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Zhao L, Yao L, Liu M, Qiu S, He J, Lin J, Tao Z, Lu Y, Deng S, Chen H, Qiu SX. Longistylin A from Cajanus cajan (L.) Millsp. disturbs glycerophospholipid metabolism and cytokinin biosynthesis of Nocardia seriolae. J Ethnopharmacol 2024; 330:118199. [PMID: 38631486 DOI: 10.1016/j.jep.2024.118199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 04/19/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Nocardiosis is an uncommon infectious disease that bears certain similarities to tuberculosis, with a continuous increase in its incidence and a poor prognosis. In traditional Chinese medicine, the leaves of Cajanus cajan (L.) Millsp. are employed to treat wounds, malaria, coughs, and abdominal pain. AIM OF THE STUDY In this study, we investigated the effects and mechanisms of longistylin A (LGA), a natural stilbene isolated from C. cajan, as a potential antibiotic against nocardiosis. MATERIALS AND METHODS LGA was isolated from the leaves of C. cajan and assessed using a minimum bactericidal concentration (MBC) determination against Nocardia seriolae. Multi-omics analysis encompassing genes, proteins, and metabolites was conducted to investigate the impact of LGA treatment on N. seriolae. Additionally, quantitative analysis of 40 cytokinins in N. seriolae mycelium was performed to assess the specific effects of LGA treatment on cytokinin levels. Cryo-scanning electron microscopy was utilized to examine morphological changes induced by LGA treatment, particularly in the presence of exogenous trans-zeatin-O-glucoside (tZOG). The therapeutic effect of LGA was investigated by feeding N. seriolae-infected largemouth bass. RESULTS LGA exhibited significant efficacy against N. seriolae, with MBC value of 2.56 μg/mL. Multi-omics analysis revealed that LGA disrupted glycerophospholipid metabolism and hormone biosynthesis by notably reducing the expression of glycerol-3-phosphate dehydrogenase and calmodulin-like protein. Treatment with LGA markedly disrupted 12 distinct cytokinins in N. seriolae mycelium. Additionally, the addition of exogenous tZOG counteracted the inhibitory effects of LGA on filamentous growth, resulting in mycelial elongation and branching. Furthermore, LGA treatment improved the survival rate of largemouth bass infected with N. seriolae. CONCLUSIONS We found for the first time that LGA from C. cajan exhibited significant efficacy against N. seriolae by interfering with glycerophospholipid metabolism and cytokinin biosynthesis.
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Affiliation(s)
- Liyun Zhao
- State Key Laboratory of Plant Diversity and Specialty Crops & Guangdong Provincial Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, 510650, China
| | - Liyuan Yao
- State Key Laboratory of Plant Diversity and Specialty Crops & Guangdong Provincial Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, 510650, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Meilan Liu
- State Key Laboratory of Plant Diversity and Specialty Crops & Guangdong Provincial Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, 510650, China; College of Life Science and Engineering, Foshan University, Foshan, 528231, China; Guangzhou Leader Biotechnology Co., LTD, Guangzhou, 510650, China
| | - Silin Qiu
- State Key Laboratory of Plant Diversity and Specialty Crops & Guangdong Provincial Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, 510650, China
| | - Jiani He
- State Key Laboratory of Plant Diversity and Specialty Crops & Guangdong Provincial Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, 510650, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jindong Lin
- Guangzhou Leader Biotechnology Co., LTD, Guangzhou, 510650, China
| | - Zhengguo Tao
- Guangzhou Leader Biotechnology Co., LTD, Guangzhou, 510650, China
| | - Yu Lu
- Guangzhou Leader Biotechnology Co., LTD, Guangzhou, 510650, China
| | - Shulin Deng
- State Key Laboratory of Plant Diversity and Specialty Crops & Guangdong Provincial Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, 510650, China
| | - Hongfeng Chen
- State Key Laboratory of Plant Diversity and Specialty Crops & Guangdong Provincial Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, 510650, China
| | - Sheng-Xiang Qiu
- State Key Laboratory of Plant Diversity and Specialty Crops & Guangdong Provincial Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, 510650, China.
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Pham J, Benefield RJ, Baker N, Lindblom S, Canfield N, Gomez CA, Fisher M. In vitro activity of omadacycline against clinical isolates of Nocardia. Antimicrob Agents Chemother 2024; 68:e0168623. [PMID: 38534103 PMCID: PMC11064614 DOI: 10.1128/aac.01686-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
Nocardiosis typically requires a prolonged treatment duration of ≥6 months and initial combination therapy with 2-3 antibiotics. First-line regimens for nocardiosis are associated with considerable toxicity; therefore, alternative therapies are needed. Omadacycline is an aminomethylcycline with broad antimicrobial activity whose in vitro activity against Nocardia species has not been formally assessed. The in vitro potency of omadacycline was evaluated against 300 Nocardia clinical isolates by broth microdilution. The most common Nocardia species tested were N. cyriacigeorgica (21%), N. nova (20%), and N. farcinica (12%). The most common specimens were respiratory (178 isolates, 59%) and wound (57 isolates, 19%). Omadacycline minimum inhibitory concentrations (MICs) across all Nocardia species ranged from 0.06 µg/mL to 8 µg/mL, with an MIC50 of 2 µg/mL and MIC90 of 4 µg/mL. The lowest MICs were found among N. paucivorans (MIC50 = 0.25 µg/mL, MIC90 = 0.25 µg/mL), N. asiatica (MIC50 = 0.25 µg/mL, MIC90 = 1 µg/mL), N. abscessus complex (MIC50 = 0.5 µg/mL, MIC90 = 1 µg/mL), N. beijingensis (MIC50 = 0.5 µg/mL, MIC90 = 2 µg/mL), and N. otitidiscaviarum (MIC50 = 1 µg/mL, MIC90 = 2 µg/mL). The highest MICs were found among N. farcinica (MIC50 = 4 µg/mL, MIC90 = 8 µg/mL). In vitro potency differed by species among Nocardia clinical isolates. Further studies are warranted to evaluate the potential clinical utility of omadacycline for nocardiosis.
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Affiliation(s)
- Jonathan Pham
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Russell J. Benefield
- Department of Pharmacy, University of Utah Health, Salt Lake City, Utah, USA
- Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
| | - Natali Baker
- Associated Regional and University Pathologists (ARUP) Laboratories, Salt Lake City, Utah, USA
| | - Shane Lindblom
- Associated Regional and University Pathologists (ARUP) Laboratories, Salt Lake City, Utah, USA
| | - Nicholas Canfield
- Associated Regional and University Pathologists (ARUP) Laboratories, Salt Lake City, Utah, USA
| | - Carlos A. Gomez
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Mark Fisher
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Associated Regional and University Pathologists (ARUP) Laboratories, Salt Lake City, Utah, USA
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Shokrpoor S, Darabian Aghdas R, Ziafati Kafi Z, Abdollahi M, Ashrafi Tamai I. Lumpy jaw caused by Nocardia farcinica in a Holstein cow. Vet Med Sci 2024; 10:e1433. [PMID: 38520249 PMCID: PMC10981914 DOI: 10.1002/vms3.1433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/03/2024] [Accepted: 03/10/2024] [Indexed: 03/25/2024] Open
Abstract
A 3-year-old Holstein cow was examined in an intensive system due to unilateral swelling in the mandible. A right mandibular mass was associated with painful mastication and Ptyalism. In palpation, the mass was raised, ulcerated, attached to the mandible bone and firm, approximately 17 × 12 × 10 cm3 in size. The lesion was sampled, and after routine bacteriology and histopathology procedures, the occurrence of lumpy jaw caused by Nocardia farcinica was confirmed. The bacterium was analysed using genome sequencing and new strain called Najm 114. Due to the risk of zoonosis of the isolated agent, the cow was euthanized. This is the first report of lumpy jaw caused by N. farcinica in a cow. This study showed that N. farcinica should be considered a possible etiological agent for lumpy jaw in cattle.
