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Wang ZZ, Weng J, Qi J, Fu XX, Xing BB, Hu Y, Huang CH, Chen CY, Wei Z. Structure-guided discovery of novel dUTPase inhibitors with anti- Nocardia activity by computational design. J Enzyme Inhib Med Chem 2024; 39:2411573. [PMID: 39390714 PMCID: PMC11486130 DOI: 10.1080/14756366.2024.2411573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 09/17/2024] [Accepted: 09/25/2024] [Indexed: 10/12/2024] Open
Abstract
The zoonosis caused by Nocardia is increasing seriously. But commonly used antibiotic drugs often lead to resistance. N. seriolae dUTPase (NsdUTPase) plays a key role in the proliferation of Nocardia, and was regarded as a potent drug target. However, there was little report about the NsdUTPase inhibitors. In this study, we discovered a series of novel NsdUTPase inhibitors to fight against Nocardia. The first crystal structure of NsdUTPase was released, and a structure-based computational design was performed. Compounds 4b and 12b exhibited promising activities towards NsdUTPase (IC50 = 0.99 μM and 0.7 μM). In addition, they showed satisfied anti-Nocardia activity (MIC value ranges from 0.5 to 2 mg/L) and low cytotoxicity, which were better than approved drugs oxytetracycline and florfenicol. Molecular modelling study indicated that hydrophobic interaction might be the main contribution for ligand binding. Our results suggested that NsdUTPase inhibitors might be a useful way to repress Nocardia.
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Affiliation(s)
- Zhi-Zheng Wang
- School of Life Sciences, State Key Laboratory of Biocatalysis and Enzyme Engineering, National & Local Joint Engineering Research Center of High-throughput Drug Screening Technology, Hubei University, Wuhan, PR China
| | - Jun Weng
- School of Life Sciences, State Key Laboratory of Biocatalysis and Enzyme Engineering, National & Local Joint Engineering Research Center of High-throughput Drug Screening Technology, Hubei University, Wuhan, PR China
- College of Life Science and Technology, Key Laboratory of Molecular Biophysics of Ministry of Education, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan, PR China
| | - Jing Qi
- School of Life Sciences, State Key Laboratory of Biocatalysis and Enzyme Engineering, National & Local Joint Engineering Research Center of High-throughput Drug Screening Technology, Hubei University, Wuhan, PR China
| | - Xin-Xin Fu
- School of Life Sciences, State Key Laboratory of Biocatalysis and Enzyme Engineering, National & Local Joint Engineering Research Center of High-throughput Drug Screening Technology, Hubei University, Wuhan, PR China
| | - Ban-Bin Xing
- School of Life Sciences, State Key Laboratory of Biocatalysis and Enzyme Engineering, National & Local Joint Engineering Research Center of High-throughput Drug Screening Technology, Hubei University, Wuhan, PR China
| | - Yang Hu
- School of Life Sciences, State Key Laboratory of Biocatalysis and Enzyme Engineering, National & Local Joint Engineering Research Center of High-throughput Drug Screening Technology, Hubei University, Wuhan, PR China
| | - Chun-Hsiang Huang
- Protein Diffraction Group, Experimental Facility Division, National Synchrotron Radiation Research Center, Hsinchu, Taiwan
| | - Chin-Yu Chen
- School of Life Sciences, State Key Laboratory of Biocatalysis and Enzyme Engineering, National & Local Joint Engineering Research Center of High-throughput Drug Screening Technology, Hubei University, Wuhan, PR China
| | - Zigong Wei
- School of Life Sciences, State Key Laboratory of Biocatalysis and Enzyme Engineering, National & Local Joint Engineering Research Center of High-throughput Drug Screening Technology, Hubei University, Wuhan, PR China
- Hubei Jiangxia Laboratory, Wuhan, PR China
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2
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Shen J, Ji XZ, Han L, Yao J, Liang Y, Yuan M, Xu S, Li Z. Activation of NF-κB/MAPK signaling and induction of apoptosis by salicylate synthase NbtS in Nocardia farcinica promotes neuroinflammation development. mSystems 2024; 9:e0089324. [PMID: 39240104 PMCID: PMC11494946 DOI: 10.1128/msystems.00893-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 07/17/2024] [Indexed: 09/07/2024] Open
Abstract
Nocardia farcinica can cause a rare, yet potentially fatal, central nervous system infection. NbtS protein may be a key virulence factor in N. farcinica infection of the brain. In this study, we investigated the function of the virulence-associated factor NbtS in microglial cells in vitro and in infected mice in vivo. We explored the interactions between NbtS and microglial cells (BV2 and human microglial clone 3), revealing that NbtS activates the toll-like receptor 4-dependent MyD88-IRAK4-IRAK1 and MAPK/nuclear factor kappa B (NF-κB) pathways, significantly enhancing pro-inflammatory responses as indicated by increased levels of tumor necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β), as measured by ELISA and quantitative PCR. Apoptosis was elevated in these cells, as shown by increased expression of Bax and caspase-3 and decreased Bcl-2 levels. The terminal deoxynucleotidyl transferase dUTP nick end labeling assay also confirmed the occurrence of apoptosis. In vivo, mice infected with an RS03155-deficient strain of N. farcinica exhibited higher survival rates and reduced brain inflammation, suggesting a pivotal role for the NbtS protein in the pathogenesis of Nocardia. Conservation of the RS03155 gene across Nocardia spp. was verified by PCR, and the immunogenic potential of NbtS was confirmed by Western blot analysis using sera from infected mice. These findings suggest that targeting NbtS may offer a novel therapeutic strategy against Nocardia infection. IMPORTANCE The study presented in this article delves into the molecular underpinnings of Nocardia farcinica-induced neuroinflammation. By focusing on the salicylate synthase gene, RS03155, and its encoded protein, NbtS, we uncover a pivotal virulence factor that triggers a cascade of immunological responses leading to apoptosis in microglial cells. This research not only enhances our comprehension of the pathogenesis of Nocardia infections but also provides a potential therapeutic target. Given the rising importance of understanding host-microbe interactions within the context of the central nervous system, especially in immunocompromised individuals, the findings are of significant relevance to the field of microbiology and could inform future diagnostic and treatment modalities for Nocardia-associated neurological disorders. Our work emphasizes the need for continued research into the intricate mechanisms of microbial pathogenesis and the development of novel strategies to combat life-threatening infections.
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Affiliation(s)
- Jirao Shen
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xing zhao Ji
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lichao Han
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiang Yao
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Yihe Liang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Min Yuan
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuai Xu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenjun Li
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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3
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Lambert JR, Cheng AC, Lee LM, Raiford D, Zuber E, Kilbane E, Fish EJ, Królak E, Hlusko KC, McMichael M, Wilkes RP, Wiederhold NP, Cañete-Gibas CF, Barrantes Murillo DF. Intra-abdominal nocardiosis and scedosporiosis in a dog: case report and literature review. J Vet Diagn Invest 2024:10406387241287799. [PMID: 39397659 DOI: 10.1177/10406387241287799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2024] Open
Abstract
A 2-y-old, intact female, mixed-breed dog was presented to the veterinary hospital with abdominal distension, anemia, and lethargy following a chronic history of nonspecific gastrointestinal signs. CBC and serum biochemistry revealed moderate nonregenerative anemia with neutrophilia, hypoalbuminemia, hyperglobulinemia, hypoglycemia, decreased urea and creatinine, and hypercholesterolemia. Abdominal radiographs and ultrasound revealed a large heterogeneous mesenteric mass and ascites. Abdominocentesis confirmed septic peritonitis with filamentous bacteria. Fine-needle aspiration of the mass yielded pyogranulomatous inflammation and hyphae. An exploratory laparotomy revealed a large cranial abdominal mass with granulomas present throughout the abdominal cavity. Due to the poor prognosis and disseminated disease, the owner elected euthanasia. Postmortem and histologic examinations detected intralesional mycetomas and bacterial colonies within the mesenteric masses. 16S ribosomal RNA gene PCR and sequencing using formalin-fixed, paraffin-embedded sections identified Nocardia yamanashiensis, Nocardioides cavernae, and Nocardioides zeicaulis. Fungal culture, PCR, and sequencing confirmed Scedosporium apiospermum. Our report highlights the importance of molecular methods in conjunction with culture and histologic findings for diagnosing coinfections caused by infrequent etiologic agents. Additionally, we provide a comprehensive literature review of Scedosporium apiospermum infections in dogs.
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Affiliation(s)
- Jessica Rose Lambert
- Departments of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Arthur Colombari Cheng
- Departments of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Laura M Lee
- Departments of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Donna Raiford
- Departments of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Emily Zuber
- Departments of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Erin Kilbane
- Departments of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | | | - Ewa Królak
- Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Katelyn C Hlusko
- Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Maureen McMichael
- Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Rebecca P Wilkes
- Department of Comparative Pathobiology, Animal Disease Diagnostic Laboratory (ADDL), College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Nathan P Wiederhold
- Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, TX, USA
| | - Connie F Cañete-Gibas
- Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, TX, USA
| | - Daniel Felipe Barrantes Murillo
- Departments of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK, USA
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Yu L, Yan J, Zhang Z, Li F, Zheng R, Shi J. Brain abscess caused by Nocardia farcinica in a person living with HIV. BMC Infect Dis 2024; 24:1100. [PMID: 39363255 PMCID: PMC11451152 DOI: 10.1186/s12879-024-10014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 09/27/2024] [Indexed: 10/05/2024] Open
Abstract
Nocardia farcinica is the most pathogenic Nocardia, which is easy to disseminate. It can be caused by trauma, and even lead to severe lung or central nervous system infection. This report covers a case of Nocardia brain abscess in an HIV patient, who underwent resection of the brain abscess, followed by anti-infective therapy with sulfamethoxazole and meropenem, and eventually made a good recovery. The mortality rate of Nocardia farcinica brain abscess has been attributed to the severity of the underlying disease, the difficulty in identifying the pathogen, and its inherent resistance to antibiotics, leading to inappropriate or late initiation of treatment. Medication should follow the principle of sufficient dosage and sufficient course of treatment.
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Affiliation(s)
- Lele Yu
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hengbu Street No. 2, Hangzhou, 310023, Zhejiang, China
| | - Jun Yan
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hengbu Street No. 2, Hangzhou, 310023, Zhejiang, China
| | - Zhongdong Zhang
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hengbu Street No. 2, Hangzhou, 310023, Zhejiang, China
| | - Feng Li
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hengbu Street No. 2, Hangzhou, 310023, Zhejiang, China
| | - Rongrong Zheng
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hengbu Street No. 2, Hangzhou, 310023, Zhejiang, China
| | - Jinchuan Shi
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hengbu Street No. 2, Hangzhou, 310023, Zhejiang, China.
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5
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Carvalho CS, de Aquino VMS, Meyer R, Seyffert N, Castro TLP. Diagnosis of bacteria from the CMNR group in farm animals. Comp Immunol Microbiol Infect Dis 2024; 113:102230. [PMID: 39236397 DOI: 10.1016/j.cimid.2024.102230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 08/18/2024] [Accepted: 08/20/2024] [Indexed: 09/07/2024]
Abstract
The CMNR group comprises bacteria of the genera Corynebacterium, Mycobacterium, Nocardia, and Rhodococcus and share cell wall and DNA content characteristics. Many pathogenic CMNR bacteria cause diseases such as mastitis, lymphadenitis, and pneumonia in farmed animals, which cause economic losses for breeders and represent a threat to public health. Traditional diagnosis in CMNR involves isolating target bacteria on general or selective media and conducting metabolic analyses with the assistance of laboratory biochemical identification systems. Advanced mass spectrometry may also support diagnosing these bacteria in the clinic's daily routine despite some challenges, such as the need for isolated bacteria. In difficult identification among some CMNR members, molecular methods using polymerase chain reaction (PCR) emerge as reliable options for correct specification that is sometimes achieved directly from clinical samples such as tracheobronchial aspirates and feces. On the other hand, immunological diagnostics such as the skin test or Enzyme-Linked Immunosorbent Assay (ELISA) for Mycobacterium tuberculosis yield promising results in subclinical infections with no bacterial growth involved. In this review, we present the methods most commonly used to diagnose pathogenic CMNR bacteria and discuss their advantages and limitations, as well as challenges and perspectives on adopting new technologies in diagnostics.
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Affiliation(s)
- Cintia Sena Carvalho
- Department of Biointeraction, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
| | - Vitória M S de Aquino
- Department of Biointeraction, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
| | - Roberto Meyer
- Department of Biointeraction, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
| | - Núbia Seyffert
- Department of Biointeraction, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
| | - Thiago L P Castro
- Department of Biotechnology, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil.
