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Liu Y, Wu SY, Deng J, Zhuang KW, Tang Y, Wu N, Zhang WL, Liao QF, Xiao YL, Kang M. Application of MALDI-TOF mass spectrometry for identification of Nocardia species. BMC Microbiol 2024; 24:358. [PMID: 39304812 DOI: 10.1186/s12866-024-03483-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 08/29/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Nocardiosis, despite its rarity and underreporting, is significant due to its severe impact, characterized by high morbidity and mortality rates. The development of a precise, reliable, rapid, and straightforward technique for identifying the pathogenic agent in clinical specimens is crucial to reduce fatality rates and facilitate timely antimicrobial treatment. In this study, we aimed to identify Nocardia spp. in clinical isolates, using MALDI-TOF MS as the primary method, with molecular methods as the gold standard. Clinical Nocardia isolates were identified using 16S rRNA/hsp65/gyrB/secA1/rpoB gene sequencing. Identification performance of the Bruker MALDI Biotyper 3.1 (V09.0.0.0_8468) and MBT Compass 4.1 (V11.0.0.0_10833) for Nocardia identification was evaluated. RESULTS Seventy-six Nocardia isolates were classified into 12 species through gene sequencing. The MALDI Biotyper 3.1 (V09.0.0.0_8468) achieved 100% genus-level accuracy and 84.2% species accuracy (64/76). The MBT Compass 4.1 with the BDAL Database (V11.0.0.0_10833) improved species identification to 98.7% (75/76). The updated database enhanced species level identification with scores > 1.7, increasing from 77.6% (59/76) to 94.7% (72/76), a significant improvement (P = 0.001). The new and simplified extraction increased the proportion of strains identified to the species level with scores > 1.7 from 62.0% (18/29) to 86.2% (25/29) (P = 0.016). An in-house library construction ensured accurate species identification for all isolates. CONCLUSIONS The Bruker mass spectrometer can accurately identify Nocardia species, albeit with some variations observed between different database versions. The MALDI Biotyper 3.1 (V09.0.0.0_8468) has limitations in identifying Nocardia brasiliensis, with some strains only identifiable to the genus level. MBT Compass 4.1 (V11.0.0.0_10833) effectively addresses this shortfall, improving species identification accuracy to 98.7%, and offering quick and reliable identification of Nocardia. Both database versions incorrectly identified the clinically less common Nocardia sputorum as Nocardia araoensis. For laboratories that have not upgraded their databases and are unable to achieve satisfactory identification results for Nocardia, employing the new and simplified extraction method can provide a degree of improvement in identification outcomes.
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Affiliation(s)
- Ya Liu
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China
- Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, China
| | - Si-Ying Wu
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China
- Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, China
| | - Jin Deng
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China
- Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, China
| | - Kai-Wen Zhuang
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Tang
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China
- Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, China
| | - Nan Wu
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China
- Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, China
| | - Wei-Li Zhang
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China
- Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, China
| | - Quan-Feng Liao
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China
- Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, China
| | - Yu-Ling Xiao
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China
- Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, China
| | - Mei Kang
- Division of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China.
- Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, China.
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Hara Y. Search for natural products from actinomycetes of the genus Nocardia. J Nat Med 2024; 78:828-837. [PMID: 39093356 PMCID: PMC11364655 DOI: 10.1007/s11418-024-01833-y] [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: 05/01/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
The genus Nocardia are gram-positive bacteria, many of which possess pathogenicity and infect human lungs, skin, brain, and other organs. Since research on the genus Nocardia has not progressed as rapidly as that on the genus Streptomyces, the genus Nocardia is considered a useful undeveloped resource for exploring natural products. On the other hand, when the genus Nocardia infects the human body, the strains are attacked by immune cells such as macrophages. Therefore, we suggested a new method for screening natural products by culturing the genus Nocardia in the presence of animal cells. In this review, we describe our recent results in searching for natural products from the genus Nocardia.
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Affiliation(s)
- Yasumasa Hara
- Faculty of Agriculture, Kagawa University, 2393 Ikenobe, Miki, Kagawa, 761-0795, Japan.
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Kim EM, Yun CS, Bae YC, Lee H, Moon BY, Lee K, Jeoung HY, Ku BK, Kim J. Case report: Pathology, antimicrobial resistance, and molecular characterization of bovine abortion cases caused by Nocardia farcinica in Korean native cattle. Front Vet Sci 2024; 11:1407634. [PMID: 39234171 PMCID: PMC11373135 DOI: 10.3389/fvets.2024.1407634] [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: 03/27/2024] [Accepted: 07/30/2024] [Indexed: 09/06/2024] Open
Abstract
Introduction Nocardia farcinica is an opportunistic bacterium that causes bovine mastitis and pulmonary, cutaneous, and central nervous system infections in humans. Bovine abortion caused by N. farcinica has been sporadically reported. The purpose of this study was to analyze the pathological findings of bovine abortions caused by N. farcinica in the Republic of Korea and determine the antimicrobial resistance and genotypical characteristics of N. farcinica isolates. Case presentation Three cases of bovine abortions were submitted to the Animal and Plant Quarantine Agency for differential diagnosis. Grossly, one fetus showed severe lung consolidation following palpation of the entire lobes. Histologically, necrotizing granulomatous interstitial pneumonia was observed in all fetuses; a fetus with a gross lesion demonstrated necrotizing lymphadenitis in the mesenteric lymph nodes and necrotizing dermatitis in the ear. N. farcinica isolates were isolated from the abomasal contents and lungs of all fetuses. Finally, two cases were diagnosed as abortions due to N. farcinica, and one was diagnosed as an N. farcinica abortion coinfected with bovine viral diarrhea virus. According to the multilocus sequence analysis, all isolates were identified as N. farcinica and were determined to be genetically related to isolates from humans. Two N. farcinica isolates were resistant to trimethoprim-sulfamethoxazole, which is recommended as the first treatment for human nocardial infections. Conclusion This is the first pathological report of bovine abortion caused by N. farcinica in the Republic of Korea. Further studies are needed to phenotypically and genotypically characterize N. farcinica isolates with various sources and continuously monitor antimicrobial resistance patterns.
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Affiliation(s)
- Eun-Mi Kim
- Animal Disease Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea
| | - Chi Sun Yun
- Animal Disease Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea
| | - You-Chan Bae
- Animal Disease Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea
| | - Hyunkyoung Lee
- Animal Disease Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea
| | - Bo-Youn Moon
- Animal Disease Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea
| | - Kichan Lee
- Animal Disease Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea
| | - Hye-Young Jeoung
- Animal Disease Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea
| | - Bok-Kyung Ku
- Animal Disease Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea
| | - Jongho Kim
- Animal Disease Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea
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Lu L, Zhao Z, Liu C, Zhang B, Fu M, Wang D, Shen J, Cai H, Shang W. Multiple lymph nodes enlargement and fever as main manifestations of nocardiosis in immunocompetent individuals: Two case reports. Heliyon 2024; 10:e35681. [PMID: 39170217 PMCID: PMC11336883 DOI: 10.1016/j.heliyon.2024.e35681] [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: 05/26/2024] [Revised: 07/08/2024] [Accepted: 08/01/2024] [Indexed: 08/23/2024] Open
Abstract
Nocardia farcinica is an aerobic gram-positive bacterium that is pathogenic to humans. It usually causes local and adjacent tissues' diseases at the entry of infection (most commonly occur in the lungs, skin, or central nervous system), which can also spread to other organs through the bloodstream such as joints, kidneys, and liver. However, these infections are often seen as opportunistic that occur in immunocompromised patients. Here, we report for the first time two immunocompetent patients lacking evidence of local infections, with multiple lymph node enlargements and fever as main clinical manifestations, finally diagnosed as nocardiosis by Metagenomic Next-Generation Sequencing testing (mNGS) from formalin-fixed and paraffin-embedded (FFPE) lymph node tissue, after all the other standard tests were negative. Both patients recovered after receiving anti-nocardia therapies. These two cases indicates that in healthy population, there may be more potential nocardia infections than we expected. Multiple lymph node enlargements and fever suggest a possibility of nocardiosis, especially in patients with fever of unknown origin (FUO). mNGS detection from FFPE lymph node tissue is an accurate, reliable and traceable method for diagnosis of nocardiosis.
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Affiliation(s)
| | | | | | - Beibei Zhang
- Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China
| | - Mengya Fu
- Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China
| | - Dongyi Wang
- Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China
| | - Junyi Shen
- Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China
| | - Hui Cai
- Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China
| | - Wei Shang
- Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China
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Irifune S, Ide S, Koga S, Mine K, Sugasaki N, Kosai K, Fukuda M, Yanagihara K, Mukae H. Pulmonary Nocardiosis Caused by Nocardia sputorum Identified via 16S rRNA Gene Sequencing: A Case Report. Cureus 2024; 16:e66137. [PMID: 39229387 PMCID: PMC11371458 DOI: 10.7759/cureus.66137] [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: 08/04/2024] [Indexed: 09/05/2024] Open
Abstract
Nocardia sputorum, a novel Nocardia species discovered in Japan in 2023, has not been reported to infect humans. Here, we report a case of pulmonary nocardiosis in a 70-year-old immunocompetent woman infected with N. sputorum. The patient presented to the hospital with a chief complaint of weight loss. She worked at a fruit sorting facility where she was exposed to dust. Chest computed tomography revealed a single cavity and diffuse nodular opacities in both lungs. Nocardia species was isolated from tracheal sputum and bronchial lavage fluid and identified as N. sputorum via 16S rRNA gene sequencing. The patient was treated with oral sulfamethoxazole and trimethoprim but developed oral mucositis on the 12th day of treatment. Consequently, minocycline was prescribed, and the patient's condition improved after a six-month course of treatment. To our knowledge, this is the first reported case of pulmonary nocardiosis caused by N. sputorum in humans. Accurate species identification and antimicrobial susceptibility tests will be necessary to prescribe appropriate treatment for Nocardia infections.