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Affiliation(s)
- Sara Shokrpoor
- Department of Pathology, Faculty of Veterinary MedicineUniversity of TehranTehranIran
| | | | - Zahra Ziafati Kafi
- Department of Microbiology and Immunology, Faculty of Veterinary MedicineUniversity of TehranTehranIran
| | - Mostafa Abdollahi
- Department of Clinical Sciences, Faculty of Veterinary MedicineSemnan UniversitySemnanIran
| | - Iradj Ashrafi Tamai
- Department of Microbiology and Immunology, Faculty of Veterinary MedicineUniversity of TehranTehranIran
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Madike R, Rana K, Patel S, Selva D. A case of disseminated nocardiosis with orbital apex involvement and endophthalmitis. Orbit 2024:1-4. [PMID: 38647136 DOI: 10.1080/01676830.2024.2343302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
Nocardia is a rare cause of ocular infections and most commonly occurs secondary to trauma. Systemic Nocardiosis may have ocular involvement in rare cases. We report a case of disseminated nocardiosis with orbital apex involvement and endophthalmitis in an immunocompromised patient. The patient presented with respiratory sepsis, and later developed complete ptosis and ophthalmoplegia in the left eye. This was on the background of treatment with high-dose prednisolone. Magnetic resonance imaging showed enhancement of the entire clivus, extending into the left orbital apex and cavernous sinus. The patient was initially treated empirically for CNS tuberculosis. Bronchoscopic cultures returned positive for Nocardia farcinica, and the patient was treated with trimethoprim/sulfamethoxazole and weaned off previous corticosteroids.
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Affiliation(s)
- Reema Madike
- School of Medicine, University of Adelaide, Adelaide, Australia
| | - Khizar Rana
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Sandy Patel
- South Australia Medical Imaging, Royal Adelaide Hospital, Adelaide, Australia
| | - Dinesh Selva
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
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Iotti LR, de Frutos M, Lorenzo-Vidal B, Eiros JM. [Disseminated nocardiosis]. Rev Esp Quimioter 2024; 37:180-182. [PMID: 38287667 PMCID: PMC10945094 DOI: 10.37201/req/119.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/22/2023] [Accepted: 12/19/2023] [Indexed: 01/31/2024]
Affiliation(s)
- L R Iotti
- Laura Rita Iotti, Servicio de Microbiología y Parasitología, Hospital Universitario Río Hortega, C. Dulzaina, 2, 47012, Valladolid, Spain.
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Yetmar ZA, Khodadadi RB, Chesdachai S, McHugh JW, Challener DW, Wengenack NL, Bosch W, Seville MT, Beam E. Epidemiology, Timing, and Secondary Prophylaxis of Recurrent Nocardiosis. Open Forum Infect Dis 2024; 11:ofae122. [PMID: 38560606 PMCID: PMC10977627 DOI: 10.1093/ofid/ofae122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Background Nocardia tends to cause infection in immunocompromised patients or those with chronic pulmonary disease. Nocardia is known to recur, prompting the practice of secondary prophylaxis in patients perceived at high risk. However, few data exist regarding the epidemiology of recurrent nocardiosis or the effectiveness of secondary prophylaxis. Methods We performed a multicenter, retrospective cohort study of adults diagnosed with nocardiosis from November 2011 to April 2022, including patients who completed primary treatment and had at least 30 days of posttreatment follow-up. Propensity score matching was used to analyze the effect of secondary prophylaxis on Nocardia recurrence. Results Fifteen of 303 (5.0%) patients developed recurrent nocardiosis after primary treatment. Most recurrences were diagnosed either within 60 days (N = 6/15, 40.0%) or between 2 to 3 years (N = 4/15, 26.7%). Patients with primary disseminated infection tended to recur within 1 year, whereas later recurrences were often nondisseminated pulmonary infection. Seventy-eight (25.7%) patients were prescribed secondary prophylaxis, mostly trimethoprim-sulfamethoxazole (N = 67/78). After propensity-matching, secondary prophylaxis was not associated with reduced risk of recurrence (hazard ratio, 0.96; 95% confidence interval, .24-3.83), including in multiple subgroups. Eight (53.3%) patients with recurrent nocardiosis required hospitalization and no patients died from recurrent infection. Conclusions Recurrent nocardiosis tends to occur either within months because of the same Nocardia species or after several years with a new species. Although we did not find evidence for the effectiveness of secondary prophylaxis, the confidence intervals were wide. However, outcomes of recurrent nocardiosis are generally favorable and may not justify long-term antibiotic prophylaxis for this indication alone.
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Affiliation(s)
- Zachary A Yetmar
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Infectious Disease, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ryan B Khodadadi
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Supavit Chesdachai
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jack W McHugh
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Douglas W Challener
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Nancy L Wengenack
- Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Wendelyn Bosch
- Division of Infectious Diseases, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Elena Beam
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Paumier M, Coussement J, Matignon M, Chauvet C, Bouvier N, Poncelet A, Dantal J, Scemla A, Ceunen H, Van Wijngaerden E, Kamar N, van der Beek MT, Wunderink HF, De Greef J, Candon S, Bougnoux ME, Lebeaux D. (1-3)-ß-D-glucan for the diagnosis of Nocardia infection in solid organ transplant recipients. Diagn Microbiol Infect Dis 2024; 108:116184. [PMID: 38241921 DOI: 10.1016/j.diagmicrobio.2024.116184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Affiliation(s)
- Margot Paumier
- Unité de Parasitologie-Mycologie. AP-HP, Hôpital Necker enfants malades; 149 rue de Sèvres, Paris 75015, France
| | - Julien Coussement
- University of Melbourne, Sir Peter MacCallum Department of Oncology, Melbourne, Australia
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil 94010, France.; IMRB (Institut Mondor de Recherche Biomédicale), VIC (Virus-Immunité-Cancer), DHU (Département Hospitalo-Universitaire), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 21, Créteil 94010, France
| | - Cécile Chauvet
- Service de Transplantation Rénale, Hôpital Edouard HERRIOT, Lyon, France
| | - Nicolas Bouvier
- Service de Néphrologie, Université de Caen - Normandie, Caen, France
| | - Arthur Poncelet
- Department of Infectious Diseases, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Jacques Dantal
- ITUN (Institut de Transplantation, d'Urologie et de Néphrologie), CHU Nantes, Nantes, France
| | - Anne Scemla
- Kidney Transplantation Unit, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, RTRS Centaure, Labex Transplantex, Paris, France
| | - Helga Ceunen
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Eric Van Wijngaerden
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation,; Toulouse Rangueil University Hospital, INSERM UMR, Toulouse 1291, France; Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Paul Sabatier University, Toulouse, France
| | - Martha T van der Beek
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Herman F Wunderink
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Julien De Greef
- Service de Médecine interne et Maladies infectieuses, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Sophie Candon
- CHU de Rouen Normandie, Université de Rouen Normandie, Rouen France
| | - Marie-Elisabeth Bougnoux
- Unité de Parasitologie-Mycologie. AP-HP, Hôpital Necker enfants malades; 149 rue de Sèvres, Paris 75015, France; Institut Pasteur, Université Paris Cité, Fungal Biology and Pathogenicity Unit - INRA USC Mycology Department, Paris 75015, France
| | - David Lebeaux
- Institut Pasteur, Université Paris Cité, CNRS UMR 6047, Genetics of Biofilms Laboratory, Paris 75015, France.; Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris 75015, France..
