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Traxler RM, Bell ME, Lasker B, Headd B, Shieh WJ, McQuiston JR. Updated Review on Nocardia Species: 2006-2021. Clin Microbiol Rev 2022; 35:e0002721. [PMID: 36314911 PMCID: PMC9769612 DOI: 10.1128/cmr.00027-21] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This review serves as an update to the previous Nocardia review by Brown-Elliott et al. published in 2006 (B. A. Brown-Elliott, J. M. Brown, P. S. Conville, and R. J. Wallace. Jr., Clin Microbiol Rev 19:259-282, 2006, https://doi.org/10.1128/CMR.19.2.259-282.2006). Included is a discussion on the taxonomic expansion of the genus, current identification methods, and the impact of new technology (including matrix-assisted laser desorption ionization-time of flight [MALDI-TOF] and whole genome sequencing) on diagnosis and treatment. Clinical manifestations, the epidemiology, and geographic distribution are briefly discussed. An additional section on actinomycotic mycetoma is added to address this often-neglected disease.
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Affiliation(s)
- Rita M. Traxler
- Bacterial Special Pathogens Branch (BSPB), Division of High-Consequence Pathogens and Pathology (DHCPP), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Melissa E. Bell
- Bacterial Special Pathogens Branch (BSPB), Division of High-Consequence Pathogens and Pathology (DHCPP), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Brent Lasker
- Bacterial Special Pathogens Branch (BSPB), Division of High-Consequence Pathogens and Pathology (DHCPP), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Brendan Headd
- Bacterial Special Pathogens Branch (BSPB), Division of High-Consequence Pathogens and Pathology (DHCPP), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Wun-Ju Shieh
- Infectious Diseases Pathology Branch (IDPB), Division of High-Consequence Pathogens and Pathology (DHCPP), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - John R. McQuiston
- Bacterial Special Pathogens Branch (BSPB), Division of High-Consequence Pathogens and Pathology (DHCPP), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
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Hao Z, Dang H, Gao X, Zhang C, Deng A, Tan Y, Ding G. Successful control of scleritis caused by Nocardia farcinica: A case report. Medicine (Baltimore) 2022; 101:e31481. [PMID: 36397417 PMCID: PMC9666110 DOI: 10.1097/md.0000000000031481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
RATIONALE Nocardia farcinica is an opportunistic pathogen that rarely causes ocular infections. This study reviewed a case of N. farcinica-mediated scleritis involving the corneal limbus. PATIENT CONCERNS A 56-year-old man was admitted to the Department of Keratology of Jinan Second People's Hospital due to "a red and swollen right eye accompanied with severe pain for >1 month." He denied any history of hypertension, diabetes, systemic immune diseases and eye surgery. DIAGNOSES Corneal defect and scleral necrosis were observed by slit lamp. Combination of anterior segment optical coherence tomography and ophthalmic ultrasound biomicroscopy was used for diagnosis and evaluation of corneal and scleral conditions. Culture and metagenomic sequencing verified that the pathogen of scleritis was N. farcinica. INTERVENTIONS The patient was treated by sulfacetamide sodium eye drops, oral administration of sulfamethoxazole tablets, amikacin anterior chamber flushing, scleral debridement, and allogeneic scleral transplantation. OUTCOMES The disease was successfully controlled. LESSONS Infectious scleritis caused by N. farcinica is extremely rare. Culture of pathogenic microorganisms remains to be the gold standard for the diagnosis of infectious eye diseases. Metagenomic sequencing shows potential promise in the diagnosis of infectious eye diseases. N. farcinica is sensitive to sulfonamides and amikacin.