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Affiliation(s)
- Satoshi Irifune
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JPN
- Department of Respiratory Medicine, Nagasaki Prefecture Shimabara Hospital, Nagasaki, JPN
| | - Shotaro Ide
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, Nagasaki, JPN
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, JPN
| | - Satoru Koga
- Department of Respiratory Medicine, Nagasaki Prefecture Shimabara Hospital, Nagasaki, JPN
| | - Keisuke Mine
- Department of Respiratory Medicine, Nagasaki Prefecture Shimabara Hospital, Nagasaki, JPN
| | - Nanae Sugasaki
- Department of Respiratory Medicine, Nagasaki Prefecture Shimabara Hospital, Nagasaki, JPN
| | - Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, JPN
| | - Minoru Fukuda
- Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Nagasaki, JPN
| | | | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JPN
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, JPN
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Subramanian A, Rohilla M, Dhibar DP, Singh H, Bandi AS, Suri V, Bhalla A. An Unusual Case of Nocardia Breast Abscess. Am J Med 2024:S0002-9343(24)00483-2. [PMID: 39094843 DOI: 10.1016/j.amjmed.2024.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/24/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024]
Affiliation(s)
- Aravind Subramanian
- Division of Clinical Infectious Diseases, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manish Rohilla
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deba Prasad Dhibar
- Division of Clinical Infectious Diseases, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Harpreet Singh
- Division of Clinical Infectious Diseases, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Akshay S Bandi
- Division of Clinical Infectious Diseases, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Suri
- Division of Clinical Infectious Diseases, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Bhalla
- Division of Clinical Infectious Diseases, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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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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Garcia Rueda JE, Monsalve Naranjo AD, Giraldo Benítez C, Ramírez Quintero JD. Suppurative Thyroiditis: Coinfection by Nocardia spp. and Mycobacterium tuberculosis in an Immunocompromised Patient. Cureus 2024; 16:e65744. [PMID: 39211687 PMCID: PMC11361131 DOI: 10.7759/cureus.65744] [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: 07/30/2024] [Indexed: 09/04/2024] Open
Abstract
Suppurative thyroiditis is a rare entity with a low incidence in thyroid diseases, manifesting with pain, fever, dysphagia, and dysphonia. Its infrequency is explained by the thyroid gland's resistance to infections due to its encapsulated position, high blood flow, bactericidal action of iodine, and extensive lymphatic network. We present the first report in the literature of a 72-year-old woman with a history of inflammatory myopathy and immunosuppression diagnosed with suppurative thyroiditis co-infected with Nocardia spp. and Mycobacterium tuberculosis. This entity requires a high clinical suspicion, and fine-needle aspiration biopsy (FNAB) is preferred as the diagnostic method for microbiological sampling. Although rare, it carries high morbidity and mortality if not suspected in time.
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Del Ricco VF, Occhineri S, Leonildi A, Falcone M, Lupetti A, Rindi L. A rare case of primary cutaneous Nocardia vinacea in an immunocompetent patient: A case report and a review of the literature. Diagn Microbiol Infect Dis 2024; 109:116307. [PMID: 38733753 DOI: 10.1016/j.diagmicrobio.2024.116307] [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: 02/19/2024] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024]
Abstract
The nocardiae are a complex group of bacteria belonging to the aerobic saprophytes actinomycetes. Although nocardiosis typically occurs in immunocompromised patients, infection may occasionally develop in immunocompetent patients as well. Here we describe a rare case of primary cutaneous nocardiosis due to Nocardia vinacea in an immunocompetent 79-year-old patient. Since cutaneous nocardiosis presents variably and mimics other cutaneous infections, acid-fast and Gram stainings on clinical samples are significant to obtain a rapid and presumptive diagnosis.
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Affiliation(s)
| | - Sara Occhineri
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Marco Falcone
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Antonella Lupetti
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Laura Rindi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Garcia Rueda JE, García Rueda KY, Bermúdez Flórez AM, Peña Mejía LA, Cardona Palacio A, Castaño Ruiz W. Nocardia in an Immunocompetent Patient Simulating Pulmonary Carcinoma: A Case Report and Literature Review. Cureus 2024; 16:e64491. [PMID: 39139318 PMCID: PMC11319823 DOI: 10.7759/cureus.64491] [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: 07/13/2024] [Indexed: 08/15/2024] Open
Abstract
Nocardiosis is an opportunistic infectious pathology of low incidence that usually affects the lungs, skin, and brain. It has been implicated in causing serious and potentially fatal infections without treatment. It affects immunocompetent and immunocompromised patients. In immunocompetent patients, it is presented with local conditions, and in immunocompromised patients, it is seen in disseminated forms. We present the case of a 61-year-old male immunocompetent patient with a high suspicion of pulmonary carcinoma, in whom pathology showed infection by Nocardia spp.
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Thipmontree W, Suputtamonkol Y. Comparison of clinical outcomes of pulmonary nocardiosis between AIDS and non-AIDS patients. BMC Infect Dis 2024; 24:649. [PMID: 38943055 PMCID: PMC11212375 DOI: 10.1186/s12879-024-09519-2] [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: 02/06/2024] [Accepted: 06/17/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Nocardia species can affect both immunocompetent and immunocompromised people. METHOD This retrospective study, from 2009 to 2022, aims to compare the survival analyses of pulmonary nocardiosis in AIDS and non-AIDS patients in northeastern Thailand. RESULTS A total of 215 culture-confirmed cases of pulmonary nocardiosis: 97 with AIDS and 118 without AIDS. The median CD4 count of AIDS patients was 11 cells/µL (range: 1-198), and 33% had concurrent opportunistic infections. 63.6% of 118 non-AIDS patients received immunosuppressive medications, 28.8% had comorbidities, and 7.6% had no coexisting conditions. Disseminated nocardiosis and pleural effusion were more prevalent among AIDS patients, whereas non-AIDS patients revealed more shock and respiratory failure. One hundred-fifty patients underwent brain imaging; 15 (10%) had brain abscesses. Patients with pulmonary nocardiosis have overall 30-day and 1-year mortality rates of 38.5% (95% CI: 32.3%, 45.4%) and 52.1% (95% CI: 45.6%, 58.9%), respectively. The Cox survival analysis showed that AIDS patients with disseminated nocardiosis had a 7.93-fold (95% CI: 2.61-24.02, p < 0.001) increased risk of death within 30 days compared to non-AIDS patients when considering variables such as age, Charlson comorbidity index, concurrent opportunistic infections, duration of illness, shock, respiratory failure, multi-lobar pneumonia, lung abscesses, and combination antibiotic therapy. While AIDS and pulmonary nocardiosis had a tendency to die within 30 days (2.09 (95% CI, 0.74-5.87, p = 0.162)). CONCLUSION AIDS with pulmonary nocardiosis, particularly disseminated disease, is a serious opportunistic infection. Early diagnosis and empiric treatment with a multidrug regimen may be the most appropriate approach in a resource-limited setting.
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Affiliation(s)
- Wilawan Thipmontree
- Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, 30000, Thailand.
| | - Yupin Suputtamonkol
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
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Li Y, Hu J, Zhang Y, Yan K, Wang X, Zhou S, Xu S, Yan X, Wang Y. Complement C1q is involved in the activation of membrane attack complexes, regulation of bacterial infectious inflammation, and apoptosis through overexpression in primary cells of silver pomfret (Pampus argenteus) in vitro. Int J Biol Macromol 2024; 268:131863. [PMID: 38670188 DOI: 10.1016/j.ijbiomac.2024.131863] [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: 03/01/2024] [Revised: 04/21/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024]
Abstract
The complement system is pivotal in innate immune defense, with Complement 1qb (C1qb) playing a key role in recognizing immune complexes and initiating the classical pathway. In this research, we cloned the full-length cDNA of silver pomfret (Pampus argenteus) c1qb and demonstrated its role in mediating defense responses against Nocardia seriolae (N. seriolae) infection, which notably causes significant economic losses in the aquaculture industry. Our investigation revealed that N. seriolae infection led to tissue damage in fish bodies, as observed in tissue sections. Subsequent analysis of differential genes (DEGs) in the transcriptome highlighted genes linked to apoptosis and inflammation. Through experiments involving overexpression and interference of c1qb in vitro, we confirmed that c1qb could suppress N. seriolae-induced apoptosis and inflammation. Moreover, overexpression of c1qb hindered N. seriolae invasion, and the purified and replicated C1qb protein displayed antimicrobial properties. Additionally, our study unveiled that overexpression of c1qb might stimulate the expression of membrane attack complexes (MAC), potentially enhancing opsonization and antibacterial effects. In conclusion, our findings offer valuable insights into the immune antibacterial mechanisms of c1qb and contribute to the development of strategies for controlling N. seriolae.
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Affiliation(s)
- Yuanbo Li
- College of marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Jiabao Hu
- College of marine Sciences, Ningbo University, Ningbo, China; School of Civil & Environmental Engineering and Geography Science, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China.
| | - Youyi Zhang
- College of marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Kaiheng Yan
- College of marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Xubo Wang
- College of marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China.
| | - Suming Zhou
- College of marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China.
| | - Shanliang Xu
- College of marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Xiaojun Yan
- College of marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Yajun Wang
- College of marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China.
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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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Zhang W, Zhou K, Huang L, Yang N, Lin L, Chen L, Yao J, Dong M, Shen J, Pan X. Biological characteristics and pathogenicity comparison of Nocardia seriolae isolated from Micropterus salmoides and Channa argus. Front Vet Sci 2024; 11:1367066. [PMID: 38659458 PMCID: PMC11040683 DOI: 10.3389/fvets.2024.1367066] [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: 01/08/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Nocardia seriolae is the primary pathogen causing nocardiosis in various fish species, leads to significant economic losses in the aquaculture industry. In this study, 10 bacterial strains isolated from Micropterus salmoides and Channa argus infected with nocardiosis, were identified as N. seriolae by physiological and biochemical identification, as well as 16S rDNA sequencing. Moreover, the key virulence-related genes such as ESX-1, T7SS-2, T7SS-3, EspG1, sodC, sod2 and ESAT6 were all positive, and showing high homology among different strains. Pathogenicity testing revealed mortality rates ranging from 70 to 100%, accompanied by the presence of white nodules in the viscera of deceased fish. The drug sensitivity test demonstrated that LY21811, the most lethal strain, exhibited high sensitivity to nine types of antibiotics, including azithromycin, doxycycline, florfenicol and compound sulfamethoxazole, yet showed complete resistance to β-lactam antibiotics. Additionally, the tannic acid also demonstrated potent inhibitory effects against LY21811, with a minimum inhibitory concentration of 0.0625 mg/mL. These results showed that N. seriolae originated from M. salmoides and C. argus in Zhejiang Province were highly conserved, demonstrating a high homogeneity in genetic characteristics, pathogenicity and antimicrobial susceptibilities. These results provide a foundation for further research on the pathogenic characteristics and disease prevention of N. seriolae infections.