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O'Brien A, Hart J, Higgins A, Arthur I, Lee GH, Leung M, Kennedy K, Bradbury S, Foster S, Warren S, Korman TM, Abbott IJ, Heney C, Bletchley C, Warner M, Wells N, Wilson D, Varadhan H, Stevens R, Lahra M, Newton P, Maley M, van Hal S, Ingram PR. Nocardia species distribution and antimicrobial susceptibility within Australia. Intern Med J 2024; 54:613-619. [PMID: 37929813 DOI: 10.1111/imj.16234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/29/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Nocardia is a ubiquitous saprophyte capable of causing human disease. Disease is primarily respiratory or cutaneous, usually acquired via inhalation or inoculation. Under the influence of environmental and host factors, Nocardia incidence and species distribution demonstrate geographical variation. AIMS To examine for differences in Nocardia incidence within Western Australia (WA) and analyse species distribution in the context of prior published studies. To analyse antibiogram data from a nationwide passive antimicrobial resistance surveillance program. METHODS Retrospective extraction of laboratory data for Western Australian Nocardia isolates over a 21-year period. Analysis of Nocardia antimicrobial susceptibility testing data submitted to the Australian Passive Antimicrobial Resistance Surveillance (APAS) program between 2005 and 2022. RESULTS Nine hundred sixty WA isolates were identified, giving an annual incidence of 3.03 per 100 000 population with apparent latitudinal variation. The four most common species identified within WA and amongst APAS isolates were N. nova, N. cyriacigeorgica, N. brasiliensis and N. farcinica. APAS data demonstrated that all species exhibited high rates of susceptibility to linezolid (100%) and trimethoprim-sulfamethoxazole (98%). Amikacin (>90% susceptibility for all species except N. transvalensis) was the next most active parenteral agent, superior to both carbapenems and third-generation cephalosporins. Susceptibility to oral antimicrobials (other than linezolid) demonstrated significant interspecies variation. CONCLUSIONS We demonstrate geographical variation in the distribution of Nocardia incidence. Four species predominate in the Australian setting, and nationwide data confirm a high in vitro susceptibility to trimethoprim-sulphamethoxazole and linezolid, justifying their ongoing role as part of first-line empiric therapy.
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Affiliation(s)
- Aine O'Brien
- Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Julie Hart
- Department of Infectious Diseases, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia
| | - Ammie Higgins
- PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Ian Arthur
- PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Gar-Hing Lee
- PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Michael Leung
- PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Karina Kennedy
- ACT Health, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Susan Bradbury
- ACT Health, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Sarah Foster
- Launceston General Hospital, Tasmanian Health Service (THS), Hobart, Tasmania, Australia
| | - Sanchia Warren
- Royal Hobart Hospital, Department of Microbiology and Infectious Diseases, Hobart, Tasmania, Australia
| | - Tony M Korman
- Monash Health, Monash Infectious Diseases, Melbourne, Victoria, Australia
| | | | - Claire Heney
- Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | | | - Morgyn Warner
- Infectious Diseases and Microbiology Department, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Nicholas Wells
- South Australia Pathology, Adelaide, South Australia, Australia
| | - Desley Wilson
- South Australia Pathology, Adelaide, South Australia, Australia
| | - Hemalatha Varadhan
- Hunter New England, NSW Health Pathology, Newcastle, New South Wales, Australia
| | - Robert Stevens
- South Eastern Sydney, NSW Health Pathology, Sydney, New South Wales, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Monica Lahra
- NSW Health Pathology, Newcastle, New South Wales, Australia
| | - Peter Newton
- Illawarra-Shoalhaven, NSW Health Pathology, Wollongong, New South Wales, Australia
| | - Michael Maley
- South Western Sydney, NSW Health Pathology, Sydney, New South Wales, Australia
- Microbiology, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Sebastian van Hal
- NSW Health Pathology, Newcastle, New South Wales, Australia
- Infectious Diseases and Microbiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Paul R Ingram
- Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Western Australia, Australia
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Marak R, Abdullah, Behera M, Kaul A, Bhadauria D, Prasad N, Patel M, Kushwaha R, Yachha M. Nocardiosis in kidney transplant recipients: A tertiary care center experience. Transpl Immunol 2024; 84:102041. [PMID: 38537681 DOI: 10.1016/j.trim.2024.102041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/01/2024]
Abstract
INTRODUCTION Kidney transplant recipients are at increased risk of opportunistic infections, including Nocardia. The incidence of nocardiosis in kidney transplant recipients is 0.4-1.3%. The data regarding its epidemiology and outcomes is limited. METHODS This was a 10-year retrospective observational study from January 2012 to December 2021 at a tertiary care center in northern India, in which all kidney transplant recipients with Nocardia infection were included and followed. RESULTS 12 (1.1%) patients had a Nocardia infection among the 1108 kidney transplant recipients. All were living donor kidney transplant recipients, and the mean age at diagnosis was 48.67 ± 12.60 years. Nocardia infection occurred at a median of 26 months (range 4-235) post-transplantation, with 4 (33.1%) of the cases occurring within a year of transplant. Breakthrough infection occurred in 7 (58.3%) patients on cotrimoxazole prophylaxis. 41.7% (n = 5) cases had an episode of rejection in the preceding year of Nocardia diagnosis. Concurrent cytomegalovirus (CMV) infection was present in one (8.3%) case. The lung was the most frequently involved organ. Microscopy was positive in all the cases; while culture was positive in 10 cases, and antimicrobial susceptibility testing (AST) were performed for these isolates. The majority (60%) of isolates were resistant to cotrimoxazole. All tested isolates remained susceptible to Amikacin, Imipenem, and Linezolid. No patients experienced Nocardia recurrence after completion of antibiotic therapy. The mortality at 12 months was 66.7% (n = 4), and only one death was Nocardia-related. CONCLUSION Nocardia may cause a late-manifesting infection beyond the traditional window. The cotrimoxazole prophylaxis may not be sufficient for Nocardia prevention.
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Affiliation(s)
- Rungmei Marak
- Professor, Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Abdullah
- Assistant Professor, Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Manas Behera
- Associate Professor, Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Anupma Kaul
- Professor, Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
| | - Dharmendra Bhadauria
- Additional Professor, Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Narayan Prasad
- Professor, Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Manas Patel
- Associate Professor, Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Ravi Kushwaha
- Associate Professor, Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Monika Yachha
- Associate Professor, Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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Xiong W, Liu B, Lu H, Liu X. Two novel bacteriophages isolated from the environment that can help control activated sludge foaming. Folia Microbiol (Praha) 2024:10.1007/s12223-024-01145-4. [PMID: 38363443 DOI: 10.1007/s12223-024-01145-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024]
Abstract
Nocardia spp., which belongs to one of the Nocardio-form filamentous bacteria, is usually surface hydrophobic and when overproduced attaches to the surface of bubbles under the action of surfactants, allowing the stable presence of foam on the surface of aeration tanks, leading to the occurrence of sludge-foaming events. Two novel phages, P69 and KYD2, were isolated from the environment, and their hosts were Nocardia transvalensis and Nocardia carnea, respectively. These two phages are Siphophages-like with long tails. An aeration tank pilot plant was constructed in the laboratory to simulate sludge foaming, and these two strains of phage were applied. Compared with the reactor not dosed with phage, the application of phage could reduce the host level in the reactor, resulting in the highest decrease in turbidity by more than 68% and sludge volume index by more than 25%. The time for surface foam disappearance was 9 h earlier than that of the control group (the group with the same concentration of Nocardia carnea but no bacteriophage applied), significantly improving water quality. The phage can effectively inhibit the propagation of Nocardia in the actual sludge-foaming event, control the sludge foaming, and improve the effluent quality. It provides a novel and relatively economical solution for controlling sludge foaming in sewage treatment plants in the future, shows that the phages have potential application value in the prevention and control of Nocardia, and provides another way to control the sludge-foaming event caused by the excessive reproduction of Nocardia in the future.
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Affiliation(s)
- Wenbin Xiong
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Bingxin Liu
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 101408, China.
| | - Han Lu
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Xinchun Liu
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 101408, China.