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Affiliation(s)
- Zhongkai Hao
- Department of Ophthalmology, School of Clinical Medicine, Weifang Medical University, Weifang, China
- Department of Ophthalmology, Jinan Second People’s Hospital, Jinan, China
| | - Hui Dang
- Department of Ophthalmology, Jinan Second People’s Hospital, Jinan, China
| | - Xin Gao
- Department of Ophthalmology, Jinan Second People’s Hospital, Jinan, China
| | - Chenming Zhang
- Department of Ophthalmology, School of Clinical Medicine, Weifang Medical University, Weifang, China
- Department of Ophthalmology, Jinan Second People’s Hospital, Jinan, China
- * Correspondence: Chenming Zhang, Department of Ophthalmology, Jinan Second People’s Hospital, Jinan 250200, China (e-mail: )
| | - Aijun Deng
- Department of Ophthalmology, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Yue Tan
- Department of Ophthalmology, Jinan Second People’s Hospital, Jinan, China
| | - Gang Ding
- Department of Ophthalmology, Jinan Second People’s Hospital, Jinan, China
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Adre E, Durkee H, Arboleda A, Alawa K, Maestre J, Mintz KJ, Leblanc RM, Amescua G, Parel JM, Miller D. Rose Bengal and Riboflavin Mediated Photodynamic Antimicrobial Therapy Against Selected South Florida Nocardia Keratitis Isolates. Transl Vis Sci Technol 2022; 11:29. [PMID: 35044443 PMCID: PMC8787600 DOI: 10.1167/tvst.11.1.29] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To examine and compare the efficacy of in vitro growth inhibition using rose bengal and riboflavin photodynamic antimicrobial therapy (PDAT) for Nocardia keratitis isolates. Methods Nocardia asteroides complex, Nocardia amikacinitolerans, and Nocardia farcinica species were isolated from patients with confirmed Nocardia keratitis. Isolates were tested against three experimental groups: (1) no photosensitizer/no irradiation, (2) photosensitizer/no irradiation, and (3) photosensitizer/irradiation. Each isolate was prepared in suspension to a concentration of 1.5 × 108 CFU/mL. Bacterial suspensions were mixed with water or prepared 0.1% photosensitizer solution for a final bacterial concentration of 1.5 × 107 CFU/mL. Aliquots of 1 mL were plated on 5% sheep blood agar. Rose bengal and riboflavin PDAT plates were irradiated for 15 minutes with a 525- or 375-nm custom 6-mW/cm2 powered light source for a total fluence of 5.4 J/cm2. All experimental groups were repeated in triplicate. Plates were incubated in a 35°C non-CO2 incubator for 96 hours and photographed. Percent inhibition was evaluated using LabVIEW-based software. Results All strains of Nocardia tested with 0.1% rose bengal and irradiated for 15 minutes demonstrated statistically significant inhibition of growth (P < 0.05). No other experimental groups displayed any bacterial inhibition. Conclusions Rose bengal is superior to riboflavin PDAT against selected Nocardia isolates. In vivo testing is warranted to investigate the utility of rose bengal PDAT for severe Nocardia keratitis. Translational Relevance In vitro results for three clinical strains of Nocardia support the possible use of rose bengal PDAT as a complementary treatment of Nocardia keratitis.
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Affiliation(s)
- Ethan Adre
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Heather Durkee
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA
| | - Alejandro Arboleda
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Karam Alawa
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jorge Maestre
- Ocular Microbiology Laboratory, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Keenan J Mintz
- Department of Chemistry, College of Arts and Science, University of Miami, Coral Gables, FL, USA
| | - Roger M Leblanc
- Department of Chemistry, College of Arts and Science, University of Miami, Coral Gables, FL, USA
| | - Guillermo Amescua
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jean-Marie Parel
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA.,Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Darlene Miller
- Ocular Microbiology Laboratory, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Abstract
PURPOSE To report a case of Nocardia farcinica keratitis in a pediatric contact lens wearer. METHODS Case report and literature review. RESULTS A pediatric contact lens wearer was initially misdiagnosed with a poorly healing corneal abrasion after swimming with his contact lenses. On examination at our center, he was found to have a 2.5 by 2.5 mm corneal infiltrate with feathery margins. Microbiology revealed N. farcinica keratitis, which was treated with topical amikacin. The patient returned to his baseline visual acuity after treatment. CONCLUSIONS Nocardia keratitis can be misdiagnosed because of its low prevalence, especially in young patients. Prompt diagnosis is important for proper management in these cases. The infection resolved in our patient with prompt diagnosis and treatment with topical amikacin eye drops.
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Sharma N, O'Hagan S. Correction to: The role of oral co-trimoxazole in treating Nocardia farcinica keratitis: a case report. J Ophthalmic Inflamm Infect 2018; 8:1. [PMID: 29313162 PMCID: PMC5758484 DOI: 10.1186/s12348-017-0143-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Neharika Sharma
- Cairns Base Hospital, 165 The Esplanade, Cairns, QLD, Australia.
| | - Stephen O'Hagan
- Cairns Base Hospital, 165 The Esplanade, Cairns, QLD, Australia.,James Cook University, 1 James Cook Drive, Townsville City, QLD, Australia
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