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Affiliation(s)
- Wei Zhang
- School of Pharmacy, Qingdao University, Qingdao, China
- Agriculture Ministry Key Laboratory of Healthy Freshwater Aquaculture, Key Laboratory of Fish Health and Nutrition of Zhejiang Province, Zhejiang Institute of Freshwater Fisheries, Huzhou, China
- Ningbo Sansheng Biological Technology Co., Ltd., Ningbo, China
| | - Kexin Zhou
- Agriculture Ministry Key Laboratory of Healthy Freshwater Aquaculture, Key Laboratory of Fish Health and Nutrition of Zhejiang Province, Zhejiang Institute of Freshwater Fisheries, Huzhou, China
| | - Lei Huang
- Agriculture Ministry Key Laboratory of Healthy Freshwater Aquaculture, Key Laboratory of Fish Health and Nutrition of Zhejiang Province, Zhejiang Institute of Freshwater Fisheries, Huzhou, China
| | - Na Yang
- Agriculture Ministry Key Laboratory of Healthy Freshwater Aquaculture, Key Laboratory of Fish Health and Nutrition of Zhejiang Province, Zhejiang Institute of Freshwater Fisheries, Huzhou, China
| | - Lingyun Lin
- Agriculture Ministry Key Laboratory of Healthy Freshwater Aquaculture, Key Laboratory of Fish Health and Nutrition of Zhejiang Province, Zhejiang Institute of Freshwater Fisheries, Huzhou, China
| | - Lu Chen
- Ningbo Sansheng Biological Technology Co., Ltd., Ningbo, China
| | - Jiayun Yao
- Agriculture Ministry Key Laboratory of Healthy Freshwater Aquaculture, Key Laboratory of Fish Health and Nutrition of Zhejiang Province, Zhejiang Institute of Freshwater Fisheries, Huzhou, China
| | - Mingxin Dong
- School of Pharmacy, Qingdao University, Qingdao, China
| | - Jinyu Shen
- Agriculture Ministry Key Laboratory of Healthy Freshwater Aquaculture, Key Laboratory of Fish Health and Nutrition of Zhejiang Province, Zhejiang Institute of Freshwater Fisheries, Huzhou, China
| | - Xiaoyi Pan
- Agriculture Ministry Key Laboratory of Healthy Freshwater Aquaculture, Key Laboratory of Fish Health and Nutrition of Zhejiang Province, Zhejiang Institute of Freshwater Fisheries, Huzhou, China
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15
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Wang D, Hu MT, Liu WJ, Zhao Y, Xu YC. Bacteremia caused by Nocardia farcinica: a case report and literature review. BMC Infect Dis 2024; 24:381. [PMID: 38589778 PMCID: PMC11003049 DOI: 10.1186/s12879-024-09230-2] [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: 10/03/2023] [Accepted: 03/17/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Nocardia farcinica is one of the most common Nocardia species causing human infections. It is an opportunistic pathogen that often infects people with compromised immune systems. It could invade human body through respiratory tract or skin wounds, cause local infection, and affect other organs via hematogenous dissemination. However, N. farcinica-caused bacteremia is uncommon. In this study, we report a case of bacteremia caused by N. farcinica in China. CASE PRESENTATION An 80-year-old woman was admitted to Peking Union Medical College Hospital with recurrent fever, right abdominal pain for one and a half month, and right adrenal gland occupation. N. farcinica was identified as the causative pathogen using blood culture and plasma metagenomics next-generation sequencing (mNGS). The clinical considerations included bacteremia and adrenal gland abscess caused by Nocardia infection. As the patient was allergic to sulfanilamide, imipenem/cilastatin and linezolid were empirically administered. Unfortunately, the patient eventually died less than a month after the initiation of anti-infection treatment. CONCLUSION N. farcinica bacteremia is rare and its clinical manifestations are not specific. Its diagnosis depends on etiological examination, which can be confirmed using techniques such as Sanger sequencing and mNGS. In this report, we have reviewed cases of Nocardia bloodstream infection reported in the past decade, hoping to improve clinicians' understanding of Nocardia bloodstream infection and help in its early diagnosis and timely treatment.
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Affiliation(s)
- Di Wang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Meng-Ting Hu
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Wen-Jing Liu
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ying Zhao
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
| | - Ying-Chun Xu
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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Anan T, Takahashi Y, Kimura Y, Tabayashi T, Kubota Y. Successful Treatment of Disseminated Nocardiosis by Rapid Identification of the Organism via Genetic Analysis in a Leukemia Patient Undergoing Allogeneic Hematopoietic Stem Cell Transplantation. Cureus 2024; 16:e58489. [PMID: 38765332 PMCID: PMC11101261 DOI: 10.7759/cureus.58489] [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: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Nocardia infections have been reported to occur in immunocompromised patients. Early diagnosis and therapeutic intervention are especially important for disseminated nocardiosis because of its high mortality rate. A case of disseminated nocardiosis after allogeneic hematopoietic stem cell transplantation, which was promptly treated after identification of the organism by genetic analysis, is presented. A 43-year-old man was diagnosed with T-cell prolymphocytic leukemia and underwent allogeneic hematopoietic stem cell transplantation. Subsequently, during long-term prednisolone administration for chronic graft-versus-host disease, he developed mass lesions throughout his body at 1033 days after transplantation. Pus culture and genetic testing of the parotid mass showed Nocardia farcinica, which improved with treatment with sulfamethoxazole, trimethoprim, and imipenem cilastatin, and there has been no recurrence. When multiple mass lesions occur after hematopoietic stem cell transplantation, and the diagnosis is difficult, disseminated nocardiosis should be included in the differential diagnosis, and appropriate laboratory testing and treatment should be performed.
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Affiliation(s)
- Tomoe Anan
- Department of Hematology, Saitama Medical University, Saitama Medical Center, Kawagoe, JPN
| | - Yasuyuki Takahashi
- Department of Hematology, Saitama Medical University, Saitama Medical Center, Kawagoe, JPN
| | - Yuta Kimura
- Department of Hematology, Saitama Medical University, Saitama Medical Center, Kawagoe, JPN
| | - Takayuki Tabayashi
- Department of Hematology, Saitama Medical University, Saitama Medical Center, Kawagoe, JPN
| | - Yasushi Kubota
- Department of Hematology, Saitama Medical University, Saitama Medical Center, Kawagoe, JPN
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17
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Timothy LD, Healy CM, Quintanilla NM, Montgomery N, Okcu MF. Nocardiosis in an infant with spindle cell rhabdomyosarcoma treated with mild immunosuppressive chemotherapy. Pediatr Blood Cancer 2024; 71:e30873. [PMID: 38259045 DOI: 10.1002/pbc.30873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/24/2024]
Affiliation(s)
- Leander D Timothy
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas, USA
| | - C Mary Healy
- Department of Infectious Diseases, Texas Children's Hospital, Houston, Texas, USA
| | - Norma M Quintanilla
- Department of Pathology and Immunology, Texas Children's Hospital, Houston, Texas, USA
| | - Nicole Montgomery
- Department of Orthopedics, Texas Children's Hospital, Houston, Texas, USA
| | - M Fatih Okcu
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas, USA
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Guo X, Zhang Z, Chen Q, Wang L, Xu X, Wei Z, Zhang Y, Chen K, Wang Z, Lu X, Liang Q. Whole Genome Sequencing Highlights the Pathogenic Profile in Nocardia Keratitis. Invest Ophthalmol Vis Sci 2024; 65:26. [PMID: 38502137 PMCID: PMC10959193 DOI: 10.1167/iovs.65.3.26] [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: 08/26/2023] [Accepted: 02/26/2024] [Indexed: 03/20/2024] Open
Abstract
Purpose Nocardia keratitis is a serious and sight-threatening condition. This study aims to reveal the virulence and antimicrobial resistance gene profile of Nocardia strains using whole genome sequencing. Methods Whole-genome sequencing was performed on 23 cornea-derived Nocardia strains. Together with genomic data from the respiratory tract and the environment, 141 genomes were then utilized for phylogenetic and pan-genome analyses, followed by virulence and antibiotic resistance analysis. The correlations between virulence genes and pathogenicity were experimentally validated, including the characteristics of Nocardia colonies and clinical and histopathological evaluations of Nocardia keratitis mice models. Results Whole-genome sequencing of 141 Nocardia strains revealed a mean of 220 virulence genes contributed to bacterial pathogenesis. The mce gene family analysis led to the categorization of strains from the cornea into groups A, B, and C. The colonies of group C had the largest diameter, height, and fastest growth rate. The size of corneal ulcers and the clinical scores showed a significant increase in mouse models induced by group C. The relative expression levels of pro-inflammatory cytokines (CD4, IFN-γ, IL-6Rα, and TNF-α) in the lesion area exhibited an increasing trend from group A to group C. Antibiotic resistance genes (ARGs) spanned nine distinct drug classes, four resistance mechanisms, and seven primary antimicrobial resistance gene families. Conclusions Whole genome sequencing highlights the pathogenic role of mce gene family in Nocardia keratitis. Its distribution pattern may contribute to the distinct characteristics of the growth of Nocardia colonies and the clinical severity of the mice models.
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Affiliation(s)
- Xiaoyan Guo
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zijun Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qiankun Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Leying Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xizhan Xu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhenyu Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kexin Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhiqun Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xinxin Lu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qingfeng Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Suda T, Fujii H. Nocardia Bacteremia Associated with a Prosthetic Vascular Graft Infection. Intern Med 2024; 63:623-624. [PMID: 37380460 PMCID: PMC10937139 DOI: 10.2169/internalmedicine.0906-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/17/2023] [Indexed: 06/30/2023] Open
Affiliation(s)
- Takuya Suda
- Department of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, Japan
| | - Hiroshi Fujii
- Department of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, Japan
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Arahirwa V, Thahir S, Hernandez L, Willis ZI. Disseminated Nocardia nova in a child with relapsed acute lymphoblastic leukemia: a case report. BMC Infect Dis 2024; 24:154. [PMID: 38302864 PMCID: PMC10832261 DOI: 10.1186/s12879-023-08895-5] [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: 08/10/2023] [Accepted: 12/12/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Nocardiosis is a rare infection that typically results from inhalation of or inoculation with Nocardia organisms. It may cause invasive disease in immunocompromised patients. This case describes nocardiosis with bacteremia and pulmonary involvement in a child with a hematologic malignancy. CASE PRESENTATION A boy with testicular relapsed acute lymphoblastic leukemia with marrow involvement presented with sudden onset of fever, body aches, headaches, chills, and moderate respiratory distress during continuation 2 chemotherapy. Radiographic imaging demonstrated consolidation and ground glass opacities in bilateral lower lungs. Central line blood cultures grew Nocardia nova complex, prompting removal of the central line and initiation of triple therapy with imipenem-cilastatin, linezolid, and trimethoprim-sulfamethoxazole with rapid improvement of symptoms. Antibiotic susceptibilities showed a multidrug-susceptible isolate. The patient is anticipated to remain on trimethoprim-sulfamethoxazole for at least 12 months. CONCLUSIONS In an immunocompromised child, blood cultures, chest imaging, and head imaging can aid in the diagnosis of disseminated nocardiosis. Long-term antibiotic therapy is necessary, guided by the organism and simplified with the results of antimicrobial susceptibility testing.
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Affiliation(s)
- Victor Arahirwa
- University of North Carolina School of Medicine, Chapel Hill, USA.
| | - Sahal Thahir
- University of North Carolina School of Medicine, Chapel Hill, USA
| | - Lauren Hernandez
- University of North Carolina School of Medicine, Chapel Hill, USA
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21
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Khellaf L, Lemiale V, Decavèle M, de Chambrun MP, Beurton A, Kamel T, Stoclin A, Mokart D, Bruneel F, Vigneron C, Kouatchet A, Henry B, Quenot JP, Jolly G, Issa N, Bellal M, Poissy J, Pichereau C, Schmidt J, Layios N, Gaillet M, Azoulay E, Joseph A. Critically Ill Patients with Visceral Nocardia Infection, France and Belgium, 2004-2023. Emerg Infect Dis 2024; 30:345-349. [PMID: 38270199 PMCID: PMC10826782 DOI: 10.3201/eid3002.231440] [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] [Indexed: 01/26/2024] Open
Abstract
We studied 50 patients with invasive nocardiosis treated during 2004-2023 in intensive care centers in France and Belgium. Most (65%) died in the intensive care unit or in the year after admission. Nocardia infections should be included in the differential diagnoses for patients in the intensive care setting.