- Binzhou Institute of Technology, Weiqiao-UCAS Science and Technology Park, Binzhou, Shandong Province, 256606, China.
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11
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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12
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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] [What about the content of this article? (0)] [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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13
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Hershko Y, Rannon E, Adler A, Burstein D, Barkan D. WarA, a remote homolog of NpmA and KamB from Nocardia wallacei, confers broad spectrum aminoglycoside resistance in Nocardia and Mycobacteria. Int J Antimicrob Agents 2024; 63:107089. [PMID: 38218322 DOI: 10.1016/j.ijantimicag.2024.107089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/24/2023] [Accepted: 01/07/2024] [Indexed: 01/15/2024]
Abstract
OBJECTIVES Aminoglycoside resistance in bacteria is typically conferred by specific drug-modifying enzymes. Infrequently, such resistance is achieved through 16S ribosomal RNA methyltransferases, such as NpmA and KamB encoded by Escherichia coli and Streptoalloteichus tenebrarius, respectively. These enzymes are not widespread and have not been described in Nocardia species to date. METHODS We report the genomic mining of 18 Nocardia wallacei isolates that were found to be specifically and substantially resistant to amikacin. RESULTS We identified a gene coding for a protein with very distant homology to NpmA and KamB. However, 3-D modeling revealed that the tertiary structure of these three proteins was highly similar. Cloning and expressing this gene in two susceptible bacteria Nocardia asteroides, and Mycobacterium smegmatis (another Actinobacterium) led to high-level, pan-aminoglycoside resistance in both cases. We named this gene warA (Wallacei Amikacin Resistance A). CONCLUSIONS This is the first description and experimental characterization of a gene of this family in Nocardia, and the first demonstration that such activity could lead to pan-aminoglycoside resistance in Mycobacteria as well. The discovery of this novel gene has important biotechnology and clinical implications.
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Affiliation(s)
- Yizhak Hershko
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel; Clinical Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ella Rannon
- The Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel-Aviv University, Tel Aviv, Israel
| | - Amos Adler
- Clinical Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Burstein
- The Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel-Aviv University, Tel Aviv, Israel
| | - Daniel Barkan
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
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14
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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15
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Nakata JA, Arif A, Chai LF, Su S. First report of a post-pneumonectomy nocardia empyema. J Surg Case Rep 2024; 2024:rjae002. [PMID: 38304314 PMCID: PMC10832585 DOI: 10.1093/jscr/rjae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
Post-pneumonectomy empyema (PPE) is an uncommon but serious complication that carries significant therapeutic challenges. We present a late-onset PPE due to Nocardia nova in an immunocompetent individual. Nine years after a right pneumonectomy for non-small cell lung cancer, surveillance scans revealed new right pleural thickening and FDG avidity concerning for recurrence. Thoracoscopic pleural biopsies were negative for malignancy, but tissue cultures grew N. nova. Nocardia empyema is rare with few reported cases. Most occur in immunocompromised hosts, and all were associated with pulmonary or disseminated nocardiosis. Our case describes the first report of a PPE secondary to Nocardia.
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Affiliation(s)
- Jonathan A Nakata
- Division of Thoracic Surgery, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
| | - Azzan Arif
- Division of Thoracic Surgery, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
| | - Louis F Chai
- Department of Thoracic Medicine and Surgery, Temple University Health Systems, Philadelphia, PA 19140, United States
| | - Stacey Su
- Division of Thoracic Surgery, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
- Department of Thoracic Medicine and Surgery, Temple University Health Systems, Philadelphia, PA 19140, United States
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16
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Ishibashi M. [Learning from Natural Products: Study on Actinomycetes of the Genus Nocardia]. YAKUGAKU ZASSHI 2024; 144:33-37. [PMID: 38171791 DOI: 10.1248/yakushi.23-00161-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The genus Nocardia comprises gram-positive bacteria, most of which are pathogenic and cause opportunistic infections of the lungs, skin, and brain in humans. Based on a collaboration study with the Medical Mycology Research Center, Chiba University, we focused on Nocardia actinomycetes as a new natural-product resource. First, by culturing (monoculture) Nocardia in various media, we isolated a new aminocyclitol nabscessin A from Nocardia abscessus IFM10029T and a new γ-lactone inohanalactone from Nocardia inohanaensis IFM0092T. On the other hand, by imitating the state in which the genus Nocardia actinomycete infects animal cells and culturing the genus in the presence of animal cells (coculture), this genus was expected to produce new compounds through interactions with the animal cells. Using mouse macrophage-like cells (J774.1) as animal cells, a new pantothenic acid amide derivative and a cyclic peptide, nocarjamide, with Wnt signal activation activity were isolated from Nocardia tenerifensis IFM10554T strain.
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Affiliation(s)
- Masami Ishibashi
- School of Pharmacy at Fukuoka, International University of Health and Welfare
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17
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Cui W, Wan M, Liu ZH, Chen L, Miao Y. Painful nodule on the nose of a child. Pediatr Dermatol 2024; 41:127-129. [PMID: 37493344 DOI: 10.1111/pde.15384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/15/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Wenjuan Cui
- Department of Dermatology, Hangzhou Children's Hospital, Zhejiang, Hangzhou, China
| | - Mingshun Wan
- Department of Dermatology, Hangzhou Children's Hospital, Zhejiang, Hangzhou, China
| | - Ze-Hu Liu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingjing Chen
- Department of Dermatology, Hangzhou Children's Hospital, Zhejiang, Hangzhou, China
| | - Yingying Miao
- Department of Dermatology, Hangzhou Children's Hospital, Zhejiang, Hangzhou, China
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18
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Poudel PB, Dhakal D, Lee JC, Sohng JK. Functional characterization of a naphthalene-O-methyltransferase from Nocardia sp. CS682. Enzyme Microb Technol 2024; 172:110351. [PMID: 37939423 DOI: 10.1016/j.enzmictec.2023.110351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023]
Abstract
Methylation plays important roles in biosynthesis, metabolism, signal transduction, detoxification, protein sorting and repair, and nucleic acid processing. Generally the methyltransferases transfer methyl groups in various natural products using S-adenosyl methionine (SAM) as a cofactor. In this study, we examined and functionally characterized ThnM3 (enzyme), by testing various substrates with different chemical structures. Among the tested substrates, 1,8-dihydroxynaphthalene was the best substrate for methylation. Whole-cell biotransformation was performed using the enzyme in engineered Escherichia coli to produce 8-methoxynaphthalene-1-ol, and 1,8-dimethoxynaphthalene derivatives of 1,8-dihydroxynaphthalene. The products were confirmed using high-performance liquid chromatography, mass spectrometry, and nuclear magnetic resonance spectroscopic analyses. Therefore, this study is the first to amplify, express the thnM3 (gene), and functionally characterize theThnM3, which exhibits the regioselective modifications of 1,8-dihydroxynaphthalene.
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Affiliation(s)
- Purna Bahadur Poudel
- Institute of Biomolecule Reconstruction (iBR), Department of Life Science and Biochemical Engineering, Sun Moon University, 70 Sun Moon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, South Korea
| | - Dipesh Dhakal
- Institute of Biomolecule Reconstruction (iBR), Department of Life Science and Biochemical Engineering, Sun Moon University, 70 Sun Moon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, South Korea
| | - Jong Cheol Lee
- Department of Pharmaceutical Engineering and Biotechnology, Sun Moon University, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, South Korea
| | - Jae Kyung Sohng
- Institute of Biomolecule Reconstruction (iBR), Department of Life Science and Biochemical Engineering, Sun Moon University, 70 Sun Moon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, South Korea; Department of Pharmaceutical Engineering and Biotechnology, Sun Moon University, 70 Sunmoon-ro 221, Tangjeong-myeon, Asan-si, Chungnam 31460, South Korea.