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6
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Jin L, Zhang W, Su F, Ji Y, Ge Y. Brain abscesses: the first report of disseminated Nocardia beijingensis infection in an immunocompetent individual in China. BMC Neurol 2024; 24:341. [PMID: 39272012 PMCID: PMC11396844 DOI: 10.1186/s12883-024-03826-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 08/26/2024] [Indexed: 09/15/2024] Open
Abstract
Nocardia is widely distributed in the natural environment and typically cause opportunistic infections. However, it is important to note that the pathogenicity of different Nocardia species may vary significantly. Here we reported the first case of brain abscess caused by Nocardia beijingensis (N. beijingensis) infection in China. A 70-year-old male immunocompetent individual came to our hospital for treatment due to headache. After examination, it was found that he had a brain abscess caused by N. beijingensis. By utilizing a combination of surgical intervention and antibiotic therapy, the patient ultimately achieved full recovery. In addition, we isolated this strain and displayed its ultrastructure through scanning electron microscopy. The phylogenetic tree was analyzed by 16 S rRNA sequence. A literature review of N. beijingensis infections in all immunocompetent and immunocompromised patients was presented. It highlighted that abscess formation appears to be a common manifestation of N. beijingensis infection, and N. beijingensis has become an emerging pathogen in immunocompetent individuals.
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Affiliation(s)
- Lihong Jin
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China
- Department of Clinical Laboratory, The First People's Hosiptal of Lin'an District, Hangzhou, Zhejiang, 311399, China
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China
| | - Weiqun Zhang
- Department of Clinical Laboratory, The First People's Hosiptal of Lin'an District, Hangzhou, Zhejiang, 311399, China
| | - Fang Su
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China
| | - Youqi Ji
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China
| | - Yumei Ge
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China.
- Key Laboratory of Biomarkers and In Vitro Diagnosis Translation of Zhejiang Province, Hangzhou, Zhejiang, 310053, China.
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7
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Huang L, Jia L. Disseminated nocardiosis caused by Nocardia otitidiscaviarum-A case report. Diagn Microbiol Infect Dis 2024; 110:116347. [PMID: 38878341 DOI: 10.1016/j.diagmicrobio.2024.116347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/19/2024] [Accepted: 05/09/2024] [Indexed: 07/30/2024]
Abstract
In this article we report a case of disseminated nocardiosis caused by Nocardia otitidiscaviarum in an immunocompetent patient with chronic obstructive pulmonary disease (COPD) who complained of a cough, followed by skin and intracranial lesions. On metagenomic next-generation sequencing (mNGS) technology of respiratory samples (bronchoalveolar lavage fluid, BALF) Nocardia otitidiscaviarum was identified. The patient was treated with therapy combined with a low dose of TMP-SMX and imipenem cilastatin sodium and had a favorable outcome. The timely diagnosis of Nocardia with the help of mNGS technology and early rational treatment of TMP-SMX can help improve the prognosis.
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Affiliation(s)
- Linyue Huang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu Sichuan 610041, PR China
| | - Lian Jia
- Pulmonary and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu Sichuan 610041, PR China; State Key Laboratory of Respiratory Health and Multimorbidity, Chengdu Sichuan 610041, PR China.
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8
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Xue K, Zhang A, Liu S, Chen D. Multiple brain abscesses caused by Nocardia farcinica infection after hand injury: A case report and literature review. Medicine (Baltimore) 2024; 103:e39019. [PMID: 39029015 PMCID: PMC11398785 DOI: 10.1097/md.0000000000039019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
RATIONALE Nocardia infection is commonly regarded as an opportunistic pulmonary pathogen affecting debilitated or immunocompromised individuals. Brain abscesses caused by Nocardia farcinica are rare and pose a diagnostic challenge. Traditional diagnostic techniques for identifying Nocardia species, such as blood culture, microscopy, and pathology, have shown inadequate performance. In the reported case, we applied metagenomic next-generation sequencing (mNGS) to diagnose a case of brain abscess due to N. farcinica. PATIENT CONCERNS A 66-year-old female developed a brain abscess after sustaining a hand injury. The patient exhibited a gradual change in personality and experienced tremors in her right upper limb for a duration of 1 month. DIAGNOSES The pathogen responsible for the multiple brain abscesses was identified in the cerebrospinal fluid as N. farcinica through mNGS. INTERVENTIONS Antibiotic treatment included trimethoprim-sulfamethoxazole, linezolid, amikacin, meropenem, and moxifloxacin. OUTCOMES The patient's symptoms and signs improved significantly after administration of antibiotics to which the pathogen is known to be sensitive. After 5 months of follow-up, magnetic resonance imaging of the head showed that the abscess was basically cured. The patient lived a normal life with no adverse drug reactions. LESSONS Nocardia brain infection is characterized by an insidious onset and lacks distinctive clinical and imaging features. mNGS was advantageous for the timely identification and management of Nocardia-associated brain abscess in the present case and obviated the need for invasive brain surgery. Expeditious and precise diagnosis coupled with prompt antibiotic therapy can significantly reduce the mortality rate associated with this condition.
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Affiliation(s)
- Kun Xue
- Department of Neuro-oncology Surgery, the First Hospital of Jilin University, Changchun City, Jilin, China
| | - Anling Zhang
- Department of Stomatology, Jilin FAW General Hospital, Changchun City, Jilin, China
| | - Shuyu Liu
- Department of Neuro-oncology Surgery, the First Hospital of Jilin University, Changchun City, Jilin, China
| | - Dawei Chen
- Department of Neuro-oncology Surgery, the First Hospital of Jilin University, Changchun City, Jilin, China
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Nazareth SC, Cheng LW, Wang PC, Chen SC. Comparative pathogenicity of Nocardia seriolae in Nile tilapia (Oreochromis niloticus), milkfish (Chanos chanos) and Asian seabass (Lates calcarifer). JOURNAL OF FISH DISEASES 2024; 47:e13947. [PMID: 38523361 DOI: 10.1111/jfd.13947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/26/2024]
Abstract
Nocardiosis, caused by Nocardia seriolae, has been a prominent disease in Southeast Asian aquaculture in the last three decades. This granulomatous disease reported in various fish species is responsible for significant economic losses. This study investigated the pathogenicity of N. seriolae in three cultured species in Taiwan: Nile tilapia (omnivore), milkfish (herbivore) and Asian seabass (carnivore). Administration of an infective dose of 1 × 106 CFU/ fish in tilapia, seabass and milkfish demonstrated mortalities of 100%, 90% and 75%, respectively. Additionally, clinical signs namely, granuloma and lesions displayed varying intensities between the groups and pathological scores. Polymerase chain reaction (PCR) amplification specific for N. seriolae was confirmed to be positive (432 bp) using NS1/NG1 primers. Post-mortem lesions revealed the absence of granulomas in tilapia and milkfish and their presence in the seabass. Interestingly, the gut in tilapia showed an influx of eosinophils suggesting its role during the acute stages of infection. However, post-challenge, surviving milkfish exhibited granulomatous formations, while surviving seabass progressed toward healing and tissue repair within sampled tissues. Overall, in conclusion, these results demonstrate the versatility in the immunological ability of individual Perciformes to contain this pathogen as a crucial factor that influences its degree of susceptibility.
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Affiliation(s)
- Sandra Celenia Nazareth
- Department of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Li-Wu Cheng
- Department of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Pei-Chi Wang
- College of Veterinary Medicine, Southern Taiwan Fish Diseases Research Centre, National Pingtung University of Science and Technology, Pingtung, Taiwan
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Research Centre for Fish Vaccine and Diseases, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Shih-Chu Chen
- Department of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- College of Veterinary Medicine, Southern Taiwan Fish Diseases Research Centre, National Pingtung University of Science and Technology, Pingtung, Taiwan
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Research Centre for Fish Vaccine and Diseases, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- General Research Service Centre, National Pingtung University of Science and Technology, Pingtung, Taiwan
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10
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Mitwalli H, Alekrish Y, Nafisah F, Alkhamshi A. A Diagnostic Challenge: A Case of Disseminated Nocardiosis Presenting With Generalized Lymphadenopathy in a Patient With Interleukin-12 Deficiency. Cureus 2024; 16:e62396. [PMID: 39006736 PMCID: PMC11246730 DOI: 10.7759/cureus.62396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2024] [Indexed: 07/16/2024] Open
Abstract
Deficiency in interleukin-12 (IL-12) can result in susceptibility to opportunistic infection, with IL-12 deficiency being a rare genetic cause. Nocardia farcinica is a gram-positive aerobic actinomycete that can cause disseminated and potentially lethal nocardiosis in immunocompromised patients. This report describes a 16-year-old male adolescent with IL-12 deficiency presenting with generalized lymphadenopathy due to disseminated Nocardia farcinica. The subject of our study is a male adolescent who exhibited clinical manifestations consistent with cholestasis. He underwent extensive workup for malignancy, suspecting cholangiocarcinoma initially. The workup turned out unremarkable, and later during his hospital stay, he deteriorated and required intensive care unit (ICU) admission, as he developed superior vena cava (SVC) syndrome from massive enlargement of mediastinal and cervical lymph nodes. During the patient's admission, it was found that he had a deficiency of interleukin-12 (IL-12). Later on, a blood culture revealed the presence of Nocardia farcinica species. Subsequently, the patient was initiated and improved drastically on an empirical antibiotic regimen consisting of amikacin, co-trimoxazole, meropenem, and moxifloxacin. Following that, the susceptibility results came out, and he was switched to oral co-trimoxazole and oral moxifloxacin as he no longer required inpatient care. This report highlights the importance of accurate diagnosis of causes of immunosuppression and early investigation, diagnosis, and management of potentially fatal opportunistic infections such as disseminated Nocardia farcinica.
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Affiliation(s)
- Hussam Mitwalli
- Division of Rheumatology, Department of Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Yazeed Alekrish
- Department of Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Faris Nafisah
- Department of Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Abdullah Alkhamshi
- Department of Medicine, College of Medicine, King Saud University, Riyadh, SAU
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11
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Bury K, Citriniti V, Bahrampour S, Bajaj S, Ferguson JF. Understanding the Risk Factors and Pathogenesis of Disseminated Nocardiosis in Immunocompromised Patients. Cureus 2024; 16:e59838. [PMID: 38846199 PMCID: PMC11156491 DOI: 10.7759/cureus.59838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
Nocardia is a genus of aerobic, Gram-positive, partially acid-fast, filamentous bacilli notoriously known for causing multisystemic infections in immunocompromised individuals. Notably, this genus of bacteria commonly infects the pleural and central nervous system, leading to pneumonia and brain abscesses, respectively. Our patient is a 71-year-old female who initially presented to the emergency department complaining of shortness of breath and altered mental status. Imaging revealed multiple enhancing brain lesions, a pleural effusion, and a paraspinal abscess, which upon aspiration and culture demonstrated Nocardia farcinica/kroppenstedtii. The patient underwent antibiotic treatment, including intravenous (IV) imipenem and trimethoprim/sulfamethoxazole (TMP-SMX), before being transitioned to oral TMP-SMX and amoxicillin/clavulanate. This case demonstrates the importance of diagnosing nocardiosis acutely and treating it appropriately.