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22
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Kisiel M, Bass VM, Fong C, Graham AK, Yahya S, Eichorn FC, Lannon M, Kameda-Smith M, Reddy KKV, Lu JQ. Clinicopathologic characteristics of Nocardia brain abscesses: Necrotic and non-necrotic foci of various stages. J Neurol Sci 2024; 456:122850. [PMID: 38142539 DOI: 10.1016/j.jns.2023.122850] [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: 10/25/2023] [Revised: 12/09/2023] [Accepted: 12/17/2023] [Indexed: 12/26/2023]
Abstract
Nocardia brain abscesses are rare bacterial infections associated with a high mortality rate, and their preoperative diagnosis can be difficult for various reasons including a nonspecific clinical presentation. While late-stage nocardial brain abscesses may be radiologically characteristic, early-stage lesions are nonspecific and indistinguishable from another inflammatory/infectious process and other mimics. Despite the paucity of previous histopathological descriptions, histopathological examination is critical for the identification of the pathogen, lesion stage(s), and possible coexisting pathology. In this study, we examined the clinical, radiological and histopathological features of 10 patients with brain nocardiosis. Microscopic findings were analysed in correlation with clinical and radiological features in 9 patients, which revealed that brain nocardiosis was characterized by numerous necrotic and non-necrotic foci of various stages (I-IV) along with Nocardia identification, as well as the leptomeningeal involvement in most cases, and co-infection of brain nocardiosis with toxoplasmosis in 2 patients. The imaging features were characteristic with a multilobulated/bilobed ring-enhancing appearance in 8 patients including 2 patients with multiple lobulated and non-lobulated lesions and 1 patient showing the progression from a non-lobulated to lobulated lesion. These findings suggest that nocardial brain abscesses particularly at late-stages share common characteristics. Nevertheless, given the complex pathologic features, including possible co-infection by other pathogens, nocardial brain abscesses remain a therapeutic challenge.
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Affiliation(s)
- Marta Kisiel
- Department of Pathology and Molecular Medicine, Canada
| | | | - Crystal Fong
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | | | - Sultan Yahya
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | | | | | | | | | - Jian-Qiang Lu
- Department of Pathology and Molecular Medicine, Canada.
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Gupta RK, Verma KK, Ramchandani R. Scapular ulcero-nodular Actinomycosis masquerading as soft tissue tumour: A case report. Trop Doct 2024; 54:62-65. [PMID: 37769609 DOI: 10.1177/00494755231203263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Affiliation(s)
- Rakesh Kumar Gupta
- Assistant professor, Departments of Pathology, All India Institute of Medical Sciences, Raipur, Raipur, India
| | - Kartavya Kumar Verma
- Assistant professor, Departments of Pathology, All India Institute of Medical Sciences, Raipur, Raipur, India
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Chirila RM, Harris D, Gupta V, Hata DJ, Matei C, Alvarez S, Dumitrascu AG. Clinical and Radiological Characterization of Central Nervous System Involvement in Nocardiosis: A 20-Year Experience. Cureus 2024; 16:e52950. [PMID: 38406155 PMCID: PMC10894056 DOI: 10.7759/cureus.52950] [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: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Background This study aimed to present the clinical and radiological characteristics and the outcomes of patients with Nocardia infection of the central nervous system (CNS). Methodology We conducted a retrospective review of patients aged 18 and older admitted between August 1998 and November 2018 with culture-proven nocardiosis and CNS involvement. Results Out of 110 patients with nocardiosis, 14 (12.7%) patients had CNS involvement. The median age was 54.5 (27, 86) years, and 12 (85.7%) patients were male. Overall, 12 (85.7%) patients were immunosuppressed on high doses of glucocorticoids; seven (50%) patients were solid organ transplant recipients. Only eight (57.1%) patients had neurological symptoms at presentation, and the rest were diagnosed with CNS involvement after imaging surveillance. Three distinct radiologic patterns were identified, namely, single or multiple abscesses, focal cerebritis, and small, septic embolic infarcts. All isolates of Nocardia were susceptible to trimethoprim/sulfamethoxazole and amikacin, with susceptibility to linezolid and carbapenems being 90.9% and 79.5%, respectively. Despite receiving antibiotic therapy, six (42.8%) patients died, most of them within weeks of initial admission. All surviving patients underwent prolonged antimicrobial therapy until the resolution of MRI abnormalities. All solid organ transplant recipients recovered. Conclusions Nocardia CNS infection was a rare condition, even among a large, immunosuppressed patient population. CNS imaging surveillance is paramount for immunosuppressed patients with nocardiosis, as CNS involvement influences the choice and duration of therapy. Nocardia antibiotic susceptibility varied widely between strains and the empiric therapy should consist of multiple classes of antimicrobials with CNS penetration. Mortality was high, but all solid organ transplant recipients recovered.
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Affiliation(s)
| | - Dana Harris
- Internal Medicine, Mayo Clinic, Jacksonville, USA
| | | | | | - Claudiu Matei
- Neurological Surgery, Lucian Blaga University, Sibiu, ROU
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25
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Alotaibi F, Lee SJ, Lahrach Z, St-Arnaud M, Hijri M. Draft Genome of Nocardia canadensis sp. nov. Isolated from Petroleum-Hydrocarbon-Contaminated Soil. Microorganisms 2023; 11:2972. [PMID: 38138115 PMCID: PMC10745995 DOI: 10.3390/microorganisms11122972] [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: 10/24/2023] [Revised: 11/30/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
The bacterial strain WB46 was isolated from the rhizosphere of willow plants (Salix purpurea L.) growing in soil contaminated with petroleum hydrocarbons. The strain was subjected to whole-genome shotgun sequencing using Illumina HiSeq. Its draft genome is 7.15 Mb, with a 69.55% GC content, containing 6387 protein-coding genes and 51 tRNA and 15 rRNA sequences. The quality and reliability of the genome were assessed using CheckM, attaining an estimated genome completeness of 98.75% and an estimated contamination of 1.68%. These results indicate a high-quality genome (>95%) and low contamination (<5%). Many of these genes are responsible for petroleum hydrocarbon degradation, such as alkane 1-monooxygenase (alkB) and naphthalene dioxygenase (ndo). 16S rRNA gene analysis, including in silico DNA-DNA hybridization (DDH) and average nucleotide identity (ANI), showed that strain WB46 belongs to the genus Nocardia, and the most closely related species is Nocardia asteroides. The strain WB46 showed a distance of 63.4% and sequence identity of 88.63%, respectively. These values fall below the threshold levels of 70% and 95%, respectively, suggesting that the strain WB46 is a new species. We propose the name of Nocardia canadensis sp. nov. for this new species. Interestingly, the sequence divergence of the 16S rRNA gene showed that the divergence only occurred in the V2 region. Therefore, the conventional V3-V4, V5-V7, or V8-V9 targeting metabarcoding, among others, would not be able to assess the diversity related to this new species.
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Affiliation(s)
- Fahad Alotaibi
- Institut de Recherche en Biologie Végétale, Université de Montréal, 4101 East Sherbrooke St., Montréal, QC H1X 2B2, Canada; (S.-J.L.); (Z.L.); (M.S.-A.)
- Department of Soil Science, King Saud University, Riyadh 11564, Saudi Arabia
| | - Soon-Jae Lee
- Institut de Recherche en Biologie Végétale, Université de Montréal, 4101 East Sherbrooke St., Montréal, QC H1X 2B2, Canada; (S.-J.L.); (Z.L.); (M.S.-A.)
| | - Zakaria Lahrach
- Institut de Recherche en Biologie Végétale, Université de Montréal, 4101 East Sherbrooke St., Montréal, QC H1X 2B2, Canada; (S.-J.L.); (Z.L.); (M.S.-A.)
- African Genome Center, University Mohammed VI Polytechnic (UM6P), Ben Guerir 43150, Morocco
| | - Marc St-Arnaud
- Institut de Recherche en Biologie Végétale, Université de Montréal, 4101 East Sherbrooke St., Montréal, QC H1X 2B2, Canada; (S.-J.L.); (Z.L.); (M.S.-A.)
| | - Mohamed Hijri
- Institut de Recherche en Biologie Végétale, Université de Montréal, 4101 East Sherbrooke St., Montréal, QC H1X 2B2, Canada; (S.-J.L.); (Z.L.); (M.S.-A.)
- African Genome Center, University Mohammed VI Polytechnic (UM6P), Ben Guerir 43150, Morocco
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Corcione S, Vita D, De Nicolò A, Scabini S, Mornese Pinna S, Cusato J, Mangiapia M, D'Avolio A, De Rosa FG. Pharmacokinetics and pharmacogenetics of high-dosage tedizolid for disseminated nocardiosis in a lung transplant patient. J Antimicrob Chemother 2023; 78:3003-3004. [PMID: 37788983 DOI: 10.1093/jac/dkad299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Affiliation(s)
- Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
- School of Medicine, Tufts University, Boston, MA, USA
| | - Davide Vita
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | - Amedeo De Nicolò
- Department of Medical Sciences, Laboratory of Clinical Pharmacology and Pharmacogenetics, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, Italy
| | - Silvia Scabini
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | - Simone Mornese Pinna
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | - Jessica Cusato
- Department of Medical Sciences, Laboratory of Clinical Pharmacology and Pharmacogenetics, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, Italy
| | - Mauro Mangiapia
- Pneumology Unit, Department of Cardiovascular and Thoracic Diseases, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Antonio D'Avolio
- Department of Medical Sciences, Laboratory of Clinical Pharmacology and Pharmacogenetics, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Turin, Italy
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Gupta S, Grant LM, Powers HR, Kimes KE, Hamdi A, Butterfield RJ, Gea-Banacloche J, Vijayvargiya P, Hata DJ, Meza Villegas DM, Dumitrascu AC, Harris DM, Chirila RM, Zhang N, Razonable RR, Kusne S, Alvarez S, Vikram HR. Invasive Nocardia Infections across Distinct Geographic Regions, United States. Emerg Infect Dis 2023; 29. [PMID: 37987603 PMCID: PMC10683819 DOI: 10.3201/eid2912.230673] [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] [Indexed: 11/22/2023] Open
Abstract
We reviewed invasive Nocardia infections in 3 noncontiguous geographic areas in the United States during 2011–2018. Among 268 patients with invasive nocardiosis, 48.2% were from Minnesota, 32.4% from Arizona, and 19.4% from Florida. Predominant species were N. nova complex in Minnesota (33.4%), N. cyriacigeorgica in Arizona (41.4%), and N. brasiliensis in Florida (17.3%). Transplant recipients accounted for 82/268 (30.6%) patients overall: 14 (10.9%) in Minnesota, 35 (40.2%) in Arizona, and 33 (63.5%) in Florida. Manifestations included isolated pulmonary nocardiosis among 73.2% of transplant and 84.4% of non–transplant patients and central nervous system involvement among 12.2% of transplant and 3.2% of non–transplant patients. N. farcinica (20.7%) and N. cyriacigeorgica (19.5%) were the most common isolates among transplant recipients and N. cyriacigeorgica (38.0%), N. nova complex (23.7%), and N. farcinica (16.1%) among non–transplant patients. Overall antimicrobial susceptibilities were similar across the 3 study sites.