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19
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Feuillard J, Couston J, Benito Y, Hodille E, Dumitrescu O, Blaise M. Biochemical and structural characterization of a class A β-lactamase from Nocardia cyriacigeorgica. Acta Crystallogr F Struct Biol Commun 2024; 80:13-21. [PMID: 38168018 PMCID: PMC10833343 DOI: 10.1107/s2053230x23010671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
Nocardia are Gram-positive bacteria from the Actinobacteria phylum. Some Nocardia species can infect humans and are usually considered to be opportunist pathogens, as they often infect immunocompromised patients. Although their clinical incidence is low, many Nocardia species are now considered to be emerging pathogens. Primary sites of infection by Nocardia are the skin or the lungs, but dissemination to other body parts is very frequent. These disseminated infections are very difficult to treat and thus are tackled with multiple classes of antibiotics, in addition to the traditional treatment targeting the folate pathway. β-Lactams are often included in the regimen, but many Nocardia species present moderate or strong resistance to some members of this drug class. Genomic, microbiological and biochemical studies have reported the presence of class A β-lactamases (ABLs) in a handful of Nocardia species, but no structural investigation of Nocardia β-lactamases has yet been performed. In this study, the expression, purification and preliminary biochemical characterization of an ABL from an N. cyriacigeorgica (NCY-1) clinical strain are reported. The crystallization and the very high resolution crystal structure of NCY-1 are also described. The sequence and structural analysis of the protein demonstrate that NCY-1 belongs to the class A1 β-lactamases and show its very high conservation with ABLs from other human-pathogenic Nocardia. In addition, the presence of one molecule of citrate tightly bound in the catalytic site of the enzyme is described. This structure may provide a solid basis for future drug development to specifically target Nocardia spp. β-lactamases.
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Affiliation(s)
| | - Julie Couston
- IRIM, Montpellier University, CNRS, Montpellier, France
| | - Yvonne Benito
- Institut des Agents Infectieux, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Lyon, France
| | - Elisabeth Hodille
- Institut des Agents Infectieux, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, ENS Lyon, Université Lyon 1, Lyon, France
| | - Oana Dumitrescu
- Institut des Agents Infectieux, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Biologie Nord, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, ENS Lyon, Université Lyon 1, Lyon, France
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20
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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] [What about the content of this article? (0)] [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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21
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Sun H, Xie X, Wang Y, Wang J, Deng T. Clinical screening of Nocardia in sputum smears based on neural networks. Front Cell Infect Microbiol 2023; 13:1270289. [PMID: 38094748 PMCID: PMC10716215 DOI: 10.3389/fcimb.2023.1270289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Objective Nocardia is clinically rare but highly pathogenic in clinical practice. Due to the lack of Nocardia screening methods, Nocardia is often missed in diagnosis, leading to worsening the condition. Therefore, this paper proposes a Nocardia screening method based on neural networks, aiming at quick Nocardia detection in sputum specimens with low costs and thereby reducing the missed diagnosis rate. Methods Firstly, sputum specimens were collected from patients who were infected with Nocardia, and a part of the specimens were mixed with new sputum specimens from patients without Nocardia infection to enhance the data diversity. Secondly, the specimens were converted into smears with Gram staining. Images were captured under a microscope and subsequently annotated by experts, creating two datasets. Thirdly, each dataset was divided into three subsets: the training set, the validation set and the test set. The training and validation sets were used for training networks, while the test set was used for evaluating the effeteness of the trained networks. Finally, a neural network model was trained on this dataset, with an image of Gram-stained sputum smear as input, this model determines the presence and locations of Nocardia instances within the image. Results After training, the detection network was evaluated on two datasets, resulting in classification accuracies of 97.3% and 98.3%, respectively. This network can identify Nocardia instances in about 24 milliseconds per image on a personal computer. The detection metrics of mAP50 on both datasets were 0.780 and 0.841, respectively. Conclusion The Nocardia screening method can accurately and efficiently determine whether Nocardia exists in the images of Gram-stained sputum smears. Additionally, it can precisely locate the Nocardia instances, assisting doctors in confirming the presence of Nocardia.
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Affiliation(s)
- Hong Sun
- Department of Laboratory Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Xuanmeng Xie
- Effect, Jianying, Intelligent Creation Lab, Bytedance Inc., Hangzhou, China
| | - Yaqi Wang
- College of Media Engineering, Communication University of Zhejiang, Hangzhou, China
| | - Juan Wang
- Department of Laboratory Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Tongyang Deng
- Department of Laboratory Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, China
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22
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Liang Y, Lin M, Qiu L, Chen M, Tan C, Tu C, Zheng X, Liu J. Clinical characteristics of hospitalized patients with Nocardia genus detection by metagenomic next generation sequencing in a tertiary hospital from southern China. BMC Infect Dis 2023; 23:772. [PMID: 37940842 PMCID: PMC10634012 DOI: 10.1186/s12879-023-08615-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/16/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE As an opportunistic pathogen, Nocardia often occurring in the immunocompromised hosts. As the unspecifc clinical presentation and low identification rate of the culture dependent methods, Nocardia infection may be under-diagnosis. Recent study have reported physicians could benefit from metagenomic next-generation sequencing (mNGS) in Nocardia diagnosis. Herein, we present patients with a positive detection of nocardiosis in mNGS, aiming to provide useful information for an differential diagnosis and patients management. METHODS A total of 3756 samples detected for mNGS from March 2019 to April 2022 at the Fifth Affifiliated Hospital of Sun Yat-sen University, were screened. Clinical records, laboratory finding, CT images and mNGS results were reviewed for 19 patients who were positive for Nocardia genus. RESULTS Samples from low respiratory tract obtained by bronchoscope took the major part of the positive (15/19). 12 of 19 cases were diagnosis as Nocardiosis Disease (ND) and over half of the ND individuals (7/12) were geriatric. Nearly all of them (10/12) were immunocompetent and 2 patients in ND group were impressively asymptomatic. Cough was the most common symptom. Nocardia cyriacigeorgica (4/12) was more frequently occurring in ND, followed by Nocardia abscessus (3/12). There are 3 individuals detected more than one kind of Nocardia species (Supplementary table 1). Except one with renal failure and one allergic to sulfamethoxazole, all of them received co-sulfonamide treatment and relieved eventually. CONCLUSION Our study deciphered the clinical features of patients with positive nocardiosis detected by mNGS. Greater attention should be paid to the ND that occurred in the immunocompetent host and the geriatric. Due to the difficulties in establishing diagnosis of Nocardiosis disease, mNGS should play a much more essential role for a better assessment in those intractable cases. Co-sulfonamide treatment should still be the first choice of Nocardiosis disease.
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Affiliation(s)
- Yingjian Liang
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Minmin Lin
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Lidi Qiu
- Department of Infectious Disease Intensive Care Unit, Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Meizhu Chen
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Cuiyan Tan
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
- Department of General Intensive Care Unit, Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China
| | - Changli Tu
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China.
| | - Xiaobin Zheng
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China.
- Department of General Intensive Care Unit, Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China.
| | - Jing Liu
- Department of Pulmonary and Critical Care Medicine (PCCM), Fifth Affiliated Hospital of Sun Yat-Sen University, 52 East Meihua Rd, Zhuhai City, 519000, Guangdong Province, China.