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Affiliation(s)
- Kacper Bury
- Internal Medicine, Touro College of Osteopathic Medicine, Middletown, USA
| | - Vincent Citriniti
- Internal Medicine, Touro College of Osteopathic Medicine, Middletown, USA
| | - Sheeva Bahrampour
- Internal Medicine, Touro College of Osteopathic Medicine, Middletown, USA
| | - Sonal Bajaj
- Infectious Disease, Garnet Health Medical Center, Middletown, USA
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Han Y, Cheng M, Li Z, Chen H, Xia S, Zhao Y, Wang Y, He W, Wang W. Clinical characteristics and drug resistance of Nocardia in Henan, China, 2017-2023. Ann Clin Microbiol Antimicrob 2024; 23:23. [PMID: 38449006 PMCID: PMC10919010 DOI: 10.1186/s12941-024-00677-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND The aim of this study was to investigate the clinical features of Nocardia infections, antibiotic resistance profile, choice of antibiotics and treatment outcome, among others. In addition, the study compared the clinical and microbiological characteristics of nocardiosis in bronchiectasis patients and non-bronchiectasis patients. METHODS Detailed clinical data were collected from the medical records of 71 non-duplicate nocardiosis patients from 2017 to 2023 at a tertiary hospital in Zhengzhou, China. Nocardia isolates were identified to the species level using MALDI-TOF MS and 16S rRNA PCR sequencing. Clinical data were collected from medical records, and drug susceptibility was determined using the broth microdilution method. RESULTS Of the 71 cases of nocardiosis, 70 (98.6%) were diagnosed as pulmonary infections with common underlying diseases including bronchiectasis, tuberculosis, diabetes mellitus and chronic obstructive pulmonary disease (COPD). Thirteen different strains were found in 71 isolates, the most common of which were N. farcinica (26.8%) and N. cyriacigeorgica (18.3%). All Nocardia strains were 100% susceptible to both TMP-SMX and linezolid, and different Nocardia species showed different patterns of drug susceptibility in vitro. Pulmonary nocardiosis is prone to comorbidities such as bronchiectasis, diabetes mellitus, COPD, etc., and Nocardia is also frequently accompanied by co-infection of the body with pathogens such as Mycobacterium and Aspergillus spp. Sixty-one patients underwent a detailed treatment regimen, of whom 32 (52.5%) received single or multi-drug therapy based on TMP-SMX. Bronchiectasis was associated with a higher frequency of Nocardia infections, and there were significant differences between the bronchiectasis and non-bronchiectasis groups in terms of age distribution, clinical characteristics, identification of Nocardia species, and antibiotic susceptibility (P < 0.05). CONCLUSIONS Our study contributes to the understanding of the species diversity of Nocardia isolates in Henan, China, and the clinical characteristics of patients with pulmonary nocardiosis infections. Clinical and microbiologic differences between patients with and without bronchiectasis. These findings will contribute to the early diagnosis and treatment of patients.
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Affiliation(s)
- Yungang Han
- Key Laboratory of Medical Laboratory, Henan Provincial Chest Hospital, Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Disciplines (Laboratory Diagnostics), Henan Provincial Chest Hospital, Zhengzhou, China
| | - Meijin Cheng
- Key Laboratory of Medical Laboratory, Henan Provincial Chest Hospital, Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Disciplines (Laboratory Diagnostics), Henan Provincial Chest Hospital, Zhengzhou, China
| | - Zheng Li
- Key Laboratory of Medical Laboratory, Henan Provincial Chest Hospital, Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Disciplines (Laboratory Diagnostics), Henan Provincial Chest Hospital, Zhengzhou, China
| | - Huihui Chen
- Key Laboratory of Medical Laboratory, Henan Provincial Chest Hospital, Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Disciplines (Laboratory Diagnostics), Henan Provincial Chest Hospital, Zhengzhou, China
| | - Shuang Xia
- Key Laboratory of Medical Laboratory, Henan Provincial Chest Hospital, Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Disciplines (Laboratory Diagnostics), Henan Provincial Chest Hospital, Zhengzhou, China
| | - Yue Zhao
- Key Laboratory of Medical Laboratory, Henan Provincial Chest Hospital, Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Disciplines (Laboratory Diagnostics), Henan Provincial Chest Hospital, Zhengzhou, China
| | - Yali Wang
- Key Laboratory of Medical Laboratory, Henan Provincial Chest Hospital, Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Disciplines (Laboratory Diagnostics), Henan Provincial Chest Hospital, Zhengzhou, China
| | - Wenyi He
- Key Laboratory of Medical Laboratory, Henan Provincial Chest Hospital, Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Medical Key Disciplines (Laboratory Diagnostics), Henan Provincial Chest Hospital, Zhengzhou, China
| | - Wei Wang
- Key Laboratory of Medical Laboratory, Henan Provincial Chest Hospital, Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, China.
- Henan Provincial Medical Key Disciplines (Laboratory Diagnostics), Henan Provincial Chest Hospital, Zhengzhou, China.
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Zhou SM, Shu FL, Liu H, Qian D, Xie JS, Wang YJ, Yin F. Disruption of a kasB homolog gene (kasB) causes attenuation of cell invasion and virulence of Nocardia seriolae. JOURNAL OF FISH DISEASES 2024; 47:e13896. [PMID: 38054569 DOI: 10.1111/jfd.13896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 12/07/2023]
Abstract
Nocardia seriolae is the primary aetiological agent of nocardiosis in fish, which causes mass mortality in freshwater and marine fish. β-ketoacyl-ACP synthase (KAS) is one of the essential enzymes in the synthesis of mycolic acids (MASs) in Mycobacterium spp. and has been chosen as the target for therapeutic intervention in mycobacterial diseases. In the present study, a kasB homologue gene (kasB) was identified in the genome of N. seriolae, and the gene-deficient mutant (ΔkasB) was generated based on a clinical isolate, XSYC-Ns. Compared to the wild-type (WT) strain, the ΔkasB showed a measurably growth defect in vitro but retained the acid-fastness in acid-fast staining. Observation of the cell ultrastructure showed some alterations in the cell wall of the ΔkasB strain. Compared to its original strain, the cell wall lipid layer seemed sparser, and a wider electron-transparent zone was observed in the cell wall of ΔkasB strain. Moreover, the ΔkasB strain showed impaired ability of cell invasion as well as intracellular survival in the cell line originating from the head-kidney of the large yellow croaker (LYC-hK), compared to its original strain. In addition, the deficiency of ΔkasB significantly attenuated the virulence of N. seriolae in largemouth bass. The present study suggested that the ΔkasB gene might be involved in the synthesis of extracellular cell-wall lipids in N. seriolae and play a crucial role in its pathogenicity.
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Affiliation(s)
- Su-Ming Zhou
- Key Laboratory of the Ministry of Education for Applied Marine Biotechnology, School of Marine Science, Ningbo University, Ningbo, China
| | - Feng-Ling Shu
- Key Laboratory of the Ministry of Education for Applied Marine Biotechnology, School of Marine Science, Ningbo University, Ningbo, China
| | - Hao Liu
- Key Laboratory of the Ministry of Education for Applied Marine Biotechnology, School of Marine Science, Ningbo University, Ningbo, China
| | - Dong Qian
- Key Laboratory of the Ministry of Education for Applied Marine Biotechnology, School of Marine Science, Ningbo University, Ningbo, China
| | - Jia-Song Xie
- Key Laboratory of the Ministry of Education for Applied Marine Biotechnology, School of Marine Science, Ningbo University, Ningbo, China
| | - Ya-Jun Wang
- Key Laboratory of the Ministry of Education for Applied Marine Biotechnology, School of Marine Science, Ningbo University, Ningbo, China
| | - Fei Yin
- Key Laboratory of the Ministry of Education for Applied Marine Biotechnology, School of Marine Science, Ningbo University, Ningbo, China
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Amano T, Nishikawa T, Oka K, Ota K, Shimizu T. How an Antimicrobial Stewardship Team Treated a Nocardia farcinica-Associated Brain Abscess: A Case Report. Cureus 2024; 16:e54605. [PMID: 38523941 PMCID: PMC10958982 DOI: 10.7759/cureus.54605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Nocardia species, which are ubiquitous in the environment, form lesions primarily in immunocompromised patients via oral or cutaneous infection. Some of these Nocardia species, such as N. farcinica, also infect the central nervous system via hematogenous dissemination, which rarely results in brain abscesses. Notably, N. farcinica is resistant to numerous antimicrobial drugs used in empirical therapy, necessitating the intervention of an infectious disease specialist. To date, no case of antimicrobial stewardship teams (ASTs) playing a central role in community hospitals without an infectious disease specialist has been reported. Here, we describe a case of N. farcinica-associated brain abscess in a small-to-medium-sized hospital with no infectious disease department or specialist, in which the AST assisted in the identification of the causative organism and in selecting appropriate therapeutic agents, ultimately leading to a cure. The patient was an 88-year-old man with a high fever. He had been taking prednisolone (10-15 mg/day) for approximately 1 year for pemphigoid. Considering the possibility of fever owing to bacteremia of cutaneous origin, ampicillin/sulbactam antimicrobial therapy at 6 g/day was initiated. A subsequent close examination led to the diagnosis of a brain abscess. Emergency abscess drainage was performed by a neurosurgeon, and postoperative antimicrobial combination therapy comprising ceftriaxone (4 g/day), vancomycin (2 g/day), and metronidazole (1,500 mg/day) was commenced. The AST suspected Nocardia infection earlier, but further testing was difficult to perform at this facility. Therefore, by requesting assistance from Nagoya University Hospital, we performed early bacterial identification by mass spectrometry and appropriate antimicrobial susceptibility testing by a custom panel on day 11. The patient was non-responsive to all the previously used antibiotics at the time of admission. On day 13 after admission, the patient was successfully treated with trimethoprim-sulfamethoxazole (TMP-SMX) and imipenem/cilastatin sodium, and the patient was cured. The AST can be as effective as an infectious disease specialist when a strong working relationship is established between the team and clinicians. Further, the activities of the AST can improve patient survival via active medical support in collaboration with attending physicians.
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Affiliation(s)
- Tetsushi Amano
- Antimicrobial Stewardship Team, Hekinan Municipal Hospital, Hekinan, JPN
- Department of Pharmacy, Hekinan Municipal Hospital, Hekinan, JPN
| | | | - Keisuke Oka
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, JPN
| | - Kosei Ota
- Antimicrobial Stewardship Team, Hekinan Municipal Hospital, Hekinan, JPN
- Department of Clinical Laboratory, Hekinan Municipal Hospital, Hekinan, JPN
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, JPN
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He S, Lin Y. Primary cutaneous nocardiosis in an immunocompetent host. Clin Case Rep 2024; 12:e8516. [PMID: 38374880 PMCID: PMC10875629 DOI: 10.1002/ccr3.8516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/21/2024] Open
Abstract
Nocardiosis is a rare opportunistic infection that is classically observed in immunocompromised patients but can also affect immunocompetent individuals. It tends to involve the lung, central nervous system, and skin and is often misdiagnosed.
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Affiliation(s)
- Shihuan He
- Department of Dermatology and VenereologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Youkun Lin
- Department of Dermatology and VenereologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
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Stellern JJ, Plaisted J, Welles C. Disseminated nocardiosis with persistent neurological disease. BMJ Case Rep 2024; 17:e257935. [PMID: 38195189 PMCID: PMC10806866 DOI: 10.1136/bcr-2023-257935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 01/11/2024] Open
Abstract
A man in his 80s with a history of sarcoidosis on chronic prednisone presented to the emergency department with several days of dyspnoea. A chest X-ray showed signs of pneumonia, and the patient was admitted. Blood and pleural fluid cultures grew Nocardia farcinica; therefore, the patient was started on treatment with trimethoprim-sulbactam and imipenem. Brain imaging showed evidence of dissemination of the infection to the central nervous system (CNS). The patient's admission was complicated by pleural effusions, acute kidney injury and pancytopenia, and therefore, his antibiotic regimen was ultimately transitioned from trimethoprim-sulfamethoxazole (TMP-SMX), meropenem and linezolid to imipenem and tedizolid. The patient received imipenem and tedizolid for the remainder of the admission. A repeat MRI of the brain was performed after 6 weeks of this dual antibiotic therapy, which unfortunately revealed persistent CNS disease. His regimen was then broadened to TMP-SMX, linezolid and imipenem. Despite these measures, however, the patient ultimately passed away from the infection.
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Affiliation(s)
| | - Jacob Plaisted
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Christine Welles
- University of Colorado School of Medicine, Aurora, Colorado, USA
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Trindade Torres M, Sousa Nunes B, Varandas L, Maltez F. Actinomycetoma by Cellulosimicrobium cellulans in a Young Man from Guinea-Bissau: Short Literature Review Regarding a Case Report. ACTA MEDICA PORT 2024; 37:46-50. [PMID: 36919988 DOI: 10.20344/amp.17356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/09/2022] [Indexed: 03/16/2023]
Abstract
Mycetoma is caused by the subcutaneous inoculation of filamentous fungi or aerobic filamentous bacteria. Cellulosimicrobium cellulans is a gram-positive bacterium from the order Actinomycetales that rarely causes human disease. The diagnosis is based on the clinical presentation and identification of the causative microorganism. We present a short literature review regarding the case report of a young man diagnosed with actinomycetoma due to Cellulosimicrobium cellulans and who received treatment with an association of amikacin and sulfamethoxazole/ trimethoprim (Welsh regimen).