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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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Gandham N, Kannuri S, Gupta A, Mukhida S, Das N, Mirza S. A post-transplant infection by Nocardia cyriacigeorgica. Access Microbiol 2023; 5:000569.v3. [PMID: 38074108 PMCID: PMC10702378 DOI: 10.1099/acmi.0.000569.v3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 10/24/2023] [Indexed: 10/09/2024] Open
Abstract
Nocardia are Gram-positive, acid-fast, filamentous bacteria that cause opportunistic infections in susceptible populations. We describe a case of post-transplant infection of pulmonary nocardiosis caused by the rare strain Nocardia cyriacigeorgica and the challenges faced in reaching a definitive diagnosis. This case report emphasizes on keeping nocardiosis as a differential diagnosis in transplant recipients, as this disease is largely underdiagnosed and underreported.
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Affiliation(s)
- Nageswari Gandham
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth University, Pune, Maharashtra, India
| | - Sriram Kannuri
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth University, Pune, Maharashtra, India
| | - Aryan Gupta
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth University, Pune, Maharashtra, India
| | - Sahjid Mukhida
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth University, Pune, Maharashtra, India
| | - Nikunja Das
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth University, Pune, Maharashtra, India
| | - Shahzad Mirza
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth University, Pune, Maharashtra, India
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Nguyen P, Giovanni A, Cheng LW, Wang PC, Chen SC. Pathogenicity characterization of nocardiosis in orange-spotted grouper (Epinephelus coioides) via exposure to nine distinct isolates of Nocardia seriolae and four administrative routes. JOURNAL OF FISH DISEASES 2023; 46:1257-1268. [PMID: 37584202 DOI: 10.1111/jfd.13845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/20/2023] [Accepted: 07/22/2023] [Indexed: 08/17/2023]
Abstract
Nocardia seriolae causes chronic nocardiosis in various marine and freshwater aquatic animals; however, grouper species have rarely been investigated. This study evaluated the pathogenicity of nocardiosis following N. seriolae infection in the orange-spotted grouper Epinephelus coioides. Nine identified genetic isolates of N. seriolae were tested in vivo using the intraperitoneal method and observed daily for 35 days. The most virulent isolate was then used to evaluate transmission through different routes (intraperitoneal IP, intramuscular IM, oral OR, and immersion IS) in the same fish model and was observed daily for 42 days. The results showed mild variation in virulence among N. seriolae isolates. AOD107132-2 K and OT103003-N11 strains displayed the highest and lowest risk virulence, respectively, based on the accumulation and kinetics of mortality. IM and IP administrations showed an early phase response with early mortality by 5 dpc (30%-100%), while slower kinetics of nocardiosis occurred in the OR and IS routes with slow mortality at 35 dpc (4%-8%). Histopathology revealed typical granulomas, confirming the progression of nocardiosis in the diseased fish. These results provide the basis for further studies on the virulence profile of N. seriolae in Taiwan and a well-suited route of administration in orange-spotted groupers for further prevention development.
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Affiliation(s)
- Phuong Nguyen
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Andre Giovanni
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Li-Wu Cheng
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Pei-Chi Wang
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Southern Taiwan Fish Diseases Research Centre, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Shih-Chu Chen
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Southern Taiwan Fish Diseases Research Centre, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
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Jin S, Guo X, Xing H, Li D, Wang Y, Ma W. Multiple brain abscesses caused by Nocardia asiatica: Case report and literature review. IDCases 2023; 34:e01903. [PMID: 37928816 PMCID: PMC10622833 DOI: 10.1016/j.idcr.2023.e01903] [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: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023] Open
Abstract
Nocardia are opportunistic pathogens mainly affecting immunocompromised individuals. Nocardia asiatica, a novel species, can cause severe infections. We present a case of multiple brain abscesses due to Nocardia asiatica, discussing its diagnosis and treatment. In January 2022, a 27-year-old Chinese woman with a history of atypical membranous nephropathy presented with low-grade fever, cough, limb weakness, and headaches. Imaging revealed lung and brain lesions. Neurological symptoms worsened over time, culminating in recurrent seizures and severe headaches. A brain MRI confirmed multiple abscesses. Craniotomy and lesion removal were performed, leading to a diagnosis of brain abscesses caused by Nocardia asiatica. Empirical antibiotics were followed by targeted regimen. After successful treatment, the patient remained symptom-free during follow-ups. Nocardia asiatica multiple brain abscesses are exceedingly rare. This case underscores the importance of considering nocardiosis in immunosuppressed patients presenting with neurological symptoms. Timely neurosurgical intervention and effective antibiotic therapy are crucial. Metagenomic next-generation sequencing proved invaluable for rapid diagnosis. Treatment with trimethoprim-sulfamethoxazole (TMP-SMX) and a carbapenem followed by TMP-SMX alone achieved disease control. This case contributes to the understanding of Nocardia asiatica infections and highlights the role of neurosurgical procedures in managing disseminated nocardiosis.
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Affiliation(s)
- Shanmu Jin
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- 4+4 Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiaopeng Guo
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hao Xing
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Dingding Li
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Fernández Vecilla D, Roche Matheus MP, Urrutikoetxea Gutiérrez MJ, Calvo Muro FE, Aspichueta Vivanco C, López Azkarreta I, Grau García M, Díaz de Tuesta Del Arco JL. Disseminated Nocardia farcinica infection associated with bacteraemia and osteomyelitis pubis in an elderly patient. Infect Dis (Lond) 2023; 55:738-743. [PMID: 37376969 DOI: 10.1080/23744235.2023.2229425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE We describe a rare case of a disseminated Nocardia farcinica infection associated with hip osteomyelitis. METHODS A 91-year-old female patient was admitted with oedema of her right leg, fever of 38 °C and data consistent with ruptured Baker's cyst. A disseminated Nocardia farcinica infection including bloodstream infection, pneumonia and multiple abscesses along both lower limbs was observed. RESULTS After a four-week course of 320 mg/1600 mg/12 h of intravenous trimethoprim/sulfamethoxazole and multiple chirurgic drainages the patient was discharged with oral trimethoprim/sulfamethoxazole. Nevertheless, the patient expired done month after being discharged from the hospital. CONCLUSIONS The implementation of a combination of intravenous antibiotics and drainages resulted in an initial improvement in the patient's condition. However, despite these interventions, the patient ultimately passed away probably due to natural causes.
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Affiliation(s)
| | - Mary Paz Roche Matheus
- Clinical Microbiology Service, Basurto University Hospital, Bilbao, Biscay, Spain
- Biocruces Bizkaia Health Research Institute, Biscay, Spain
| | | | - Felicitas Elena Calvo Muro
- Clinical Microbiology Service, Basurto University Hospital, Bilbao, Biscay, Spain
- Biocruces Bizkaia Health Research Institute, Biscay, Spain
| | - Cristina Aspichueta Vivanco
- Clinical Microbiology Service, Basurto University Hospital, Bilbao, Biscay, Spain
- Biocruces Bizkaia Health Research Institute, Biscay, Spain
| | | | - Mikel Grau García
- Radiodiagnosis Service of Basurto University Hospital, Bilbao, Biscay, Spain
| | - José Luis Díaz de Tuesta Del Arco
- Clinical Microbiology Service, Basurto University Hospital, Bilbao, Biscay, Spain
- Biocruces Bizkaia Health Research Institute, Biscay, Spain
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33
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Li Y, Hu J, Zhang Y, Yan K, Zhang M, Li Y, Huang X, Tang J, Yao T, Wang D, Xu S, Wang X, Zhou S, Yan X, Wang Y. Identification and characterization of toll-like receptor genes in silver pomfret (Pampus argenteus) and their involvement in the host immune response to Photobacterium damselae subsp. Damselae and Nocardia seriolae infection. FISH & SHELLFISH IMMUNOLOGY 2023; 141:109071. [PMID: 37703936 DOI: 10.1016/j.fsi.2023.109071] [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: 05/25/2023] [Revised: 08/26/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023]
Abstract
Toll-like receptors (TLRs) are vital pattern recognition receptors that play a critical role in the innate immune response against pathogenic attack. Among the bacteria commonly found in the culture process of silver pomfret, Photobacterium damselae subsp. Damselae (PDD, gram-negative) and Nocardia seriolae (NS, gram-positive), can cause large-scale mortality in this fish species. However, there is currently no research on the role of TLRs in mediating the immune response of silver pomfret to these two bacterial infections. Therefore, in this study, we identified nine PaTLRs family members, including several fish-specific TLRs (TLR14 and TLR21). Phylogenetic analysis revealed that these PaTLRs genes could be classified into five subfamilies, namely TLR1, TLR3, TLR5, TLR7, and TLR11, indicating their evolutionary conservation. To further explore the interactions of TLR genes with immune-related mediators, protein and protein interaction network (PPI) results were generated to explain the association of TLR genes with TNF receptor-associated factor 6 (TRAF6) and other relevant genes in the MyD88-dependent pathway and NF-κb signaling pathway. Subsequently, RT-qPCR was conducted to verify the expression patterns of the nine TLR genes in the gills, skin, kidney, liver, and spleen of healthy fish, with most of the TLRs showing high expression levels in the spleen. Following infection with PDD and NS, these PaTLRs exhibited different expression patterns in the spleen, with PaTLR2, PaTLR3, PaTLR5, PaTLR7, PaTLR9, and PaTLR14 being significantly up-regulated. Furthermore, when spleen cells were treated with bacterial compositions, the majority of PaTLRs expression was up-regulated in response to Lipopolysaccharide (LPS) and lipophosphorylcholic acid (LTA) treatment, except for PaTLR21. Finally, changes in the expression levels of TLR-interacting genes were also observed under the stimulation of bacteria and bacterial compositions. The results of this study provide a preliminary reference for further understanding the mechanism of the innate immune response of the TLR gene family in silver pomfret and offer theoretical support for addressing the disease problems encountered during large-scale fish breeding.
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Affiliation(s)
- Yuanbo Li
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Jiabao Hu
- College of Marine Sciences, Ningbo University, Ningbo, China; School of Civil & Environmental Engineering and Geography Science, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China.
| | - Youyi Zhang
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Kaiheng Yan
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Man Zhang
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Yaya Li
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Xiang Huang
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Jie Tang
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Tingyan Yao
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Danli Wang
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Shanliang Xu
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Xubo Wang
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Suming Zhou
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China.
| | - Xiaojun Yan
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China
| | - Yajun Wang
- College of Marine Sciences, Ningbo University, Ningbo, China; Key Laboratory of Applied Marine Biotechnology, Ningbo University, Ministry of Education, Ningbo, China; Key Laboratory of Marine Biotechnology of Zhejiang Province, Ningbo University, Ningbo, China.