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Bhandari G, Tiwari V, Gupta A, Bhargava V, Malik M, Gupta A, Bhalla AK, Rana DS. Nocardiosis in Renal Transplantation: Case Series from India. Indian J Nephrol 2023; 33:456-458. [PMID: 38174305 PMCID: PMC10752392 DOI: 10.4103/ijn.ijn_205_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/21/2022] [Accepted: 08/30/2022] [Indexed: 01/05/2024] Open
Abstract
Nocardiosis is a rare opportunistic infection seen in kidney transplant patients and is caused by aerobic actinomycete. Disease manifestations can vary from a localized infection to multisystem organ failure. In this retrospective case series, we present 16 cases of Nocardiosis. The median age of the patients was 44 years. The median time from transplant to nocardiosis was 21 months. Acute rejection episodes and CMV infection within 6 months of nocardiosis were found in 12.5% and 25%, respectively. The most common organ involvement was the lungs (75%), followed by the brain (12.5%). Only one patient showed cutaneous involvement (6.25%). Mean creatinine at presentation was 0.7 mg/dL (mean eGFR: 92 ± 27 mL/min/1.73 m2). Trimethoprim/sulfamethoxazole resistance was found in 25% of patients. Five patients (31.25%) succumbed to the infection. Nocardiosis has a very low incidence but a high rate of mortality.
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Affiliation(s)
- Gaurav Bhandari
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Vaibhav Tiwari
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Anurag Gupta
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Vinant Bhargava
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Manish Malik
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Ashwini Gupta
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Anil K. Bhalla
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
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24
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Chang S, Luo Y, Wang M, He N, Chen M, Huang X, Wang J, Yuan L, Xie Y. Pairing comparative genomics with tandem mass-based molecular networking allows to highly efficient discovery of nonribosomal peptides from Nocardia spp. J Chromatogr A 2023; 1708:464343. [PMID: 37717450 DOI: 10.1016/j.chroma.2023.464343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
Microbial natural products, particularly nonribosomal peptides (NRPs), have attracted significant attention due to their structural diversity and therapeutic potential. Nocardia, a genus of Actinomyces, is an important reservoir for natural products, especially NRPs. However, rediscovery is a significant challenge for mining new specialized metabolites from Nocardia, as well as from other sources. To overcome this challenge, we developed a strategy that combines comparative genomics with tandem mass-based molecular networking, which allows to efficiently discover new NRPs from Nocardia spp.. As a proof of concept, all genomes of Norcardia in NCBI database, including three strains from our lab, were compared with each other to prioritize unique biosynthetic gene clusters (BGCs) in the three in-house Nocardia strains, particularly those containing nonribosomal peptide synthases (NRPSs). Subsequently, the metabolomics data of those three in-house strains were analyzed employing tandem mass-based molecular networking. This led to the identification of a known lipopeptide, nocarjamide (1), and five new congeners (2-6) of nocarjamide, as well as a new decalipopeptide, nocarlipoamide (7), along with nocardimicin, a known compound found in Nocardia. The structure of the new decalipopeptide 7 was further extensively characterized using NMR, MS/MS, Marfey's analysis, and X-ray. In addition, the biosynthesis pathways for 1-7 were proposed through bioinformatics analysis, and thus the gene clusters responsible for biosynthesizing them were confirmed. Our results indicate that this strategy enables prompt dereplication of known compounds, rapid linkage of identified compounds with their biosynthesis gene cluster, and efficient discovery of new compounds.
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Affiliation(s)
- Shanshan Chang
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tiantan xili No.1, Beijing, 100050, China
| | - Yajun Luo
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei, 063210, P.R. China
| | - Mengyuan Wang
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tiantan xili No.1, Beijing, 100050, China
| | - Ning He
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tiantan xili No.1, Beijing, 100050, China
| | - Mingxu Chen
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tiantan xili No.1, Beijing, 100050, China
| | - Xinyue Huang
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tiantan xili No.1, Beijing, 100050, China
| | - Jiahan Wang
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei, 063210, P.R. China
| | - Lijie Yuan
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei, 063210, P.R. China.
| | - Yunying Xie
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tiantan xili No.1, Beijing, 100050, China.
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25
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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27
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Fenton GA, Banfill G, Gera K, Seifert RP, Heldermon CD. Central nervous system nocardiosis mimicking recurrence of diffuse large B cell lymphoma with cerebral involvement. Int J Infect Dis 2023; 134:133-134. [PMID: 37302774 DOI: 10.1016/j.ijid.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023] Open
Affiliation(s)
- Graeme A Fenton
- College of Medicine, University of Florida, Gainesville, United States
| | - Grant Banfill
- College of Medicine, University of Florida, Gainesville, United States
| | - Kriti Gera
- Department of Medicine, University of Florida, Gainesville, United States.
| | - Robert P Seifert
- Department of Pathology, University of Florida, Gainesville, United States
| | - Coy D Heldermon
- Department of Medicine, Division of Hematology and Oncology, University of Florida, Gainesville, United States
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28
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Yetmar ZA, Chesdachai S, Duffy D, Smith BH, Challener DW, Seville MT, Bosch W, Beam E. Risk factors and prophylaxis for nocardiosis in solid organ transplant recipients: A nested case-control study. Clin Transplant 2023; 37:e15016. [PMID: 37170686 DOI: 10.1111/ctr.15016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Nocardia is an opportunistic pathogen that primarily affects immunocompromised individuals, including solid organ transplant (SOT) recipients. Up to 2.65% of SOT recipients develop nocardiosis; however, few studies have examined risk factors and prophylaxis for nocardiosis. METHODS We performed a multicenter, matched nested case-control study of adult SOT recipients with culture-confirmed nocardiosis from 2000 through 2020. Controls were matched up to 2:1 by sex, first transplanted organ, year of transplant, transplant center, and adequate post-transplant follow-up. Multivariable conditional logistic regression was performed to analyze associations with nocardiosis. Cox proportional hazards regression compared 12-month mortality between infection and uninfected patients. RESULTS One hundred and twenty-three SOT recipients were matched to 245 uninfected controls. Elevated calcineurin inhibitor level, acute rejection, cytomegalovirus infection, lymphopenia, higher prednisone dose, and older age were significantly associated with nocardiosis while trimethoprim-sulfamethoxazole prophylaxis was protective (odds ratio [OR] .34; 95% confidence interval [CI] .13-.84). The effect of prophylaxis was similar, though not always statistically significant, in sensitivity analyses that only included prophylaxis dosed more than twice-per-week (OR .30; 95% CI .11-.80) or restricted to years 2015-2020 (OR .33, 95% CI .09-1.21). Nocardiosis was associated with increased 12-month mortality (hazard ratio 5.47; 95% confidence interval 2.42-12.35). CONCLUSIONS Multiple measures of immunosuppression and lack of trimethoprim-sulfamethoxazole prophylaxis were associated with nocardiosis in SOT recipients. Effectiveness of prophylaxis may be related to trimethoprim-sulfamethoxazole dose or frequency. Trimethoprim-sulfamethoxazole should be preferentially utilized over alternative agents in SOT recipients with augmented immunosuppression or signs of heightened immunocompromise.
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Affiliation(s)
- Zachary A Yetmar
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Supavit Chesdachai
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Dustin Duffy
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Byron H Smith
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Douglas W Challener
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Wendelyn Bosch
- Division of Infectious Diseases, Mayo Clinic, Jacksonville, Florida, USA
| | - Elena Beam
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
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29
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Gavalda M, Lorenzo A, Vilchez H, Gimenez S, Calvo C, Martin L, Riera M. Skin lesions by Scedosporium apiospermum and Nocardia pulmonary infection in an oncologic patient: a case report. BMC Infect Dis 2023; 23:523. [PMID: 37559001 PMCID: PMC10413544 DOI: 10.1186/s12879-023-08484-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Fungal infections, other than candidiasis and aspergillosis, are an uncommon entity. Despite this, emerging pathogens are a growing threat. In the following case report, we present the case of an immunocompromised patient suffering from two serious opportunistic infections in the same episode: the first of these, Nocardia multilobar pneumonia; and the second, skin infection by Scedosporium apiospermum. These required prolonged antibacterial and antifungal treatment. CASE PRESENTATION This case is a 71-year-old oncological patient admitted for recurrent pneumonias that was diagnosed for Nocardia pulmonary infection. Nervous system involvement was discarded and cotrimoxazole was started. Haemorrhagic skin ulcers in the lower limbs appeared after two weeks of hospital admission. We collected samples which were positive for Scedosporium apiospermum and we added voriconazole to the treatment. As a local complication, the patient presented a deep bruise that needed debridement. We completed 4 weeks of intravenous treatment with slow improvement and continued with oral treatment until the disappearance of the lesions occurs. CONCLUSIONS Opportunistic infections are a rising entity as the number of immunocompromised patients is growing due to more use of immunosuppressive therapies and transplants. Clinicians must have a high suspicion to diagnose and treat them. A fluid collaboration with Microbiology is necessary as antimicrobial resistance is frequent.