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Affiliation(s)
| | - Beatriz Sousa Nunes
- Serviço de Infeciologia Pediátrica. Hospital de Dona Estefânia. Lisboa. Portugal
| | - Luís Varandas
- Serviço de Infeciologia Pediátrica. Hospital de Dona Estefânia. Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa; Instituto de Higiene e Medicina Tropical. Lisboa. Portugal
| | - Fernando Maltez
- Serviço de Doenças Infeciosas. Hospital de Curry Cabral. Lisboa. Portugal
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Htun ZM, Gul MH, Sadikot RT. Bacterial Infections in Patients Living with HIV. Results Probl Cell Differ 2024; 73:537-549. [PMID: 39242392 DOI: 10.1007/978-3-031-62036-2_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
Pneumonia, as well as other types of acute and chronic lung injuries, remain the leading causes of death in individuals living with HIV. Individuals with HIV who are on antiretroviral therapy continue to have a greater risk for pneumonia, including bacterial and mycobacterial infections. Alveolar macrophages and lung epithelial cells constitute the first line of host defense against invading pathogens. The predisposition of individuals living with HIV to infections despite ante-retroviral therapy is mechanistically related to HIV pro-viruses integrating into host cells, including airway epithelial cells and alveolar macrophages. Alveolar macrophages harbor latent HIV even when individuals appear to have complete suppression on ART. In parallel, pneumonia can irreversibly impair lung function in HIV-infected individuals. Cells that Macrophages exposed to HIV or HIV-related proteins have been shown to secrete exosomes that contain miRNAs. These exosomes can regulate several innate and acquired immune functions by stimulating cytokine production and inflammatory responses. Furthermore, these secreted exosomal miRNAs can shuttle between cells, causing cellular dysfunction in the case of epithelial cells; they disrupt lung epithelial barrier dysfunction, which leads to a predisposition to bacterial infections. We discuss the common bacterial infections that occur in patients living with HIV and provide mechanistic insights into how the intercellular communication of miRNAs results in cellular dysfunction.
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Affiliation(s)
- Zin Mar Htun
- Division of Pulmonary, Critical Care & Sleep, Department of Internal Medicine, University of 0Nebraska Medical Center, Omaha, NE, USA
| | - Muhammad H Gul
- Division of Pulmonary, Critical Care & Sleep, Department of Internal Medicine, University of 0Nebraska Medical Center, Omaha, NE, USA
| | - Ruxana T Sadikot
- Division of Pulmonary, Critical Care & Sleep, Department of Internal Medicine, University of 0Nebraska Medical Center, Omaha, NE, USA.
- VA Nebraska Western Iowa Health Care System, Omaha, NE, USA.
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Kim S, Shi HJ, Jeon CH, Kim SB, Yi J, Kim AR, Kim KH, Lim S. Clinical Characteristics of Nocardiosis: a Multicenter Retrospective Study in Korea. Infect Chemother 2023; 55:431-440. [PMID: 37674336 PMCID: PMC10771949 DOI: 10.3947/ic.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/21/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Nocardiosis is a rare, but potentially life-threatening condition. It is difficult to diagnose, and bacterial culture identification can be time consuming. We investigated the characteristics of nocardiosis and the suitability of the treatment approach in Korea. MATERIALS AND METHODS This retrospective study was conducted at 5 medical institutions between 2011 and 2021. We reviewed the medical records of patients with microbiologically confirmed nocardiosis. Appropriate antibiotic selection was defined as follows: (1) selecting antibiotics according to the species, (2) if the species of Nocardia was unknown, trimethoprim-sulfamethoxazole-based therapy or linezolid-based therapy was administered, and (3) selection of antibiotics using the antibiotic susceptibility test. The appropriate treatment periods for antibiotics were defined as treatment maintained from 3 to 12 months, depending on involvement of the organs. Descriptive analysis and Fisher exact test were used. Statistical significance was set at P-values of <0.05. RESULTS Thirty patients were enrolled. Of these patients, 18 (60.0%) were male. The median age was 70.5 years. Among the diagnosed patients, 12 (40.0%) had an immunocompromised status. Eight (30.0%) patients received optimal treatment for the appropriate treatment period. Appropriate dosing duration was observed in 3 of the 12 (25.0%) immunocompromised patients. There was no significant difference between the presence or absence of immunosuppression and the adequacy of treatment for nocardiosis (P = 1.000). Skin and soft tissue (14 patients) were most frequently involved in this study. Nocardia species (spp.) were isolated from culture at a median of 6.0 days. There were 7 cases with N. farcinica (23.3%). CONCLUSION We found that 60.0% of the patients with nocardiosis did not have an immunocompromised status. Further, 26.7% of the total patients received adequate treatment for nocardiosis. The reasons for suboptimal management of nocardiosis in Korea are presumed to be diagnostic difficulties, lack of awareness about nocardiosis, and difficulties in selecting antibiotics for Nocardia spp. among clinicians. The lack of antibiotic susceptibility tests for Nocardia spp. could be the source of these problems. Nocardiosis should be suspected in cases of recurrent infections with skin and soft tissue, musculoskeletal, or respiratory system involvement with or without an immunocompromised status. Clinical microbiological support is required for the diagnosis and selection of antibiotics in Korea. High clinical index of suspicion and clinical microbiological support are required for the accurate diagnosis of nocardiosis in Korea.
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Affiliation(s)
- Seulki Kim
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hye Jin Shi
- Division of Infectious Diseases, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Cheon-Hoo Jeon
- Division of Infectious Diseases, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Sun Bean Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jongyoun Yi
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - A Reum Kim
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kye-Hyung Kim
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
| | - Seungjin Lim
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
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Sun H, Xie X, Wang Y, Wang J, Deng T. Clinical screening of Nocardia in sputum smears based on neural networks. Front Cell Infect Microbiol 2023; 13:1270289. [PMID: 38094748 PMCID: PMC10716215 DOI: 10.3389/fcimb.2023.1270289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Objective Nocardia is clinically rare but highly pathogenic in clinical practice. Due to the lack of Nocardia screening methods, Nocardia is often missed in diagnosis, leading to worsening the condition. Therefore, this paper proposes a Nocardia screening method based on neural networks, aiming at quick Nocardia detection in sputum specimens with low costs and thereby reducing the missed diagnosis rate. Methods Firstly, sputum specimens were collected from patients who were infected with Nocardia, and a part of the specimens were mixed with new sputum specimens from patients without Nocardia infection to enhance the data diversity. Secondly, the specimens were converted into smears with Gram staining. Images were captured under a microscope and subsequently annotated by experts, creating two datasets. Thirdly, each dataset was divided into three subsets: the training set, the validation set and the test set. The training and validation sets were used for training networks, while the test set was used for evaluating the effeteness of the trained networks. Finally, a neural network model was trained on this dataset, with an image of Gram-stained sputum smear as input, this model determines the presence and locations of Nocardia instances within the image. Results After training, the detection network was evaluated on two datasets, resulting in classification accuracies of 97.3% and 98.3%, respectively. This network can identify Nocardia instances in about 24 milliseconds per image on a personal computer. The detection metrics of mAP50 on both datasets were 0.780 and 0.841, respectively. Conclusion The Nocardia screening method can accurately and efficiently determine whether Nocardia exists in the images of Gram-stained sputum smears. Additionally, it can precisely locate the Nocardia instances, assisting doctors in confirming the presence of Nocardia.
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Affiliation(s)
- Hong Sun
- Department of Laboratory Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Xuanmeng Xie
- Effect, Jianying, Intelligent Creation Lab, Bytedance Inc., Hangzhou, China
| | - Yaqi Wang
- College of Media Engineering, Communication University of Zhejiang, Hangzhou, China
| | - Juan Wang
- Department of Laboratory Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Tongyang Deng
- Department of Laboratory Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, China
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Li X, Feng Y, Li D, Chen L, Shen M, Li H, Li S, Wu X, Lu L. Cerebral Abscess Infected by Nocardia gipuzkoensis. Infect Drug Resist 2023; 16:7247-7253. [PMID: 38023399 PMCID: PMC10657549 DOI: 10.2147/idr.s428415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Nocardia gipuzkoensis is a novel species that solely identified in patients with pulmonary infections by far. Growing evidence showed the excellent performance of metagenomics next-generation sequencing (mNGS) on pathogenic identification, especially for new species. Here, we described the first case of an elderly female patient suddenly suffering from neurological disorders owing to N. gipuzkoensis infection. And linezolid could effectively treat N. gipuzkoensis infection. Patients and Methods The results of imaging, laboratory cultures, and mNGS, as well as therapeutic process are shared. Results An elderly female patient suddenly suffered from neurological disorders with dysphasia and right limb trembles under no obvious causes. Subsequently, she was diagnosed as intracranial space-occupying lesions by magnetic resonance imaging (MRI). The isolate from brain secretion was further identified as N. gipuzkoensis through mNGS. The targeted therapy with linezolid according to the antimicrobial susceptibility was used to treat cerebral abscess induced by N. gipuzkoensis. During the follow-up, no relapse was observed for the patient after surgery for 104 days. Conclusion Cerebral abscess induced by N. gipuzkoensis is rare disorder with high mortality. mNGS has been identified as a promising tool in pathogen diagnosis for timely therapy. Linezolid as one of the antimicrobial drugs could effectively treat N. gipuzkoensis infection and prevent adverse outcomes.
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Affiliation(s)
- Xiaosi Li
- Department of Clinical Laboratory, The Second Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Yan Feng
- Department of Clinical Laboratory, Jiaxing Maternity and Child Health Care Hospital Affiliated to Jiaxing University, Jiaxing, People’s Republic of China
| | - Dan Li
- Key laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co, Ltd, Hangzhou, People’s Republic of China
| | - Liyang Chen
- Department of Clinical Laboratory, The Second Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Mengli Shen
- Department of Clinical Laboratory, The Second Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Hongsheng Li
- Department of Clinical Laboratory, The Second Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Shuo Li
- Key laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co, Ltd, Hangzhou, People’s Republic of China
| | - Xiaoyan Wu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Lingling Lu
- Key laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co, Ltd, Hangzhou, People’s Republic of China
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Liang Y, Lin M, Qiu L, Chen M, Tan C, Tu C, Zheng X, Liu J. Clinical characteristics of hospitalized patients with Nocardia genus detection by metagenomic next generation sequencing in a tertiary hospital from southern China. BMC Infect Dis 2023; 23:772. [PMID: 37940842 PMCID: PMC10634012 DOI: 10.1186/s12879-023-08615-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/16/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE As an opportunistic pathogen, Nocardia often occurring in the immunocompromised hosts. As the unspecifc clinical presentation and low identification rate of the culture dependent methods, Nocardia infection may be under-diagnosis. Recent study have reported physicians could benefit from metagenomic next-generation sequencing (mNGS) in Nocardia diagnosis. Herein, we present patients with a positive detection of nocardiosis in mNGS, aiming to provide useful information for an differential diagnosis and patients management. METHODS A total of 3756 samples detected for mNGS from March 2019 to April 2022 at the Fifth Affifiliated Hospital of Sun Yat-sen University, were screened. Clinical records, laboratory finding, CT images and mNGS results were reviewed for 19 patients who were positive for Nocardia genus. RESULTS Samples from low respiratory tract obtained by bronchoscope took the major part of the positive (15/19). 12 of 19 cases were diagnosis as Nocardiosis Disease (ND) and over half of the ND individuals (7/12) were geriatric. Nearly all of them (10/12) were immunocompetent and 2 patients in ND group were impressively asymptomatic. Cough was the most common symptom. Nocardia cyriacigeorgica (4/12) was more frequently occurring in ND, followed by Nocardia abscessus (3/12). There are 3 individuals detected more than one kind of Nocardia species (Supplementary table 1). Except one with renal failure and one allergic to sulfamethoxazole, all of them received co-sulfonamide treatment and relieved eventually. CONCLUSION Our study deciphered the clinical features of patients with positive nocardiosis detected by mNGS. Greater attention should be paid to the ND that occurred in the immunocompetent host and the geriatric. Due to the difficulties in establishing diagnosis of Nocardiosis disease, mNGS should play a much more essential role for a better assessment in those intractable cases. Co-sulfonamide treatment should still be the first choice of Nocardiosis disease.
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Affiliation(s)
- Yingjian Liang
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Minmin Lin
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Lidi Qiu
- Department of Infectious Disease Intensive Care Unit, Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Meizhu Chen
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Cuiyan Tan
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
- Department of General Intensive Care Unit, Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Changli Tu
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China.
| | - Xiaobin Zheng
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China.
- Department of General Intensive Care Unit, Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China.
| | - Jing Liu
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China.