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Zhou Y, Yang N, Ruan S, Wu S, Yu D, Jin J. Lung cancer patient with Tropheryma whipplei and Nocardia co-infection. Ultrastruct Pathol 2023; 47:451-459. [PMID: 37533314 DOI: 10.1080/01913123.2023.2241888] [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: 05/28/2023] [Revised: 07/14/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Abstract
A 34-year-old male presented with lung shadow and was asymptomatic during medical examination. The patient had a prior history of thyroid tumors. Imaging manifestation showed a nodule in the medial segment of the right middle lobe, with partial obstruction of the distal bronchus within the lesion. Ground-glass and inflammatory nodules were observed in the anterior segment of the right upper lobe, as well as chronic inflammatory changes in the lower lobe of the right lung. Lung histopathological examination suggested invasive adenocarcinoma. A morphological examination of the bronchoalveolar lavage fluid revealed the presence of Tropheryma whipplei (TW) and Nocardia. Although TW infection has been reported in cancer patients, co-infection with Nocardia is a unique occurrence in this case. Opportunistic pathogens are common in immunocompromised patients but in this case, the patient was a young adult with normal immunity and an early-stage tumor with TW and Nocardia co-infection. We demonstrated the presence of rare microorganisms through imaging findings, combined with different staining methods of bronchoalveolar lavage fluid and lung tissue sections and evaluation of morphological characteristics. The aim of the present study was to provide early diagnosis and treatment of patients by improving microbial morphological detection.
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Affiliation(s)
- Yuli Zhou
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine.261 Huan Sha Rd, Hangzhou, China
| | - Nan Yang
- Department of Nephrology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
| | - Senlin Ruan
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine.261 Huan Sha Rd, Hangzhou, China
| | - Shenghai Wu
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine.261 Huan Sha Rd, Hangzhou, China
| | - Daojun Yu
- Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine.261 Huan Sha Rd, Hangzhou, China
| | - Juan Jin
- Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
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35
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Garcia Ribeiro M, da Silva CPC, Pchevuzinske LM, Portilho FVR, Siqueira AK, Takahira RK, Paschoal NR, de Souza AAL, Rodrigues CA, de Almeida BO, Bello TS, Filho MFÁ, de Lima Paz PJ, Dutra V, Nakazato L, Pereira NA, de Aguiar DM. Pleural effusion-related Nocardia otitidiscaviarum, Anaplasma platys and Ehrlichia canis coinfection in a dog. Braz J Microbiol 2023; 54:2497-2504. [PMID: 37351788 PMCID: PMC10484848 DOI: 10.1007/s42770-023-01029-8] [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: 09/28/2022] [Accepted: 06/05/2023] [Indexed: 06/24/2023] Open
Abstract
The coinfections by some microorganisms have been related to severe diseases in humans and animals, where immunosuppressive agents favor opportunistic behavior of other pathogens. A 4-month-old, female mixed-breed dog with a two-week history of inappetence, prostration, emaciation, and respiratory distress was admitted at a veterinary hospital in Brazil. Tachycardia, pale mucous membranes, severe respiratory distress, and a large number of ticks (Rhipicephalus sanguineus s.l.) in different body regions were observed at clinical examination. Hematological examination of dog showed leukocytosis, neutrophilia, mild anemia, and thrombocytopenia, whereas unremarkable values in biochemical tests. Thoracic radiography revealed a pleural effusion image. Blood and the pleural fluid (purulent aspect) samples were subjected to qPCR (16S rRNA and dsb genes) and sequencing, which identified Ehrlichia canis and Anaplasma platys coinfection. An aggregate of coccoid-to-branching or long filamentous microorganisms, surrounded by pyogranulomatous inflammatory reaction was seen at the cytology of the pleural fluid. Bacteriological culture of pleural effusion showed colonies compatible with the genus Nocardia, which revealed gram-positive filamentous organisms with a tendency of fragmentation and were identified as Nocardia otitidiscaviarum in mass spectrometry (MALDI-TOF MS). Therapy of N. otitidiscaviarum isolate using levofloxacin (supported by a previous in vitro susceptibility testing) and doxycycline for E. canis and A. platys resulted in complete resolution of the clinical picture. Here, we report for the first time a triple coinfection by Nocardia otitidiscaviarum, A. platys, and E. canis in a dog with pleural effusion, where debilitating or immunosuppressive conditions induced by A. platys and E. canis coinfection probably contributed to the opportunistic behavior of N. otitidiscaviarum.
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Affiliation(s)
- Márcio Garcia Ribeiro
- School of Veterinary Medicine and Animal Sciences, São Paulo State University (UNESP), Botucatu, SP Brazil
| | | | - Larissa Marry Pchevuzinske
- School of Veterinary Medicine and Animal Sciences, São Paulo State University (UNESP), Botucatu, SP Brazil
| | | | | | - Regina Kiomi Takahira
- School of Veterinary Medicine and Animal Sciences, São Paulo State University (UNESP), Botucatu, SP Brazil
| | - Natália Rodrigues Paschoal
- School of Veterinary Medicine and Animal Sciences, São Paulo State University (UNESP), Botucatu, SP Brazil
| | | | | | | | - Thaís Spessotto Bello
- School of Veterinary Medicine and Animal Sciences, São Paulo State University (UNESP), Botucatu, SP Brazil
| | - Marcelo Fagali Árabe Filho
- School of Veterinary Medicine and Animal Sciences, São Paulo State University (UNESP), Botucatu, SP Brazil
| | - Patrik Júnior de Lima Paz
- School of Veterinary Medicine and Animal Sciences, São Paulo State University (UNESP), Botucatu, SP Brazil
| | - Valéria Dutra
- Faculty of Veterinary Medicine, Federal University of Mato Grosso (UFMT), Cuiabá, MT Brazil
| | - Luciano Nakazato
- Faculty of Veterinary Medicine, Federal University of Mato Grosso (UFMT), Cuiabá, MT Brazil
| | - Nathalia Assis Pereira
- Faculty of Veterinary Medicine, Federal University of Mato Grosso (UFMT), Cuiabá, MT Brazil
| | - Daniel Moura de Aguiar
- Faculty of Veterinary Medicine, Federal University of Mato Grosso (UFMT), Cuiabá, MT Brazil
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36
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Silwal S, Mir M, Boike S, Bista K, Yadav SK, Sheehy J, Khan SA, Gomez Urena EO. Disseminated Nocardia Brain Abscess Presenting as Primary Lung Cancer With Brain Metastasis. Cureus 2023; 15:e43631. [PMID: 37719483 PMCID: PMC10504867 DOI: 10.7759/cureus.43631] [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: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
We present a challenging case of disseminated Nocardia brasiliensis infection manifesting as brain and skin abscesses. Nocardia is an important potential pathogen to consider in patients with a relevant travel history to endemic regions or atypical presentations, such as brain and skin abscesses. About one-third of patients with Nocardia infections are immunocompetent, and their symptoms are nonspecific. This case shows the limitations of imaging studies in diagnosing Nocardia brain abscesses, as the patient's non-magnetic resonance (MR) conditional pacemaker precluded MRI evaluation and led to a diagnostic challenge. Therefore, the patient's initial evaluation was presumed to be primary lung cancer with brain metastasis. High clinical suspicion, imaging studies (especially MRI), and tissue biopsy are needed to diagnose this type of brain abscess in a timely manner to prevent further complications.
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Affiliation(s)
- Swechchha Silwal
- Internal Medicine, Trinity Health Oakland/Wayne State University, Pontiac, USA
| | - Mikael Mir
- Medicine, University of Minnesota Medical School, Minneapolis, USA
| | - Sydney Boike
- Medicine, University of Minnesota Medical School, Minneapolis, USA
| | - Karuna Bista
- Internal Medicine, Nepal Medical College, Kathmandu, NPL
| | - Sumeet K Yadav
- Internal Medicine, Mayo Clinic Health System, Mankato, USA
| | - Jessica Sheehy
- Infectious Diseases, Mayo Clinic Health System, Mankato, USA
| | - Syed Anjum Khan
- Critical Care Medicine, Mayo Clinic Health System, Mankato, USA
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37
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Ortiz J, Jover F, Ortiz de la Tabla V, Delgado E. Pulmonary nocardiosis after covid-19 infection: case report and literature review. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2023; 36:421-424. [PMID: 37101409 PMCID: PMC10336311 DOI: 10.37201/req/132.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/29/2023] [Accepted: 02/06/2023] [Indexed: 04/28/2023]
Affiliation(s)
| | - F Jover
- Francisco Jover, University Miguel Hernández of Alicante. Spain. Infectious Diseases Unit. Hospital Clínico San Juan de Alicante. Spain.
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38
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Bounoua F, Daoudi N, Aghrouch M, Hanchi AL, Soraa N, Serhane H, Moubachir H. Pleuropulmonary nocardiosis, an unusual radiological presentation: Case report. Radiol Case Rep 2023; 18:2725-2729. [PMID: 37304320 PMCID: PMC10250826 DOI: 10.1016/j.radcr.2023.04.057] [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: 03/01/2023] [Revised: 04/25/2023] [Accepted: 04/30/2023] [Indexed: 06/13/2023] Open
Abstract
Nocardiosis is caused by strict aerobic filamentous bacteria of the genus Nocardia belonging to the order Actinomycetales with Actinomyces, Streptomyces and Mycobacterium. The radio-clinical presentation in the chest is often misleading. We report a case of pulmonary nocardiosis with an unusual radiological presentation. A 54-year-old patient, chronic smoker, never treated for pulmonary tuberculosis, who presented with a chronic cough complicated by moderate hemoptysis, all evolving in a context of altered general condition and feverish sensations. The radiological aspect was in favor of a hydro-pneumothorax, the pleural puncture brought back a chocolate colored purulent liquid with the presence of numerous yellow grains and the direct examination showed numerous branched gram-positive bacilli. The bacteriological study allowed to retain the presumptive diagnosis of nocardiosis, the patient was put under antibiotic treatment with a clear clinical and radiological improvement. This observation illustrates the diagnostic difficulty of pulmonary nocardiosis and emphasizes the importance of thinking about nocardiosis in front of any dark thoracic syndrome.
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Affiliation(s)
- Fatiha Bounoua
- Pneumology Department, Faculty of Medicine and Pharmacy of Agadir, Souss-Massa University Hospital, Ibn Zohr University, Agadir, Morocco
| | - Naima Daoudi
- Pneumology Department, Faculty of Medicine and Pharmacy of Agadir, Souss-Massa University Hospital, Ibn Zohr University, Agadir, Morocco
| | | | - Asmae Lamrani Hanchi
- Faculty of Medicine and Pharmacy of Marrakech, Laboratory of Microbiology, University Hospital Mohammed VI of Marrakech, Marrakesh, Morocco
| | - Nabila Soraa
- Faculty of Medicine and Pharmacy of Marrakech, Laboratory of Microbiology, University Hospital Mohammed VI of Marrakech, Marrakesh, Morocco
| | - Hind Serhane
- Pneumology Department, Faculty of Medicine and Pharmacy of Agadir, Souss-Massa University Hospital, Ibn Zohr University, Agadir, Morocco
| | - Houda Moubachir
- Pneumology Department, Faculty of Medicine and Pharmacy of Agadir, Souss-Massa University Hospital, Ibn Zohr University, Agadir, Morocco
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39
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Barratclough A, Ferguson SH, Lydersen C, Thomas PO, Kovacs KM. A Review of Circumpolar Arctic Marine Mammal Health-A Call to Action in a Time of Rapid Environmental Change. Pathogens 2023; 12:937. [PMID: 37513784 PMCID: PMC10385039 DOI: 10.3390/pathogens12070937] [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: 04/13/2023] [Revised: 06/16/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The impacts of climate change on the health of marine mammals are increasingly being recognised. Given the rapid rate of environmental change in the Arctic, the potential ramifications on the health of marine mammals in this region are a particular concern. There are eleven endemic Arctic marine mammal species (AMMs) comprising three cetaceans, seven pinnipeds, and the polar bear (Ursus maritimus). All of these species are dependent on sea ice for survival, particularly those requiring ice for breeding. As air and water temperatures increase, additional species previously non-resident in Arctic waters are extending their ranges northward, leading to greater species overlaps and a concomitant increased risk of disease transmission. In this study, we review the literature documenting disease presence in Arctic marine mammals to understand the current causes of morbidity and mortality in these species and forecast future disease issues. Our review highlights potential pathogen occurrence in a changing Arctic environment, discussing surveillance methods for 35 specific pathogens, identifying risk factors associated with these diseases, as well as making recommendations for future monitoring for emerging pathogens. Several of the pathogens discussed have the potential to cause unusual mortality events in AMMs. Brucella, morbillivirus, influenza A virus, and Toxoplasma gondii are all of concern, particularly with the relative naivety of the immune systems of endemic Arctic species. There is a clear need for increased surveillance to understand baseline disease levels and address the gravity of the predicted impacts of climate change on marine mammal species.