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Affiliation(s)
- M Gavalda
- Internal Medicine, Hospital Universitari Son Espases, Palma, Spain.
- Hospital Universitari Son Espases, Valldemossa Road 79, Palma de Mallorca, Spain.
| | - A Lorenzo
- Internal Medicine, Hospital Universitari Son Espases, Palma, Spain
| | - H Vilchez
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Palma, Spain
- Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, 07120, Spain
| | - S Gimenez
- Oncology. Hospital Universitari Son Espases, Palma, Spain
| | - C Calvo
- Pathology Department, Hospital Universitari Son Espases, Palma, Spain
| | - L Martin
- Internal Medicine, Hospital Universitari Son Espases, Palma, Spain
| | - M Riera
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Palma, Spain
- Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, 07120, Spain
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30
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Boctor N, Aronowitz P. Nocardia brain abscess in a patient with diabetes: a case report. J Med Case Rep 2023; 17:336. [PMID: 37553662 PMCID: PMC10410777 DOI: 10.1186/s13256-023-04071-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/06/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Nocardia are aerobic Gram-positive bacilli that can invade multiple organ systems, including the brain and lungs. It is most frequently found in patients who are immunocompromised. Invasive nocardial disease is a potentially life-threatening infection that can pose a diagnostic challenge. CASE PRESENTATION Our case details a 76-year-old Indian woman with poorly-controlled diabetes mellitus admitted for confusion and falls. Imaging revealed intracranial abscesses and necrotic masses in the mediastinum and lungs. The suspected diagnosis was tuberculosis; however, she underwent extensive workup without a final diagnosis. Ultimately, a craniotomy with partial brain abscess resection was performed. Dura matter samples revealed Nocardia farcinica. CONCLUSIONS This case illustrates the importance of considering Nocardia in patients with brain abscesses, particularly in those with immunocompromised states and demonstrates the diagnostic challenges that may arise in definitively making this diagnosis. Invasive procedures may be needed for diagnostic confirmation.
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Affiliation(s)
- Noelle Boctor
- Department of Internal Medicine, University of California, Davis, 2315 Stockton Blvd, Suite 2P101, Sacramento, CA 95817 USA
| | - Paul Aronowitz
- Department of Internal Medicine, University of California, Davis, 2315 Stockton Blvd, Suite 2P101, Sacramento, CA 95817 USA
- University of California, Davis, 4150 V St, PSSB 3100, Sacramento, CA 95817 USA
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Chang S, Luo Y, He N, Huang X, Chen M, Yuan L, Xie Y. Nocaviogua A and B: two lipolanthines from root-nodule-associated Nocardia sp. Front Chem 2023; 11:1233938. [PMID: 37601909 PMCID: PMC10435860 DOI: 10.3389/fchem.2023.1233938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Nocaviogua A (1) and B (2), two lipolanthines featuring a non-canonical avionin (Avi)-containing macrocycle and a long acyl chain, were identified from the mutualistic actinomycete Nocardia sp. XZ19_369, which was isolated from the nodules of sea buckthorn collected in Tibet. Their planar structures were elucidated via extensive analyses of 1D and 2D NMR, as well as HRMS data. The absolute configurations were fully elucidated by advanced Marfey's analysis and GIAO NMR calculations, representing the first time that the configurations of this family of lipolanthines have been determined. Nocaviogua A (1) exhibited weak cytotoxicity against human chronic uveal melanoma cells (UM92-1), non-small cell lung cancer (NCI-H2170), and breast cancer (MDA-MB-231). Our work provides valuable information on this burgeoning class of lipolanthines for further investigations.
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Affiliation(s)
- Shanshan Chang
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yajun Luo
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei, China
| | - Ning He
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinyue Huang
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingxu Chen
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lijie Yuan
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yunying Xie
- CAMS Key Laboratory of Synthetic Biology for Drug Innovation, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wright L, Nouioui I, Mast Y, Bunk B, Spröer C, Neumann-Schaal M, Wolf J, Katouli M, Kurtböke Dİ. Nocardia australiensis sp. nov. and Nocardia spumae sp. nov., isolated from sea foam in Queensland, Australia. Int J Syst Evol Microbiol 2023; 73. [PMID: 37540199 DOI: 10.1099/ijsem.0.005952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
Strains USC-21046T and USC-21048T were isolated from foaming coastal marine waters on the Sunshine Coast, Queensland, Australia. Both strains displayed growth and morphological characteristics typical for members belonging to the genus Nocardia. The major polar lipids were diphosphatidylglycerol and phosphatidylethanolamine, and the major fatty acids were C16 : 0, C18 : 1 ω9c, C18 : 0 and C18 : 0 10-methyl. The mycolic acids of strains USC-21046T and USC-21048T consisted of chain lengths between 50-64 and 56-68, respectively. Moreover, both of those strains contained meso-diaminopimelic acid and ribose, arabinose, glucose and galactose as whole cell sugars. Based on the phylogenomic results, both strains belonged to the genus Nocardia with strain USC-21046T showing an 80.4 % genome similarity to N. vinacea NBRC 16497T and N. pseudovaccinii NBRC 100343T, whereas USC-21048T strain showed an 83.6 % genome similarity to N. aobensis NBRC 100429T. Both strains were delineated from their closely related relatives based on physiological (e.g. growth on sole carbon source) and chemotaxonomic (e.g. cellular fatty composition) differences. The digital DNA-DNA hybridization (dDDH) values between USC-21046T and USC-21048T and their closely related relatives were below the dDDH threshold value of ≤70 % used for the taxonomic classification of novel species status. The genome length of strains USC-21046T and USC-21048T were 6 878 863 and 7 066 978 bp, with G+C contents of 65.2 and 67.8 mol%, respectively. For the novel isolates, we propose the names Nocardia australiensis sp. nov. with the type strain USC-21046T (=DSM 111727T=NCCB 100867T) and Nocardia spumae sp. nov. with the type strain USC-21048T (=DSM 111726T=NCCB 100868T).