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23
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Abavisani M, Rouhani J, Keikha M. Comments on "Disseminated Nocardia transvalensis complex and farcinica: First case in an immunocompetent". New Microbes New Infect 2023; 54:101176. [PMID: 37720890 PMCID: PMC10502357 DOI: 10.1016/j.nmni.2023.101176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023] Open
Affiliation(s)
- Mohammad Abavisani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jalil Rouhani
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Keikha
- Department of Microbiology and Virology, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
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24
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McKinney WP, Smith MR, Roberts SA, Morris AJ. Species distribution and susceptibility of Nocardia isolates in New Zealand 2002-2021. Pathology 2023:S0031-3025(23)00122-8. [PMID: 37277236 DOI: 10.1016/j.pathol.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/16/2023] [Accepted: 03/13/2023] [Indexed: 06/07/2023]
Abstract
The aim was to record the distribution and susceptibility of Nocardia species in New Zealand. Local and referred isolates were identified by an evolving approach over the study period including conventional phenotypic methods, susceptibility profiles, matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF) and molecular sequencing. Isolates previously identified as a Nocardia sp. or part of the N. asteroides complex were reidentified by MALDI-TOF and/or molecular methods. Antimicrobial susceptibility to eight antibiotics was performed by standard microbroth dilution. The site of isolation, susceptibility profiles and species distribution were analysed. A total of 383 isolates were tested: N. brasiliensis 23 (6%), N. cyriacigeorgica 42 (11%), N. farcinica 41 (11%), N. nova complex 226 (59%), and 51 (13%) other species/complexes. The respiratory tract was the most common site of infection (244, 64%), with skin and soft tissue the second most common site (104, 27%). All 23 N. brasiliensis isolates were from skin and soft tissue specimens. Almost all isolates (≥98%) were susceptible to amikacin, linezolid and trimethoprim-sulfamethoxazole; 35% and 77% were resistant to clarithromycin and quinolones, respectively. The expected susceptibility profiles of the four common species and complex were observed for most agent-organism parings. Multi-drug resistance was uncommon (3.4%). The spectrum of Nocardia species in New Zealand is similar to overseas reports and our most common group is the N. nova complex. While amikacin, linezolid and trimethoprim-sulfamethoxazole remain good empiric treatment choices, other agents should have their activity confirmed before use.
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Affiliation(s)
- Wendy P McKinney
- Clinical Microbiology Laboratory, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Marian R Smith
- Clinical Microbiology Laboratory, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Sally A Roberts
- Clinical Microbiology Laboratory, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Arthur J Morris
- Clinical Microbiology Laboratory, LabPLUS, Auckland City Hospital, Auckland, New Zealand.
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25
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Wang S, Wang P, Liu J, Yang C, Li T, Yang J, Gu L, Wei M. Molecular detection of Nocardia: development and application of a real-time PCR assay in sputum and bronchoalveolar lavage fluid samples. Eur J Clin Microbiol Infect Dis 2023:10.1007/s10096-023-04619-4. [PMID: 37156981 DOI: 10.1007/s10096-023-04619-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
The diagnosis of pulmonary nocardiosis remains challenging. Rapid detection of Nocardia is of primary importance for early diagnosis and precise treatment of nocardiosis. In this study, our objective was to develop and validate a new TaqMan real-time PCR (qPCR) assay for rapidly detecting Nocardia spp. in respiratory samples. Based on published sequence data, primers in a conserved region of the 16S rRNA gene and a probe within that region that was specific for Nocardia were designed. The distinction effect of the qPCR assay was assessed between Nocardia and other respiratory-associated bacteria. Furthermore, the specificity and sensitivity of the assay were evaluated in respiratory clinical samples (n = 205), compared to the results of 16S rRNA gene amplicon sequencing and clinical diagnosis. The qPCR assay exhibited high specificity, sensitivity, repeatability, and reproducibility. The limit of detection of standard plasmid DNA was 3 × 102 copies/mL. Additionally, the qPCR assay was applied to the direct detection of 205 clinical respiratory samples. The specificity and sensitivity of the qPCR were all 100% compared to 16S rRNA gene amplicon sequencing, as well as 98.4% and 100% compared to clinical diagnosis respectively. The qPCR yielded results within 3 h of sample processing, compared to several days for culture, significantly reducing turnaround time. The results suggest that the new qPCR assay developed in this study provides reliable and rapid detection of Nocardia spp. in the respiratory tracts and is expected to reduce the time required for diagnosing and treating nocardiosis.
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Affiliation(s)
- Shuai Wang
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Peng Wang
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jun Liu
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Chunxia Yang
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Tianmeng Li
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jingxian Yang
- Department of Clinical Laboratory, Aerospace Center Hospital, Beijing, China
| | - Li Gu
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Ming Wei
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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26
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Nazareth SC, Rao S, Cheng LW, Wang PC, Chen SC. Nocardia seriolae cell wall lipids: An effective protective mechanism in resistance and virulence. JOURNAL OF FISH DISEASES 2023; 46:405-416. [PMID: 36628981 DOI: 10.1111/jfd.13753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Piscine nocardiosis, caused by Nocardia seriolae, is a refractory granulomatous disease in South-East Asian aquaculture. This study investigates the virulence of nocardial lipids essential for pathogenesis among Actinomycetes. Petroleum ether (PE) was used to selectively delipidate two groups of N. seriolae, namely, live cell (LC) and killed cell (KC); resulting in delipidated live cell (DLC) and delipidated killed cell (DKC), respectively. Changes post-delipidation on genus characteristics, such as loss in acid-fast nature and resistance to lysozyme were observed. Transmission electron microscopy revealed notable changes in the lipid layer. Additionally, Lates calcarifer, Asian seabass intraperitoneally injected with LC and DLC had mortality rates of 90% and 50%, respectively, with the latter exhibiting a delay in mortality. Reverse-transcription quantitative PCR (RT-qPCR) analysis of host cytokines from the spleen and head kidney showed delipidation contributed to the induction of an immune response with increased transcriptional levels of interferon-γ (ifn-γ). Histopathological samples collected on day 7 post-inoculation displayed a varied granulomatous response between the treatment groups and scored for pathological changes. These findings affirm that the virulence of the lipids remains independent of the living state of the cell, significantly altering the immune and granulomatous responses in L. calcarifer to N. seriolae.
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Affiliation(s)
- Sandra Celenia Nazareth
- Department of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Shreesha Rao
- Department of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Li-Wu Cheng
- Department of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Pei-Chi Wang
- Department of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- College of Veterinary Medicine, Southern Taiwan Fish Diseases Research Centre, National Pingtung University of Science and Technology, Pingtung, Taiwan
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Pingtung, Taiwan
- Research Centre for Fish Vaccine and Diseases, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Shih-Chu Chen
- Department of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- College of Veterinary Medicine, Southern Taiwan Fish Diseases Research Centre, National Pingtung University of Science and Technology, Pingtung, Taiwan
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Pingtung, Taiwan
- Research Centre for Fish Vaccine and Diseases, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Research Centre for Animal Biologics, National Pingtung University of Science and Technology, Pingtung, Taiwan
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27
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Keikha M, Zandhaghighi M, Bameri Z. Correspondence on "Xanthogranulomatous inflammation caused by K. pneumonia and nocardiosis mimicking a uterine tumor and invading the ureter and colon: A case report and review of the literature". Taiwan J Obstet Gynecol 2023; 62:375-376. [PMID: 36965914 DOI: 10.1016/j.tjog.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 03/27/2023] Open
Affiliation(s)
- Masoud Keikha
- Department of Microbiology, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.
| | - Mehdi Zandhaghighi
- Department of Microbiology and Virology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran; Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zakaria Bameri
- Department of Microbiology and Virology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran; Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
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28
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Gao L, Yang T, Zhang X, Lei W, Huang JA. Rapid detection of pulmonary nocardiosis by metagenomic next generation sequencing. Diagn Microbiol Infect Dis 2023; 106:115928. [PMID: 37001227 DOI: 10.1016/j.diagmicrobio.2023.115928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/01/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
We retrospectively analyzed 3 cases of pulmonary nocardiosis. Patients were identified by metagenomic next generation sequencing (mNGS) in the First Affiliated Hospital of Soochow University, from January 2019 to April 2022. All patients had underlying diseases, and were in immunocompromised state, with membranous nephropathy, acute lymphoblastic leukemia (ALL), and systemic lupus erythematosus (SLE), respectively. Symptoms common to all cases included fever, cough and expectoration. Chest computed tomography (CT) presented patchy shadows or nodules, with or without cavitation lesions, or pleural effusion. mNGS detected Nocardia spp. via bronchoalveolar lavage fluid (BALF) or blood samples from patients. All the patients were discharged with recovery after using the trimethoprim-sulfamethoxazole (TMP-SMX) and remained without evidence of disease during regular follow-ups. mNGS may be a tool for rapid and accurate detection and identification of pulmonary nocardiosis, but interpreting the mNGS results should be more cautious because the mNGS assay can also detect colonization.
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29
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Development of TaqMan quantitative PCR assay for detection of Nocardia seriolae in fish and the environment. J Microbiol Methods 2023; 205:106650. [PMID: 36481430 DOI: 10.1016/j.mimet.2022.106650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
Nocardia seriolae is a gram-positive bacterium that causes nocardiosis, threatening fish farming. Advanced nocardiosis is challenging to control; thus, accurate detection methods of the causal agent in the early disease stage are required. In this study, we developed a TaqMan fluorescence quantitative PCR (qPCR) assay for quantitative detection of N. seriolae in fish tissues and water samples. A pair of highly specific primers and a TaqMan probe were designed based on the N. seriolae 16S23S rRNA internal transcribed spacer (ITS) region. A high correlation coefficient (R2 = 0.998) of the standard curve with a 99.5% efficiency was obtained. The qPCR detection limit of the method was as low as 19.8 copies/μL, 1000 times more sensitive than conventional PCR, and has a good performance in the detection of cultured bacteria (y = -3.750× + 48.075, R2 = 0.974). Even 1.42 CFU/mL N. seriolae collected from 500 mL of natural pond water can be detected. Furthermore, a linear model for the relationship between the log of bacteria load and Cq values in water was established (y = -3.239× + 40.978), and the R2 value was 0.979. This assay was used for accurate N. seriolae detection in fish tissues, water samples, feeds and soils. This study provides a valuable tool for the early detection and control of nocardiosis in aquaculture.
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30
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Trejo A, Masdeu C, Serrano-Pérez I, Pedrola M, Juanola N, Ghashghaei O, Jiménez-Galisteo G, Lavilla R, Palacios F, Alonso C, Viñas M. Efficient AntiMycolata Agents by Increasing the Lipophilicity of Known Antibiotics through Multicomponent Reactions. Antibiotics (Basel) 2023; 12:83. [PMID: 36671284 PMCID: PMC9854905 DOI: 10.3390/antibiotics12010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
New antibiotic agents were prepared using Povarov and Ugi multicomponent reactions upon the known drugs sulfadoxine and dapsone. The prepared derivatives, with increased lipophilicity, showed improved efficiency against Mycolata bacteria. Microbiological guidance for medicinal chemistry is a powerful tool to design new and effective antimicrobials. In this case, the readily synthesized compounds open new possibilities in the search for antimicrobials active on mycolic acid-containing bacteria.