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Affiliation(s)
- Ashley Barratclough
- National Marine Mammal Foundation, 2240 Shelter Island Drive, San Diego, CA 92106, USA
| | - Steven H. Ferguson
- Arctic Aquatic Research Division, Fisheries and Oceans Canada, Winnipeg, MB R3T 2N6, Canada;
| | - Christian Lydersen
- Norwegian Polar Institute, Fram Centre, 9296 Tromsø, Norway; (C.L.); (K.M.K.)
| | - Peter O. Thomas
- Marine Mammal Commission, 4340 East-West Highway, Room 700, Bethesda, MD 20814, USA;
| | - Kit M. Kovacs
- Norwegian Polar Institute, Fram Centre, 9296 Tromsø, Norway; (C.L.); (K.M.K.)
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40
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Zubair SM, Khan MMM, Rahim Y, Ibad HA, Irfan M. Impact of immune status on the clinical characteristics, treatment outcomes and mortality of pulmonary nocardiosis: a retrospective analysis in a tertiary care hospital from a low- to middle-income country. Monaldi Arch Chest Dis 2023; 94. [PMID: 37367100 DOI: 10.4081/monaldi.2023.2499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
Nocardiosis is an opportunistic infection that primarily targets the immunosuppressed. We investigated the differences in demographics and characteristics between immunosuppressed and immunocompetent patients with nocardiosis in a tertiary care hospital in Pakistan. Retrospective records were reviewed for patients diagnosed with pulmonary nocardiosis between 2010 and 2020. Immunosuppressed individuals were identified as those with autoimmune diseases, hematologic diseases and malignancies, HIV, immunosuppressant therapy, etc. Data collected included basic demographics, comorbid conditions, medication history, clinical presentation, radiological and microbiological data, and nocardiosis outcomes and complications. A total of 66 patients with nocardiosis were included in this study, of whom 48 were immunosuppressed and 18 were immunocompetent. Both groups were compared for a number of variables, including patient characteristics, underlying conditions, radiological findings, treatment regimen, and outcomes. Immunosuppressed individuals were younger and had higher rates of diabetes, chronic renal disease, chronic liver disease, higher platelet counts, surgical intervention, and longer hospital stays. Fever, dyspnea, and sputum production were the most common presentations. Nocardia asteroides was found to be the most common species of Nocardia overall. Nocardiosis presents differently in immunosuppressed and immunocompetent patients, which is consistent with previous studies. Nocardiosis should be considered in any patient presenting with treatment-resistant pulmonary or neurological symptoms.
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Affiliation(s)
| | | | - Yasmin Rahim
- Kettering General Hospital, NHS Foundation Trust.
| | | | - Muhammad Irfan
- Section of Pulmonary Medicine, Aga Khan University Hospital, Karachi.
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41
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Condas LAZ, de Farias MR, Siqueira AK, Salerno T, Chi KD, Werner J, de Vargas AC, Bond GB, Gonoi T, Matsuzawa T, Ribeiro MG. Molecular identification and antimicrobial resistance pattern of Nocardia isolated from 14 diseased dogs and cats. Braz J Microbiol 2023; 54:1287-1294. [PMID: 37079272 PMCID: PMC10234972 DOI: 10.1007/s42770-023-00968-6] [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: 02/11/2022] [Accepted: 04/03/2023] [Indexed: 04/21/2023] Open
Abstract
Nocardia are ubiquitous, saprophytic and opportunistic bacteria. They cause a set of pyogenic clinical infections in animals and humans, particularly immunocompromised patients, mostly affecting the skin and respiratory tract, with refractoriness to conventional therapy. The most descriptions of nocardial infections in companion animals involve case reports, and there are scarce case series studies focused on canine and feline nocardiosis in which diagnosis has been based on molecular techniques. We investigated epidemiological aspects, clinical findings, in vitro susceptibility profile, and molecular identification of Nocardia using PCR-based method targeted 16S rRNA gene in twelve dogs and two cats. Among dogs were observed cutaneous lesions (8/12 = 67%), pneumonia (3/12 = 25%), and encephalitis (2/12 = 17%), whereas cats developed cutaneous lesions and osteomyelitis. Nocardia and canine morbillivirus coinfection was described in six dogs (6/12 = 50%). A high mortality rate (6/8 = 75%) was seen among dogs. Three dogs (3/4 = 75%) and one cat (1/2 = 50%) with systemic signs (pneumonia, encephalitis, osteomyelitis), and 83% (5/6) of dogs with a history of concomitant morbillivirus infection died. N. nova (5/12 = 42%), N. cyriacigeorgica (3/12 = 25%), N. farcinica (2/12 = 17%), N. veterana (1/12 = 8%), and N. asteroides (1/12 = 8%) species were identified in dogs, whereas N. africana and N. veterana in cats. Among the isolates from dogs, cefuroxime (12/12 = 100%), amikacin (10/12 = 83%), gentamycin (10/12 = 83%), and imipenem (10/12 = 83%) were the most effective antimicrobials, whereas cefuroxime, cephalexin, amoxicillin/clavulanic acid, imipenem, and gentamycin were efficient against isolates from cats. Multidrug resistance was observed in 36% (5/14) of isolates. We describe a variety of Nocardia species infecting dogs and cats, multidrug-resistant ones, and a high mortality rate, highlighting a poor prognosis of nocardiosis in companion animals, particularly among animals systemically compromised or coinfected by canine morbillivirus. Our study contributes to species identification, in vitro antimicrobial susceptibility profile, clinical-epidemiological aspects, and outcome of natural Nocardia-acquired infections in dogs and cats.
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Affiliation(s)
- Larissa Anuska Zeni Condas
- Faculdade de Medicina Veterinária, UniBrasil Centro Universitário, Curitiba, PR, Brasil.
- Faculdade de Medicina Veterinária e Zootecnia, Departamento de Produção Animal e Medicina Veterinária Preventiva, UNESP, Botucatu, SP, Brasil.
| | | | - Amanda Keller Siqueira
- Faculdade de Medicina Veterinária e Zootecnia, Departamento de Produção Animal e Medicina Veterinária Preventiva, UNESP, Botucatu, SP, Brasil
| | - Tatiana Salerno
- Faculdade de Medicina Veterinária e Zootecnia, Departamento de Produção Animal e Medicina Veterinária Preventiva, UNESP, Botucatu, SP, Brasil
| | - Kung Darh Chi
- Faculdade de Medicina Veterinária, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil
| | - Juliana Werner
- Laboratório de Histopatologia Veterinária Werner & Werner, Curitiba, Brasil
| | | | - Guilherme Borges Bond
- Faculdade de Medicina Veterinária, UniBrasil Centro Universitário, Curitiba, PR, Brasil
| | - Tohru Gonoi
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | | | - Márcio Garcia Ribeiro
- Faculdade de Medicina Veterinária e Zootecnia, Departamento de Produção Animal e Medicina Veterinária Preventiva, UNESP, Botucatu, SP, Brasil
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42
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George E, T CM, Baikunje N, Nair N. Hidden Behind a Veil: A Rare Case of Pulmonary Nocardiosis. Cureus 2023; 15:e38635. [PMID: 37288242 PMCID: PMC10243381 DOI: 10.7759/cureus.38635] [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: 05/06/2023] [Indexed: 06/09/2023] Open
Abstract
A 48-year-old male, a known case of seizure disorder, presented with complaints of cough for four months, which increased for two weeks, fever for two weeks and weight loss. Computed tomography (CT) scan of the thorax showed multiple heterogeneously enhancing lesions of bilateral lung fields predominantly in peribronchovascular distribution with enlarged, necrosed and conglomerated lymph nodes suggestive of infective etiology. On routine blood investigations, he was found to be reactive for the human immunodeficiency virus. He underwent bronchoscopy and bronchoalveolar lavage culture grew Nocardia. He was prescribed antibiotics based on susceptibility reports and the patient became symptomatically better after one month and was discharged.
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Affiliation(s)
| | | | | | - Nandu Nair
- Pulmonary Medicine, KS Hegde Medical Academy, Mangaluru, IND
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43
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Cao S, Chang J, Yue X, Li J, Liu X. Potential virulence factors of Nocardia seriolae AHLQ20-01 based on whole-genome analysis and its pathogenicity to largemouth bass (Micropterus salmoides). JOURNAL OF FISH DISEASES 2023; 46:333-345. [PMID: 36579505 DOI: 10.1111/jfd.13747] [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: 10/24/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Nocardia seriolae is a major causative agent of fish nocardiosis that results in serious economic losses in the aquaculture industry. However, the virulence factors and pathogenic mechanisms of the bacterium are poorly understood. Here, a new N. seriolae strain AHLQ20-01 was isolated from the diseased Micropterus salmoides and identified by phenotypic examination combined with 16S rRNA sequencing. Subsequently, the potential virulence factors of the strain were analysed at genome level by whole-genome sequencing. The results showed that the whole-genome sequence derived from N. seriolae AHLQ20-01 circular chromosome contains 8,129,380 bp DNA with G + C content of 68.14%, and encompasses 7650 protein-coding genes, 114 pseudo-genes, 3 rRNAs, 66 tRNAs and 36 non-coding RNAs. More importantly, a total of 139 genes, which mainly involved in adhesion, invasion, resistance to oxidative and nitrosative stress, phagosome arresting, iron acquisition system, toxin production and bacterial secretion systems, were identified as core virulence-associated genes. Furthermore, the pathogenicity of N. seriolae AHLQ20-01 to M. salmoides was further investigated through experimental infection. It was found that the LD50 value of the strain to M. salmoides was 9.3 × 106 colony forming unit/fish. Histopathological examination demonstrated typical granuloma with varying sizes in the liver, head kidney, spleen and heart of the experimentally infected fish. Terminal deoxynucleotidyl transferase dUTP nick end labelling assay and 4',6-diamidino-2-phenylindole staining showed that there were distinctly more apoptotic cells in all the tested tissues in the infection group, but not in the control group. Together, these findings provide the foundation to further explore the pathogenic mechanism of N. seriolae, which might contribute to the prevention and treatment of fish nocardiosis.
