001) and CMT (87.12% vs. 52.65%, p<0.001). Specifically, mNGS detected more P. aeruginosa (12.03% vs 9.02%, p<0.05), H. influenzae (9.77% vs 2.26%, p<0.001), Aspergillus fumigatus (3.00% vs 0.75%, p<0.05), Candida albicans (26.32% vs 7.52%, p<0.001) and uncommon pathogens. It also demonstrated great diagnostic advantages in Mycobacterium tuberculosis with 80% sensitivity and 97.4% specificity. Over half of the patients (147, 55.26%) had modified empirical treatment according to mNGS results and 89.12% of them responded well. For three deaths with modified treatment, multiple drug resistance was predicted by mNGS and confirmed by antibiotic susceptibility test.ConclusionsThe application of mNGS can benefit clinics in pathogen identification and antimicrobial treatment stewardship. Physicians should be alert to some emerging uncommon pathogens, including Chlamydia Psittaci, Nocardia otitidiscaviarum, and rare NTM.

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Section: Discussionmentioning

confidence: 99%

Clinical utility of metagenomic next-generation sequencing in pathogen detection for lower respiratory tract infections and impact on clinical outcomes in southernmost China

Hao,

Li,

Wang

et al. 2023

Front. Cell. Infect. Microbiol.

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Antibacterials

2024

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Nocardia otitidiscaviarum causing pulmonary nocardiosis: a case report and its review of the literature

Srivastava,

Samaddar,

Khan

et al. 2024

Access Microbiology

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Background. Infections caused by Nocardia spp. can occur in immunocompromised as well as immunocompetent individuals. Although nocardiosis is rare, it is being increasingly recognized owing to the rise in occurrence rate over the years. The documentation of pleural involvement in nocardiosis is rare in India. Case. We report a case of pulmonary nocardiosis in an immunocompromised individual caused by Nocardia otitidiscaviarum. Discussion. Pulmonary nocardiosis caused by Nocardia otitidiscaviarum may go unnoticed without clinical suspicion. Correct and timely identification is the key to proper patient management. Conclusion. Coordination between clinicians and microbiologists is necessary for early diagnosis and appropriate management of nocardiosis.

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Manifestations and Management of Trimethoprim/Sulfamethoxazole–Resistant Nocardia otitidiscaviarum Infection

Cited by 3 publications

References 5 publications

Clinical utility of metagenomic next-generation sequencing in pathogen detection for lower respiratory tract infections and impact on clinical outcomes in southernmost China

Clinical utility of metagenomic next-generation sequencing in pathogen detection for lower respiratory tract infections and impact on clinical outcomes in southernmost China

Antibacterials

Nocardia otitidiscaviarum causing pulmonary nocardiosis: a case report and its review of the literature

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