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Affiliation(s)
- Angela Trejo
- Departamento de Química Orgánica I, Facultad de Farmacia, Universidad del País Vasco/Euskal Herriko, Unibertsitatea (UPV/EHU), Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain
| | - Carme Masdeu
- Departamento de Química Orgánica I, Facultad de Farmacia, Universidad del País Vasco/Euskal Herriko, Unibertsitatea (UPV/EHU), Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain
| | - Irene Serrano-Pérez
- Laboratory of Molecular Microbiology & Antimicrobials, Department of Pathology & Experimental Therapeutics, Medical School, University of Barcelona and IDIBELL, Feixa Llarga, s/n, 08907 Hospitalet de Llobregat, Spain
| | - Marina Pedrola
- Laboratory of Medicinal Chemistry, Faculty of Pharmacy and Food Sciences and Institute of Biomedicine (IBUB), University of Barcelona, Av. de Joan XXIII, 27-31, 08028 Barcelona, Spain
| | - Narcís Juanola
- Laboratory of Medicinal Chemistry, Faculty of Pharmacy and Food Sciences and Institute of Biomedicine (IBUB), University of Barcelona, Av. de Joan XXIII, 27-31, 08028 Barcelona, Spain
| | - Ouldouz Ghashghaei
- Laboratory of Medicinal Chemistry, Faculty of Pharmacy and Food Sciences and Institute of Biomedicine (IBUB), University of Barcelona, Av. de Joan XXIII, 27-31, 08028 Barcelona, Spain
| | - Guadalupe Jiménez-Galisteo
- Laboratory of Molecular Microbiology & Antimicrobials, Department of Pathology & Experimental Therapeutics, Medical School, University of Barcelona and IDIBELL, Feixa Llarga, s/n, 08907 Hospitalet de Llobregat, Spain
| | - Rodolfo Lavilla
- Laboratory of Medicinal Chemistry, Faculty of Pharmacy and Food Sciences and Institute of Biomedicine (IBUB), University of Barcelona, Av. de Joan XXIII, 27-31, 08028 Barcelona, Spain
| | - Francisco Palacios
- Departamento de Química Orgánica I, Facultad de Farmacia, Universidad del País Vasco/Euskal Herriko, Unibertsitatea (UPV/EHU), Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain
| | - Concepción Alonso
- Departamento de Química Orgánica I, Facultad de Farmacia, Universidad del País Vasco/Euskal Herriko, Unibertsitatea (UPV/EHU), Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain
| | - Miguel Viñas
- Laboratory of Molecular Microbiology & Antimicrobials, Department of Pathology & Experimental Therapeutics, Medical School, University of Barcelona and IDIBELL, Feixa Llarga, s/n, 08907 Hospitalet de Llobregat, Spain
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31
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Zendri F, Richards-Rios P, Maciuca I, Ricci E, Timofte D. Disseminated Nocardiosis Caused by Nocardia farcinica in Two Puppy Siblings. Vet Sci 2022; 10:vetsci10010028. [PMID: 36669029 PMCID: PMC9860694 DOI: 10.3390/vetsci10010028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Abstract
Systemic nocardiosis due to Nocardia farcinica has not been reported in canine outbreaks. Two 14-week-old female Dogue de Bordeaux siblings presented with fever and severe, acute onset limb lameness; traumatic lesions with evidence of infection were identified over the lame limbs of both dogs. The patients were euthanised owing to lack of therapeutic response and rapid escalation to systemic infection with central nervous system manifestations. The post-mortem changes consisted of multiple disseminated abscesses, mainly affecting the skin and subcutis at the limb traumatic injuries, local and hilar lymph nodes, lung, kidney and brain. Bacterial culture and identification via MALDI-TOF and 16S rRNA sequencing revealed Nocardia farcinica from several of these sites in both dogs. Clinical significance of the isolate was supported by cytology of the post-mortem organs' impression smears showing numerous branching filamentous bacteria associated with inflammation. The organism displayed marked multidrug-resistance. No history of immunosuppression was available, and immunohistochemistry ruled out viral pathogens as canine distemper and parvovirus. N. farcinica should be considered as a potential differential cause of sudden lameness and systemic infection in dogs with traumatic skin lesions over the limbs. This is the first reported small-scale outbreak of systemic nocardiosis in dogs due to N. farcinica.
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32
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Li X, Zhuang S, He L, Wang S, Zhao M, Lyu X. Brain Abscess Caused by Nocardia brevicatena in an Immunocompetent Patient: A Case Report. Infect Drug Resist 2022; 15:7693-7697. [PMID: 36597454 PMCID: PMC9805727 DOI: 10.2147/idr.s396085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022] Open
Abstract
Nocardia brain abscess is relatively rare and generally occurs in immunodeficient patients. Here, we present the first case of brain abscess due to Nocardia brevicatena in an immunocompetent patient, with unknown origin. In this case, a 49-year-old man was admitted to our hospital with limb twitching and complained of a history of intermittent headache. He was diagnosed with brain abscess through brain imaging and cured after craniotomy for abscess excision and targeted antibiotic treatment. Surgical specimens were sent for further detection. The causative organism was identified by weak acid-fast staining, culture and metagenomic next-generation sequencing (mNGS). We hope this case could provide a reference for incoming patients as well as their clinical management.
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Affiliation(s)
- Xiaoxu Li
- Department of Neurosurgery, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China
| | - Shifang Zhuang
- Genskey Medical Technology Co., Ltd, Beijing, People’s Republic of China
| | - Lin He
- Genskey Medical Technology Co., Ltd, Beijing, People’s Republic of China
| | - Shanmei Wang
- Department of Clinical Laboratory, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Ming Zhao
- Department of Neurosurgery, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China
| | - Xiaodong Lyu
- Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China,Correspondence: Xiaodong Lyu, Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, 127 Dongming Road, Zhengzhou, 450000, People’s Republic of China, Tel/Fax +8613523417973, Email
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33
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Septic arthritis by Nocardia farcinica: Case report and literature review. IDCases 2022; 31:e01668. [PMID: 36636461 PMCID: PMC9830148 DOI: 10.1016/j.idcr.2022.e01668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/18/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Nocardiosis is a bacterial infection caused by organisms of the Nocardia genus. The disease typically involves the skin, central nervous system or pulmonary system. Very rarely nocardiosis can cause disease of other organs including bone and joints. Nocardiosis is typically a chronic, somewhat indolent infection, occurring in patients with defective cell mediated immunity. We describe a 78-year-old female with right shoulder septic arthritis resulting from Nocardia farcinica with associated involvement of her skin and lungs as well. She was treated with surgical debridement and combination antibiotic therapy. We also share a literature review of bone and joint infection caused by the N. farcinica species, highlighting its rarity. Understanding uncommon manifestations of nocardiosis allows for early recognition and treatment of the condition and optimal patient care.
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Cai Q, Huang Y, Zhou L, Hu N, Liu Y, Guo F, Liu Q, Huang X, Zhang Y, Zeng L. A Complete Genome of Nocardia terpenica NC_YFY_NT001 and Pan-Genomic Analysis Based on Different Sources of Nocardia spp. Isolates Reveal Possibly Host-Related Virulence Factors. Infect Drug Resist 2022; 15:7259-7270. [PMID: 36536862 PMCID: PMC9758982 DOI: 10.2147/idr.s384673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/29/2022] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVE We aimed to identify the possible virulence genes associated with Nocardia NC_YFY_NT001 isolated by ourselves and other Nocardia spp. METHODS The genome of Nocardia terpenica NC_YFY_NT001 was completed by using PacBio and Illumina platforms. A pan-genomic analysis was applied to selected complete Nocardia genomes. RESULTS Nocardia terpenica NC_YFY_NT001 can cause healthy mice death by tail intravenous injection. The genome of NT001 has one circular chromosome 8,850,000 bp and one circular plasmid 70,000 bp with ~68% GC content. The chromosome and plasmid encode 7914 and 80 proteins, respectively. Furthermore, a pan-genomic analysis showed a total of 45,825 gene clusters, then 304 core, 21,045 shell and 24,476 cloud gene clusters were classified using specific parameters. In addition, we found that catalases were more abundant in human isolates. Furthermore, we also found no significant differences in the MCE proteins between different strains from different sources. The pan-genomic analysis also showed that 67 genes could only be found in humoral isolates. ReX3 and DUF853 domain protein were found in all eight human isolates. The composition of unique genes in humoral isolate genomes indicated that the transcriptional regulators may be important when Nocardia invades the host, which allows them to survive in the new ecological system. CONCLUSION In this study, we confirmed that NT001 could cause infected animal death, and identified many possible virulence factors for our future studies. This study also provides new insight for our further study on Nocardia virulence mechanisms.
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Affiliation(s)
- Qinming Cai
- The First Affiliated Hospital of Nanchang University, School of Public Health, Nanchang University, Nanchang, People’s Republic of China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yongcheng Huang
- The First Affiliated Hospital of Nanchang University, School of Public Health, Nanchang University, Nanchang, People’s Republic of China
| | - Li Zhou
- The First Affiliated Hospital of Nanchang University, School of Public Health, Nanchang University, Nanchang, People’s Republic of China
| | - Niya Hu
- The First Affiliated Hospital of Nanchang University, School of Public Health, Nanchang University, Nanchang, People’s Republic of China
| | - Yanling Liu
- The First Affiliated Hospital of Nanchang University, School of Public Health, Nanchang University, Nanchang, People’s Republic of China
| | - Fujia Guo
- The First Affiliated Hospital of Nanchang University, School of Public Health, Nanchang University, Nanchang, People’s Republic of China
| | - Qiong Liu
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, People’s Republic of China
| | - Xiaotian Huang
- The First Affiliated Hospital of Nanchang University, School of Public Health, Nanchang University, Nanchang, People’s Republic of China
- Department of Medical Microbiology, School of Medicine, Nanchang University, Nanchang, People’s Republic of China
| | - Yunyi Zhang
- Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, People’s Republic of China
| | - Lingbing Zeng
- The First Affiliated Hospital of Nanchang University, School of Public Health, Nanchang University, Nanchang, People’s Republic of China
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Salar-Vidal L, Martín-García M, Macías-Valcayo A, Ponz A, Esteban J. Epidemiology and in vitro antimicrobial susceptibility of aerobic Actinomycetales in a clinical setting. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:562-567. [PMID: 36464473 DOI: 10.1016/j.eimce.2021.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/22/2021] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The incidence of infections caused by aerobic actinomycetes is increasing. Recent changes in taxonomy and the variability in susceptibility patterns among species make necessary a proper identification and antibiotic susceptibility testing. MATERIAL AND METHODS Fifty-three strains of aerobic actinomycetes were identified by MALDI-TOF MS using the VITEK MS Mycobacterium/Nocardia kit (bioMérieux, France) in a tertiary hospital in Spain during a six-year period. Antimicrobial susceptibility testing of the isolates was performed using the Sensititre Rapmycoi microdilution panel (Thermo Fisher Scientific, Massachusetts, USA). RESULTS Forty strains of Nocardia spp. were identified in the study, being N. farcinica and N. cyriacigeorgica the most prevalent ones. All isolates were susceptible to linezolid and the resistance to amikacin was only observed in one isolate of Gordonia sputi. Resistance to cotrimoxazole was only found in five isolates. CONCLUSIONS Routine identification and antimicrobial susceptibility testing of aerobic actinomycetes is advisable for an efficient identification of species and effective treatment.
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Affiliation(s)
- Llanos Salar-Vidal
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM Madrid, Spain
| | - Marta Martín-García
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM Madrid, Spain
| | | | - Ana Ponz
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM Madrid, Spain
| | - Jaime Esteban
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM Madrid, Spain.
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Gkrinia E, Bizaki-Vallaskangas A, Rautiainen M, Kivekäs I. Nocardia Farcinica Mastoiditis and Epidural Abscess in an Immunocompetent Patient: A Rare Entity. EAR, NOSE & THROAT JOURNAL 2022:1455613221139400. [PMID: 36453208 DOI: 10.1177/01455613221139400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
Nocardia is regarded as an opportunistic pathogen primarily affecting the respiratory system, whereas Nocardia farcinica is the species of the Nocardia family that is most frequently blamed for central nervous system impairment. The authors present the first case of mastoiditis caused by Nocardia farcinica, accompanied by intracranial complications. An immunocompetent 74-year-old woman who reported a three-week left ear discharge and a two-week facial nerve palsy was referred to our department. MRI revealed mastoiditis and epidural abscess. The bacterial cultures obtained during the surgical management of the patient confirmed the presence of Nocardia farcinica. Targeted antibiotic therapy was subsequently administrated, gradually resulting in favourable outcomes. Nocardia species provoke a disseminated infection that emerges not only among the immunosuppressed individuals but can also affect the healthy population. The nonspecific clinical manifestations in addition to the difficulties identifying the pathogen, remain obstacles to a punctual diagnosis. However, the combination of surgical debridement and antibiotic treatment with trimethoprim and sulfamethoxazole is considered the most appropriate management, leading to propitious results.