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Affiliation(s)
- Shoulin Cao
- Anhui Province Key Lab of Veterinary Pathobiology and Disease Control, College of Animal Science and Technology, Anhui Agricultural University, Hefei, P.R. China
| | - Jiaojiao Chang
- Anhui Province Key Lab of Veterinary Pathobiology and Disease Control, College of Animal Science and Technology, Anhui Agricultural University, Hefei, P.R. China
| | - Xiaozhen Yue
- Anhui Province Key Lab of Veterinary Pathobiology and Disease Control, College of Animal Science and Technology, Anhui Agricultural University, Hefei, P.R. China
| | - Jinnian Li
- Anhui Province Key Lab of Veterinary Pathobiology and Disease Control, College of Animal Science and Technology, Anhui Agricultural University, Hefei, P.R. China
| | - Xuelan Liu
- Anhui Province Key Lab of Veterinary Pathobiology and Disease Control, College of Animal Science and Technology, Anhui Agricultural University, Hefei, P.R. China
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44
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Nguyen P, Nazareth SC, Chen MY, Wang PC, Chen SC. An epidemiological analysis of Nocardia seriolae isolated from a wide range of aquatic animals in Taiwan, based on their genotype and enzymatic activity. JOURNAL OF FISH DISEASES 2023; 46:381-394. [PMID: 36606554 DOI: 10.1111/jfd.13751] [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: 10/09/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Chronic disease following Nocardia seriolae infection in a wide range of aquatic animals has been reported in many Asian countries and recently in America and Mexico. This study aimed to investigate the epidemiological relationship among N. seriolae isolates in Taiwan by investigating their genotype and enzymatic activities. A total of 66 strains isolated from 14 known and four unknown host fish from five sites in Taiwan were characterized using five combined methods. High genotypic diversity was recognized among the isolates with 10 pulsotypes being identified from the pulsed-field gel electrophoresis method and 21 reptypes from the repetitive extragenic palindromic amplification method; however, no natural plasmids were detected in this bacterial population. Pulsotypes A8 and RI analysed by PFGE and repPCR, respectively, were found to be predominant within five sites in Taiwan over 17 years of isolation. Enzymatically, the majority of isolates displayed high leucine arylamidase, β-glucosidase and α-glucosidase activities but were negative for lipase, α-galactosidase, β-glucuronidase, N-acetyl-glucosaminidase, α-mannosidase and α-fucosidase activities. We identified a strong association between genotype and enzymatic activity since the majority of pulsotypes displayed the same type of enzymatic profile. This study provides comprehensive and potential epidemiological data, which will aid the fish farming activities and prevention method development.
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Affiliation(s)
- Phuong Nguyen
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Sandra Celenia Nazareth
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Mei-Yun Chen
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Pei-Chi Wang
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Southern Taiwan Fish Diseases Research Centre, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Shih-Chu Chen
- International Degree Program of Ornamental Fish Technology and Aquatic Animal Health, International College, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Southern Taiwan Fish Diseases Research Centre, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
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45
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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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46
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Li F, Wang J, Chen C, Yang H, Man R, Yu S. Otomastoiditis Caused by Nocardia Farcinica: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023:1455613231165166. [PMID: 36941739 DOI: 10.1177/01455613231165166] [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: 03/23/2023] Open
Abstract
Nocardia farcinica usually infects people with impaired immune status and usually manifests in the lungs. Otomastoiditis caused by Nocardia infection is extremely rare, with only 4 cases reported to date. This report describes a case of otomastoid N. farcinica infection in an immunocompetent patient. The case was a 10-month-old immunocompetent infant who presented with an approximately 3-month history of right ear discharge for which treatment with various antibiotics had not resulted in significant improvement. Multiple cultures of secretions and pathologic examination failed to identify the causative organism. The patient then underwent right mastoidectomy. Finally, metagenomic next-generation sequencing identified the pathogen to be N. farcinica. The patient was infection-free at the 6-month follow-up but had developed labyrinthitis ossificans. Otomastoid Nocardia infection has characteristic clinical features, namely, formation of a large amount of granulation tissue and coexistence of bone destruction and new bone formation. Traditionally, Nocardia is challenging to diagnose. Metagenomic next-generation sequencing of lesions is helpful. Complete local debridement and free drainage are key to treatment.
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Affiliation(s)
- Feifan Li
- Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, China
- Shandong First Medical University, Shandong Academy of Medical Science, Jinan, China
| | - Jun Wang
- Shandong Provincial Qianfoshan Hospital, Affiliated to Shandong First Medical University, Jinan, China
| | - Chengfang Chen
- Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, China
| | - Huiming Yang
- Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, China
| | - Rongjun Man
- Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, China
| | - Shudong Yu
- Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, China
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47
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Gilderman GS, Morsy M, Antony N. Native Valve Endocarditis Caused by Nocardia asteroides in an Immunocompetent Host: A Case Report and a Review of the Literature. Cureus 2023; 15:e35977. [PMID: 37041899 PMCID: PMC10083042 DOI: 10.7759/cureus.35977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2022] [Indexed: 03/12/2023] Open
Abstract
Nocardia species are a rare cause of infective endocarditis (IE). We describe a case of native valve endocarditis caused by Nocardia asteroides in a 38-year-old Hispanic male with no apparent environmental exposures or risk factors for IE. Transesophageal echocardiography revealed severe mitral regurgitation, prompting emergent replacement of the valve. Nocardia asteroides were isolated from the tissue culture of the mitral valve. MRI of the brain also demonstrated innumerable micronodular intra-axial lesions throughout the brain, consistent with disseminated nocardiosis. The patient was treated with intravenous trimethoprim/sulfamethoxazole, meropenem, and amikacin for a six-week course, followed by oral trimethoprim/sulfamethoxazole and minocycline for 12 months. Follow-up after 18 months revealed no evidence of relapse. Although several cases of endocarditis due to Nocardia asteroides have been reported in immunocompromised hosts, to the best of our knowledge we believe the present case is the first to describe native valve endocarditis by Nocardia asteroides in an immunocompetent host with no apparent risk factors for IE.
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48
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Morjane Y, Sebestyen A, Lejeune S, Salvat M, Piliero N, Martin C, Abaziou T, Chavanon O. [Constrictive pericarditis and disseminated nocardiosis]. Ann Cardiol Angeiol (Paris) 2023; 72:101584. [PMID: 36898929 DOI: 10.1016/j.ancard.2023.02.005] [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: 01/23/2023] [Accepted: 02/13/2023] [Indexed: 03/12/2023]
Abstract
Human nocardiosis usually involves the respiratory tract or the skin but may disseminate to virtually any organ, it occurs in immunocompromised hosts as well as individuals with no apparent predisposition. Involvement of the pericardium is uncommon, having been reported infrequently in the past, but mandates a special management. This report describes the first case in Europe of a patient with chronic constrictive pericarditis from nocardia brasiliens, successfully treated with pericardiectomy and appropriate antibiotic therapy.
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Affiliation(s)
- Y Morjane
- Service de Chirurgie Cardiaque, CHU Grenoble-Alpes, La Tronche, France.
| | - A Sebestyen
- Service de Chirurgie Cardiaque, CHU Grenoble-Alpes, La Tronche, France
| | - S Lejeune
- Service de Maladies Infectieuses et Tropicales, CHU Grenoble-Alpes, La Tronche, France
| | - M Salvat
- Service de Cardiologie, CHU Grenoble-Alpes, La Tronche, France
| | - N Piliero
- Service de Cardiologie, CHU Grenoble-Alpes, La Tronche, France
| | - C Martin
- Service de Chirurgie Cardiaque, CHU Grenoble-Alpes, La Tronche, France
| | - T Abaziou
- Service d'Anesthésie-Réanimation, CHU Grenoble-Alpes, La Tronche, France
| | - O Chavanon
- Service de Chirurgie Cardiaque, CHU Grenoble-Alpes, La Tronche, France
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49
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Wu C, Lu J, Yao J. A case of intraocular infection caused by Nocardia brasiliensis in a patient who is immunocompetent. Int J Infect Dis 2023; 130:73-75. [PMID: 36889576 DOI: 10.1016/j.ijid.2023.02.026] [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: 10/12/2022] [Revised: 01/28/2023] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
Nocardia is a rare opportunistic pathogen that primarily affects the skin, lungs, and central nervous system. Intraocular infection caused by Nocardia species is a rare event in individuals who are immunocompetent. We herein present a case of a female individual who is immunocompetent, with a left eye injury caused by a contaminated nail. Unfortunately, this exposure history was not recognized at the initial visit, which led to a delay in diagnosis and the eventual development of intraocular infections with multiple hospital admissions in a short period of patients. A definitive diagnosis of Nocardia brasiliensis by matrix-assisted laser desorption ionization-time of flight mass spectrometry. With the original intention of reporting the case, we hope that physicians should be aware of rare pathogen infections, especially when conventional antibiotic therapy is ineffective, to avoid untimely treatment and poor prognosis. Furthermore, matrix-assisted laser desorption ionization-time of flight mass spectrometry or next-generation sequencing should be considered as new techniques for identifying pathogens.
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Affiliation(s)
- Cuiyun Wu
- Department of Clinical Laboratory, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, China.
| | - Jiehong Lu
- Department of Clinical Laboratory, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, China
| | - Jie Yao
- Department of Clinical Laboratory, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, China.
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50
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Clinical characteristics, outcomes, and factors associated with mortality in Nocardia pneumonia: 18 years' real-world data from a tertiary care hospital in Karachi, Pakistan. Respir Investig 2023; 61:254-260. [PMID: 36539312 DOI: 10.1016/j.resinv.2022.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/03/2022] [Accepted: 11/19/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Pulmonary nocardiosis is a rare pulmonary infection with high morbidity and mortality. Limited real-world data on pulmonary nocardiosis patients are available from developing countries like Pakistan. METHODS This retrospective observational study was conducted at the Aga Khan University Hospital, Karachi, Pakistan, from August 2003 to June 2020. Demographics, immune status, underlying diseases, laboratory data, treatment, and outcomes of all nocardiosis patients were recorded in predesigned proforma. RESULTS Sixty-six patients with smear/culture-proven pulmonary nocardiosis were identified. Most patients (83.3%) were treated with trimethoprim-sulfamethoxazole alone or in combination with other medicines. The overall mortality rate in our study was 33.3% (n = 22/66). Factors significantly associated with mortality were respiratory failure (p < 0.001), raised procalcitonin levels (p = 0.01), concomitant fungal infections (p = 0.01), concomitant TB (p = 0.03), and patients on combination therapy (p < 0.001). Respiratory failure (odds ratio [OR] 46.94 [95% confidence intervals [CI]: 5.01-439.03] p < 0.001), concomitant fungal infection (OR 17.09 [95% CI: 1.47-197.88] p- = 0.02) and patients on combination therapy (OR 6.90 [95% CI: 1.23-38.61] p = 0.02) were also identified as independent risk factors for mortality on multivariate analysis. CONCLUSIONS This study provides essential information on the clinical characteristics and risk factors, outcomes, and factors associated with mortality for pulmonary nocardial infections.
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