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Affiliation(s)
- Eleni Gkrinia
- Department of Ear and Oral Diseases and Otorhinolaryngology, Tampere University, Tampere, Finland
- ENT Department, University Hospital of Larissa and Department of Otorhinolaryngology - Head and Neck Surgery, University of Thessaly, Larissa, Greece
| | | | - Markus Rautiainen
- Department of Ear and Oral Diseases and Otorhinolaryngology, Tampere University, Tampere, Finland
| | - Ilkka Kivekäs
- Department of Ear and Oral Diseases and Otorhinolaryngology, Tampere University, Tampere, Finland
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Pan B, Wang FF, He Q. Case report: Nocardia farcinica pneumonia in early-stage post liver transplantation. Front Med (Lausanne) 2022; 9:996045. [PMID: 36160170 PMCID: PMC9490265 DOI: 10.3389/fmed.2022.996045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Liver transplantation is a well-established treatment for end-stage liver disease. The evolution of immunosuppressants has supported the recent advances in this field. However, this leads to immunosuppression and increases the risk for infections. Nocardia is an aerobic gram-positive bacillus, which can cause multi-systemic or multi-organ infections. Nocardia is an opportunistic pathogen that principally affects immunosuppressed patients. Case presentation Herein, we present a case of Nocardia farcinica pneumonia in a patient at early-stage post-liver transplantation. Following appropriate microbiological tests and imaging, the diagnosis was finally confirmed. A full recovery was achieved after optimal antibiotic therapy of sulfamethoxazole, minocycline, and amikacin. Conclusions Nocardia farcinica pneumonia is a rare and life-threatening disease, especially in patients after liver transplantation. Imaging and microbiological tests are helpful for the early diagnosis of the disease. Trimethoprim-sulfamethoxazole (TMP-SMX) as part of first-line therapy for nocardiosis is recommended.
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Ma H, Wang X, Yan H, Liu Q, Yang D, Bian T. Dual intracranial infection with Nocardia farcinica and Cryptococcus neoformans diagnosed by next-generation sequencing in a patient with nephrotic syndrome: A case report. Medicine (Baltimore) 2022; 101:e30325. [PMID: 36107518 PMCID: PMC9439795 DOI: 10.1097/md.0000000000030325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
RATIONALE Intracranial infections are associated with high morbidity and mortality in immunocompromised patients, due to delayed diagnosis and treatment. Establishing a rapid, accurate diagnosis and a precise therapeutic regimen is crucial for management of the patients. Our report described a rare intracranial infection of patient with nephrotic syndrome. PATIENT CONCERNS A 66-year-old woman with a history of nephrotic syndrome presented symptoms in central nervous system for 1 month, followed by headache and fever over several days. DIAGNOSIS Neurological examination, brain imaging, and cerebrospinal fluid (CSF) tests exhibited resemblance to intracranial infection. Subsequently, CSF cultures confirmed the presence of Cryptococcus. Fortunately, next-generation sequencing revealed the concomitant infection with Nocardia farcinica in addition to Cryptococcus neoformans. INTERVENTIONS The treatment with intravenous fluconazole combined with amphotericin could not immediately ameliorate her symptoms. The patient's condition improved significantly with minimal deficits after timely administration of antibiotics against N farcinica. OUTCOMES One month later, cranial MRI indicated that basal ganglia lesions ameliorated. The patient has recovered well. LESSONS SUBSECTIONS To our best knowledge, this is the first case report of intracranial infection caused by both N farcinica and C neoformans in a patient with nephrotic syndrome. Remarkably, extensive application of next-generation sequencing can facilitate investigation on the potential role of various pathogenic organisms in infectious diseases.
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Affiliation(s)
- Hongmei Ma
- Department of Neurology, Beijing Fengtai You’anmen Hospital, BeijingChina
- *Correspondence: Hongmei Ma, Department of Neurology, Beijing Fengtai You’anmen Hospital, No. 199 You’anmen Wai Avenue, Fengtai District, Beijing 100069, China (e-mail: )
| | - Xiangbo Wang
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Heli Yan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Qing Liu
- Department of Neurology, Beijing Fengtai You’anmen Hospital, BeijingChina
| | - Dan Yang
- Department of Neurology, Beijing Fengtai You’anmen Hospital, BeijingChina
| | - Tingting Bian
- Department of Neurology, Beijing Fengtai You’anmen Hospital, BeijingChina
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Correspondence on “A case of infected intracranial aneurysm with Nocardia meningitis treated with endovascular therapy: Case report and literature review”. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2022.101559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Gao H, He Q, Xu C, Pang Z, Feng B, Chen T, Yang W, Zhou G, Wang Y, Li J, Su J, Miao Y, Zhao Y, Liao Z, Xu C, Liu Z. The Development and Validation of Anti-paratuberculosis-nocardia Polypeptide Antibody [Anti-pTNP] for the Diagnosis of Crohn's Disease. J Crohns Colitis 2022; 16:1110-1123. [PMID: 35029687 DOI: 10.1093/ecco-jcc/jjac008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/17/2021] [Accepted: 01/11/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Non-invasive biomarkers in sera of patients with inflammatory bowel disease [IBD] are not currently available for rapidly and accurately diagnosing the disease. We aimed to investigate and validate the potential roles of anti-paratuberculosis-nocardia polypeptide antibodies [anti-pTNP] in the diagnosis of IBD. METHODS Serum samples were collected from 502 patients with diagnosed Crohn's disease [CD], 141 patients with ulcerative colitis [UC], and 109 healthy donors. The levels of anti-pTNPs and anti-Saccharomyces cerevisiae antibodies [ASCAs] were determined by enzyme-linked immunosorbent assay. The effects of each variable on the diagnosis were analysed by receiver operating characteristic [ROC] analysis. We also performed an estimate study by first developing a clinical prediction model, with external validation in CD patients from nine IBD medical centres in China. RESULTS The levels of anti-pTNPs in sera of CD patients were higher than those in UC patients and healthy donors. The positive rates of anti-pTNPs were significantly higher in ileal CD patients than in ileocolonic and colonic CD patients, and the levels of anti-pTNP IgG in perianal patients were significantly higher than those in non-perianal CD patients. Of note, anti-pTNPs and perianal diseases were important predictors for active stage of CD patients. Discriminative ability to predict active CD patients was 0.918 (95% confidence interval [CI]:0.886-0.949). CONCLUSIONS Anti-pTNP functions as a novel biological marker for diagnosing CD and can be used to assess disease severity, particularly in those with lesion locations in the terminal ileum and stricturing and perianal diseases. A validated prediction model reveals that anti-pTNPs are useful for estimating the likelihood of active CD.
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Affiliation(s)
- Han Gao
- Center for Inflammatory Bowel Disease Research, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qiong He
- Center for Inflammatory Bowel Disease Research, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chunjin Xu
- Department of Gastroenterology, First People's Hospital of Shangqiu City Affiliated to Xinxiang Medical University, Shangqiu, China
| | - Zhi Pang
- Department of Gastroenterology, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou, China
| | - Baisui Feng
- Department of Gastroenterology, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tingting Chen
- Laboratory of Experimental Analysis, Shanxi Ruihao Biotechnology, Taiyuan, China
| | - Wu Yang
- Laboratory of Experimental Analysis, Shanxi Ruihao Biotechnology, Taiyuan, China
| | - Guangxi Zhou
- Department of Gastroenterology, Affiliated Hospital of Jining Medical College, Jining, China
| | - Yufang Wang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Junxiang Li
- Department of Gastroenterology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing,China
| | - Jingling Su
- Department of Gastroenterology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Yinglei Miao
- Department of Gastroenterology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ye Zhao
- Department of Gastroenterology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhuan Liao
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Can Xu
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Zhanju Liu
- Center for Inflammatory Bowel Disease Research, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
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Lao CK, Tseng MC, Chiu CH, Chen NY, Chen CH, Chung WH, Liu TP, Lu JJ, Lai HC, Yang LY, Lee CH, Wu TS. Clinical manifestations and antimicrobial susceptibility of Nocardia species at a tertiary hospital in Taiwan, 2011-2020. J Formos Med Assoc 2022; 121:2109-2122. [PMID: 35811270 DOI: 10.1016/j.jfma.2022.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The study aimed to assess the clinical characteristics of patients with nocardiosis, to evaluate the in vitro susceptibility of antimicrobial agents against Nocardia species, and to explore changes in antimicrobial susceptibilities in this era of multidrug resistance. METHODS Nocardia isolates were identified to the species level using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA, hsp65, and secA1 gene sequencing, and minimum inhibitory concentrations (MICs) of 15 antimicrobial agents were assessed with the broth microdilution method. RESULTS Eighty-nine isolates from 68 patients were identified to species level. The most common species were Nocardia brasiliensis (n = 28, 31.5%), followed by N. farcinica (n = 24, 27%) and N. cyriacigeorgica (n = 16, 18%). Skin and soft tissue were the most common sites of nocardiosis. In multivariate analysis, cutaneous infection (OR, 0.052; p = 0.009), immunosuppressant use (OR, 16.006; p = 0.013) and Charlson combidity index (OR, 1.522; p = 0.029) were significant predictors for death. In total, 98.9% isolates were susceptible to trimethoprim-sulfamethoxazole and linezolid. Further, the MIC range and resistance rate of all Nocardia species to ceftriaxone, imipenem, and amoxicillin-clavulanic acid were found to generally increase over time. CONCLUSIONS Considering that trimethoprim-sulfamethoxazole is effective against most Nocardia species, it is the antibiotic of choice in Taiwan. Besides, amikacin, tigecycline, and linezolid showed high activity against Nocardia species and are thus good alternatives or additional therapies to treat nocardiosis, depending on patient's underlying conditions and site of infection.
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Affiliation(s)
- Chong Kei Lao
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan
| | - Mei-Chueh Tseng
- Department of Medical Research and Development, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan
| | - Cheng-Hsun Chiu
- School of Medicine, Chang Gung University, 259, Wenhua 1st Road, Guishan District, Taoyuan 33302, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan; Infection Control Committee, Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan
| | - Nan-Yu Chen
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan; School of Medicine, Chang Gung University, 259, Wenhua 1st Road, Guishan District, Taoyuan 33302, Taiwan
| | - Chih-Hung Chen
- School of Medicine, Chang Gung University, 259, Wenhua 1st Road, Guishan District, Taoyuan 33302, Taiwan; Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan
| | - Wen-Hung Chung
- School of Medicine, Chang Gung University, 259, Wenhua 1st Road, Guishan District, Taoyuan 33302, Taiwan; Department of Dermatology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan
| | - Tsui-Ping Liu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan
| | - Jang-Jih Lu
- School of Medicine, Chang Gung University, 259, Wenhua 1st Road, Guishan District, Taoyuan 33302, Taiwan; Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan
| | - Hsin-Chih Lai
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, 259, Wenhua 1st Road, Gueishan District, Taoyuan 33302, Taiwan
| | - Lan-Yan Yang
- Biostatistics Unit of Clinical Trial Center, Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City 33305, Taiwan
| | - Chia-Hui Lee
- Biostatistics Unit of Clinical Trial Center, Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan City 33305, Taiwan
| | - Ting-Shu Wu
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan; School of Medicine, Chang Gung University, 259, Wenhua 1st Road, Guishan District, Taoyuan 33302, Taiwan; Infection Control Committee, Chang Gung Memorial Hospital, 5, Fuxing Street, Guishan District, Taoyuan 33305, Taiwan.
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A Case of Pulmonary Nocardiosis Presenting with Multiple Cavitary Nodules in a Patient with Thrombocytopenia. REPORTS 2022. [DOI: 10.3390/reports5020019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nocardiosis is an infrequent opportunistic infection that deserves more attention because of its increasing morbidity and high rate of misdiagnosis. Clinical and radiological manifestations as well as antibiograms of pulmonary nocardiosis are diverse. Herein, we report a patient with idiopathic thrombocytopenia treated with glucocorticoids, which later presented with severe pulmonary infection with widely distributed nodules on chest computed tomography. Fungal infection or tuberculosis was under initial suspicion and microbiological tests of bronchoalveolar lavage fluid eventually yielded an affirmative result of Nocardia cyriacigeorgica. The patient responded in the beginning; however, therapeutic strategies had to be altered several times due to adverse events. The patient eventually ended up with radiographic resolution at the end of six months. We wish to share some experience in dealing with this disease especially recognizing pulmonary nocardiosis in computed tomography imaging.
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Luu T, Khalid R, Rehman T, Clark NM. Disseminated Nocardia paucivorans Infection Resembling Metastatic Disease in a Kidney Transplant Recipient. Cureus 2022; 14:e25365. [PMID: 35765399 PMCID: PMC9233555 DOI: 10.7759/cureus.25365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 11/29/2022] Open
Abstract
Recipients of solid-organ transplants (SOT) or hematopoietic stem-cell transplants are prone to various complications, including serious infections. Nocardiosis is an opportunistic bacterial infection that primarily affects the lung. It may also cause skin and soft-tissue infection, cerebral abscess, bloodstream infection, or infection involving other organs. We present a case of an immunocompromised kidney transplant recipient who experienced a prolonged history of unexplained indolent constitutional symptoms without a fever. Initial radiographic findings were suggestive of metastatic disease at multiple sites. However, metagenomic next-generation sequencing of microbial cell-free DNA in blood revealed disseminated Nocardia paucivorans infection, and organisms consistent with Nocardia were identified on histopathology of a lung biopsy. It is crucial for healthcare providers to be aware of unusual opportunistic infections to provide appropriate workups and interventions for immunocompromised SOT recipients.
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Han L, Ji X, Liu X, Xu S, Li F, Che Y, Qiu X, Sun L, Li Z. Estradiol Aggravate Nocardia farcinica Infections in Mice. Front Immunol 2022; 13:858609. [PMID: 35309304 PMCID: PMC8924065 DOI: 10.3389/fimmu.2022.858609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
Males are generally more susceptible to Nocardia infection than females, with a male-to-female ratio of 2 and higher clinical disease. 17β-Estradiol has been implicated in affecting the sex-based gap by inhibiting the growth of N. brasiliensis in experiments, but the underlying mechanisms have not yet been fully clarified. In the present study, however, we report increased severity in N. farcinica IFM 10152-infected female mice compared with male mice with increased mortality, elevated lung bacterial loads and an exaggerated pulmonary inflammatory response, which was mimicked in ovariectomized female mice supplemented with E2. Similarly, the overwhelming increase in bacterial loads was also evident in E2-treated host cells, which were associated with downregulating the phosphorylation level of the MAPK pathway by binding the estrogen receptor. We conclude that although there are more clinical cases of Nocardia infection in males, estrogen promotes the survival of the bacteria, which leads to aggravated inflammation in females. Our data emphasize the need to include and separately analyze both sexes in future studies of Nocardia to understand the sex differences in immune responses and disease pathogenesis.
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Affiliation(s)
- Lichao Han
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xingzhao Ji
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Shandong Key Laboratory of Infections Respiratory Disease, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xueping Liu
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Shuai Xu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fang Li
- Department of Medical, Tibet University, Lhasa, China
| | - Yanlin Che
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xiaotong Qiu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lina Sun
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenjun Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Teng J, Zhao Y, Meng QL, Zhu SR, Chen HJ, Xue LY, Ji XS. Transcriptome analysis in the spleen of Northern Snakehead (Channa argus) challenged with Nocardia seriolae. Genomics 2022; 114:110357. [PMID: 35378240 DOI: 10.1016/j.ygeno.2022.110357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/05/2022] [Accepted: 03/27/2022] [Indexed: 01/14/2023]
Abstract
Northern snakehead (Channa argus) is an indigenous fish species and is one of popularly cultured snakeheads in China and other Asian countries. Unfortunately, Nocardia seriolae infections have caused considerable losses in the snakehead aquaculture industry. However, the infectivity and the immune response induced by N. seriolae in snakehead are unclear. In order to better understand the immune response of Northern snakehead in a series of time points after N. seriolae challenge, we conducted the transcriptomic comparison in snakehead spleen at 48, 96, and 144 h after the challenge of N. seriola against their control counterparts. Gene annotation and pathway analysis of differentially expressed genes (DEGs) were carried out to understand the functions of the DEGs. Additionally, protein-protein interaction networks were conducted to obtain the interaction relationships of immune-related DEGs. These results revealed the expression changes of multiple DEGs and signaling pathways involved in immunity during N. seriolae infection, which will facilitate our comprehensive understanding of the mechanisms involved in the immune response to bacterial infection in the northern snakehead.
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Affiliation(s)
- Jian Teng
- College of Animal Science and Technology, Shandong Agricultural University, Taian, China; College of Marine Sciences, Ningbo University, Ningbo, China
| | - Yan Zhao
- College of Animal Science and Technology, Shandong Agricultural University, Taian, China
| | - Qing Lei Meng
- Shandong Freshwater Fisheries Research Institute, Jinan, China
| | - Shu Ren Zhu
- Shandong Freshwater Fisheries Research Institute, Jinan, China
| | - Hong Ju Chen
- College of Animal Science and Technology, Shandong Agricultural University, Taian, China
| | - Liang Yi Xue
- College of Marine Sciences, Ningbo University, Ningbo, China
| | - Xiang Shan Ji
- College of Animal Science and Technology, Shandong Agricultural University, Taian, China.
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Comprehensive Analysis of the Nocardia cyriacigeorgica Complex Reveals Five Species-Level Clades with Different Evolutionary and Pathogenicity Characteristics. mSystems 2022; 7:e0140621. [PMID: 35430877 PMCID: PMC9239197 DOI: 10.1128/msystems.01406-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Nocardia cyriacigeorgica is a common etiological agent of nocardiosis that has increasingly been implicated in serious pulmonary infections, especially in immunocompromised individuals. However, the evolution, diversity, and pathogenesis of N. cyriacigeorgica have remained unclear. Here, we performed a comparative genomic analysis using 91 N. cyriacigeorgica strains, 45 of which were newly sequenced in this study. Phylogenetic and average nucleotide identity (ANI) analyses revealed that N. cyriacigeorgica contained five species-level clades (8.6 to 14.6% interclade genetic divergence), namely, the N. cyriacigeorgica complex (NCC). Further pan-genome analysis revealed extensive differences among the five clades in nine functional categories, such as energy production, lipid metabolism, secondary metabolites, and signal transduction mechanisms. All 2,935 single-copy core genes undergoing purifying selection were highly conserved across NCC. However, clades D and E exhibited reduced selective constraints, compared to clades A to C. Horizontal gene transfer (HGT) and mobile genetic elements contributed to genomic plasticity, and clades A and B had experienced a higher level of HGT events than other clades. A total of 129 virulence factors were ubiquitous across NCC, such as the mce operon, hemolysin, and type VII secretion system (T7SS). However, different distributions of three toxin-coding genes and two new types of mce operons were detected, which might contribute to pathogenicity differences among the members of the NCC. Overall, our study provides comprehensive insights into the evolution, genetic diversity, and pathogenicity of NCC, facilitating the prevention of infections. IMPORTANCENocardia species are opportunistic bacterial pathogens that can affect all organ systems, primarily the skin, lungs, and brain. N. cyriacigeorgica is the most prevalent species within the genus, exhibits clinical significance, and can cause severe infections when disseminated throughout the body. However, the evolution, diversity, and pathogenicity of N. cyriacigeorgica remain unclear. Here, we have conducted a comparative genomic analysis of 91 N. cyriacigeorgica strains and revealed that N. cyriacigeorgica is not a single species but is composed of five closely related species. In addition, we discovered that these five species differ in many ways, involving selection pressure, horizontal gene transfer, functional capacity, pathogenicity, and antibiotic resistance. Overall, our work provides important clues in dissecting the evolution, genetic diversity, and pathogenicity of NCC, thereby advancing prevention measures against these infections.
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Zhang N, Zhang H, Dong Z, Wang W. Molecular Identification of Nocardia seriolae and Comparative Analysis of Spleen Transcriptomes of Hybrid Snakehead ( Channa maculata Female × Channa argus Male) With Nocardiosis Disease. Front Immunol 2022; 13:778915. [PMID: 35154103 PMCID: PMC8828968 DOI: 10.3389/fimmu.2022.778915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Hybrid snakehead (Channa maculata female × Channa argus male) is a new freshwater aquaculture fish species in southern China. During intensive aquaculture, hybrid snakeheads are often infected by Nocardia seriolae. In this study, hybrid snakehead infected suspiciously by N. seriolae in an artificial breeding pond were examined. Diseased hybrid snakeheads swam slowly without food intake, and the clinical symptoms included skin wound, anal swelling and ascites, and white granulomatous in liver, spleen, and kidney of fish. Through bacterial isolation, 16S rDNA sequencing, fluorescence in situ hybridization (FISH) and artificial infection experiment, the pathogen was identified as N. seriolae. Furthermore, the spleen samples from diseased and healthy male hybrid snakeheads in the same pond were used for RNA-Seq analysis. A total of 3,512 unique transcripts (unigenes) were identified as differentially expressed genes (DEGs), and 1,886 of them were up-regulated in diseased fish. The expression patterns of 20 DEGs were verified by quantitative polymerase chain reaction (qPCR). Several immune-related pathways and many immune-related genes were identified. qPCR results showed that the expression patterns of immune-related genes in the liver and kidney of diseased fish were comparable to that in the spleen. This study provides deep-sequencing data of hybrid snakehead spleen and will help understand the immune response of hybrid snakehead to N. seriolae. It is also helpful for the biomarker screening of fish-borne Nocardia spp. and the breeding of nocardiosis-resistant fish species.
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Affiliation(s)
- Ning Zhang
- Fisheries College, Guangdong Ocean University, Zhanjiang, China
| | - Hairui Zhang
- Zhongshan Ronghai Aquaculture Co. Ltd., Zhongshan, China
| | - Zhongdian Dong
- Fisheries College, Guangdong Ocean University, Zhanjiang, China
| | - Wei Wang
- Fisheries College, Guangdong Ocean University, Zhanjiang, China.,Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Beibu Gulf University, Qinzhou, China.,Guangdong Provincial Key Lab of Pathogenic Biology and Epidemiology for Aquatic Economic Animals, Guangdong Ocean University, Zhanjiang, China
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Khatri A, Esposito MJ, Koshy R. Unusual presentation of Nocardia abscessus infection in an immunocompetent patient. Access Microbiol 2022; 4:000308. [PMID: 35355873 PMCID: PMC8941962 DOI: 10.1099/acmi.0.000308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction.
Nocardia
infections are being increasingly reported in both immunocompetent and immunocompromised patients. We describe a case of
Nocardia abscessus
infection with an atypical presentation in an immunocompetent patient.
Case Presentation. A previously healthy 47-year-old gentleman presented with hiccups and paroxysmal spasms. Imaging revealed a pulmonary nodule, for which he underwent surgical resection. Pathologic evaluation demonstrated evidence of local inflammation, with growth of
Nocardia abscessus
on tissue cultures.
Conclusion.
Nocardia abscessus
may have atypical presentations in immunocompetent patients. Further research is needed to understand the factors leading to
Nocardia
infections in immunocompetent patients.
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Affiliation(s)
- Akshay Khatri
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine / Jackson Health System, Miami, FL, USA
| | - Michael J. Esposito
- Division of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, USA
| | - Robin Koshy
- Division of Infectious Diseases, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, USA
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Fazili T, Bansal E, Garner D, Bajwa V, Vasudeva S. Septic arthritis due to Nocardia: Case report and literature review. Am J Med Sci 2022; 364:88-91. [DOI: 10.1016/j.amjms.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 11/12/2021] [Accepted: 01/26/2022] [Indexed: 11/01/2022]
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50
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Wu J, Li X, Zhang T, Lin X, Chen YC. Disseminated Nocardia farcinica involves the spinal cord: a case report and review of the literature. BMC Infect Dis 2021; 21:1224. [PMID: 34876035 PMCID: PMC8650257 DOI: 10.1186/s12879-021-06905-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Nocardia is a relatively rare opportunistic pathogenic bacteria group, commonly seen in patients with immunocompromised or defective immune system. It can affect multiple organs of the body and cause disseminated infection, among which most occurs in the lung, secondly in the nervous system, soft tissues, rare in the spinal cord and pituitary. No case has been reported involving lung, spinal cord, skin and pituitary gland at the same time. Case presentation We report a 55-year-old female with Nocardia infection involving the lung, skin, spinal cord, and pituitary gland. The patient underwent a full set of imaging examinations and showed typical imaging findings. Chest computed tomography (CT) showed multiple nodules with cavities in the lungs. The magnetic resonance imaging (MRI) of the vertebral body showed abnormal signal of the entire spinal cord with cavity formation and ring enhancement. The subcutaneous nodules of the abdomen were punctured under ultrasound. Through the etiological tissue culture of subcutaneous nodules and the second generation sequencing of cerebrospinal fluid, the diagnosis was finally confirmed. Conclusion Disseminated Nocardiosis is an uncommon disease. This article will report a rare case of disseminated Nocardiosis simultaneously involving the lung, spinal cord, subcutaneous soft tissue and pituitary gland, especially with neuropathy as the initial symptom. Imaging is helpful for the early diagnosis of the disease and pathological and microbiological examinations are helpful for its confirming.
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Affiliation(s)
- Jing Wu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 21006, People's Republic of China
| | - Xiaoran Li
- Department of Radiology, Nanjing Gaochun People's Hospital, Nanjing, Jiangsu, People's Republic of China
| | - Tao Zhang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 21006, People's Republic of China
| | - Xin Lin
- Department of Laboratory, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 21006, People's Republic of China.
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