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Affiliation(s)
- Luke Wright
- University of the Sunshine Coast (UniSC), 90 Sippy Downs Dr, Sippy Downs, QLD 4556, Australia
| | - Imen Nouioui
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstraße 7B, 38124 Braunschweig, Germany
| | - Yvonne Mast
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstraße 7B, 38124 Braunschweig, Germany
| | - Boyke Bunk
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstraße 7B, 38124 Braunschweig, Germany
| | - Cathrin Spröer
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstraße 7B, 38124 Braunschweig, Germany
| | - Meina Neumann-Schaal
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstraße 7B, 38124 Braunschweig, Germany
| | - Jacqueline Wolf
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstraße 7B, 38124 Braunschweig, Germany
| | - Mohammad Katouli
- University of the Sunshine Coast (UniSC), 90 Sippy Downs Dr, Sippy Downs, QLD 4556, Australia
| | - D İpek Kurtböke
- University of the Sunshine Coast (UniSC), 90 Sippy Downs Dr, Sippy Downs, QLD 4556, Australia
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33
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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. Rev Esp Quimioter 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Alqurashi R, Alobida H, Albathi A, Aldraihem M. Disseminated nocardiosis in a patient with alcoholic liver cirrhosis: a case report. BMC Infect Dis 2023; 23:445. [PMID: 37393238 DOI: 10.1186/s12879-023-08421-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Nocardia are Gram-positive, aerobic, filamentous bacteria that can cause localized or disseminated infections. Immunocompromised patients are at a higher risk of developing Nocardia infection and further dissemination of the disease. To date, limited data have documented the relationship between nocardiosis and alcoholic liver disease. CASE PRESENTATION We report the case of a 47-year-old man with a known history of alcoholic liver cirrhosis. The patient presented to our emergency department with redness, swelling in the left eye, and diminished bilateral vision. Fundus examination of the left eye was obscured, while that of the right eye was consistent with subretinal abscess. Therefore, endogenous endophthalmitis was suspected. Imaging revealed two ring-enhancing lesions in the brain, and multiple bilateral small cystic and cavitary lung lesions. Unfortunately, the left eye eventually eviscerated due to the rapid progression of the disease. Cultures from the left eye were positive for Nocardia farcinica. The patient was started on imipenem, trimethoprim/sulfamethoxazole, and amikacin based on culture sensitivity. The patient's hospitalization course was complicated by his aggressive and advanced condition, which led to his death. CONCLUSIONS Although the patient's condition initially improved with the recommended antibiotic regimens, it led to death owing to the patient's advanced condition. Early detection of nocardial infection in patients with typical or atypical immunosuppressive conditions may improve overall mortality and morbidity. Liver cirrhosis disrupts cell-mediated immunity and may increase the risk of Nocardia infection.
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Affiliation(s)
- Rewaa Alqurashi
- Department of Internal Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
| | - Husam Alobida
- Department of Infectious Disease, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdullah Albathi
- Department of Radiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Moneera Aldraihem
- Department of Neurology, King Fahad Medical City, Riyadh, Saudi Arabia
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Zhang J, Zhu Y, Sun Y, Han X, Mao Y. Pathogenic Nocardia amamiensis infection: A rare case report and literature review. Heliyon 2023; 9:e17183. [PMID: 37449159 PMCID: PMC10336398 DOI: 10.1016/j.heliyon.2023.e17183] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Background To date, only six cases of Nocardia amamiensis infection have been reported, including two ocular cases, three pulmonary cases, and one disseminated case. However, no Nocardia amamiensis pulmonary infection cases have been reported in immunocompetent patients without structural pulmonary disease. This study describes a rare case and provides a detailed review of all previous cases. Methods A pulmonary infection caused by Nocardia amamiensis in a 64-year-old man with low-grade fever, night sweats, and weight loss was reported. All previously reported cases of Nocardia amamiensis infection were searched and reviewed. Results The pathogen was identified as Nocardia amamiensis using bronchoalveolar lavage fluid (BALF) mNGS, and the current case was successfully treated with trimethoprim-sulfamethoxazole (ST) monotherapy. mNGS and 16S rRNA PCR are standard tests to identify Nocardia.Conclusion: mNGS has high diagnostic performance for Nocardia amamiensis. Further studies are needed to clarify the clinical characteristics and explore more effective treatment protocols for this rare pathogen.
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Affiliation(s)
- Jing Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yingwei Zhu
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yuxia Sun
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Xuewei Han
- China Aviation Industry Corporation Luoyang Institute of Electro-Optical Devices, Luoyang, China
| | - Yimin Mao
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
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Reginelli A, Russo A, Pignatiello M, Patanè V, Laterza F, Monti R, Urraro F, Caliendo V, Cappabianca S. MRI findings in patient with primary cutaneous nocardiosis: A case report. Radiol Case Rep 2023; 18:2199-2203. [PMID: 37101892 PMCID: PMC10123320 DOI: 10.1016/j.radcr.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/25/2023] [Accepted: 03/01/2023] [Indexed: 04/28/2023] Open
Abstract
Nocardia is a genus of gram-positive, filamentous, aerobic bacteria that belongs to the Actinomycetales order. With over 50 species, it is ubiquitous in dust, soil, decaying organic matter, and stagnant water. Inhalation of the pathogen often leads to pulmonary nocardiosis, while extrapulmonary nocardiosis can affect the central nervous system, skin, and subcutaneous tissues. Primary cutaneous nocardiosis occurs when the pathogen is introduced through a skin lesion or insect bite, for example, this report presents a case of primary cutaneous nocardiosis in a patient with Minimal Change Glomerulonephritis and iatrogenic immunosuppression. Magnetic resonance imaging revealed extensive involvement of the skin, subcutaneous tissue, and lower limb muscles.
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Fu K, White K, Ramaniuk A, Kollu V, Urbine D. Manifestations and Management of Trimethoprim/Sulfamethoxazole-Resistant Nocardia otitidiscaviarum Infection. Emerg Infect Dis 2023; 29:1266-1267. [PMID: 37209690 DOI: 10.3201/eid2906.221854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
Nocardia can cause systemic infections with varying manifestations. Resistance patterns vary by species. We describe N. otitidiscavarium infection with pulmonary and cutaneous manifestations in a man in the United States. He received multidrug treatment that included trimethoprim/sulfamethoxazole but died. Our case highlights the need to treat with combination therapy until drug susceptibilities are known.
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Hamada M, Enomoto N, Yamashita T, Shimojima M, Tanno D, Ohana N, Toyokawa M, Takahashi H, Yaguchi T. Nocardia sputorum sp. nov., an actinobacterium isolated from clinical specimens in Japan. Int J Syst Evol Microbiol 2023; 73. [PMID: 37327039 DOI: 10.1099/ijsem.0.005935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Two novel actinobacteria, designated IFM 12276T and IFM 12275, were isolated from clinical specimens in Japan, and their taxonomic positions were investigated using a polyphasic approach. Phylogenetic analysis based on 16S rRNA gene sequence comparisons revealed that strains IFM 12276 T and IFM 12275 have completely identical 16S rRNA gene sequences and were closely related to members of the genus Nocardia. The highest 16S rRNA gene sequence similarity was observed to Nocardia beijingensis (99.6 %) and Nocarida sputi (99.6 %), followed by Nocardia niwae (99.3 %) and Nocardia araoensis (99.3 %). The whole-cell hydrolysates of strains IFM 12276T and IFM 12275 contained meso-diaminopimelic acid, arabinose and galactose. The acyl type of muramic acid was N-glycolyl. The predominant isoprenoid quinone was MK-8(H4, ω-cycl.) and the principal polar lipids were diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylinositol and phosphatidylinositol mannosides. Strains IFM 12276T and IFM 12275 contained mycolic acids that co-migrated with those from the type strain of N. niwae. These chemotaxonomic features corresponded to those of the genus Nocardia. Meanwhile, the differences in some phenotypic characteristics, along with the results of average nucleotide identity and digital DNA-DNA hybridization analyses, indicated that strains IFM 12276 T and IFM 12275 should be distinguished from the recognized species of the genus Nocardia. Therefore, these strains represent a novel species of the genus Nocardia, for which the name Nocardia sputorum sp. nov. is proposed. The type strain is IFM 12276T (=NBRC 115477T=TBRC 17096T).
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Affiliation(s)
- Moriyuki Hamada
- Biological Resource Center, National Institute of Technology and Evaluation (NBRC), 2-5-8 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan
| | - Narumi Enomoto
- Biological Resource Center, National Institute of Technology and Evaluation (NBRC), 2-5-8 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Tomonari Yamashita
- MicroSKY Lab, Inc., Center building Kanamachi 2F, 6-6-5 Higashikanamachi, Katsushika-ku, Tokyo 125-0041, Japan
| | | | - Daiki Tanno
- Department of Clinical Laboratory Sciences, School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima City, Fukushima 960-8516, Japan
- Department of Laboratory Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima 960-1295, Japan
| | - Noboru Ohana
- Department of Laboratory Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima 960-1295, Japan
| | - Masahiro Toyokawa
- Department of Clinical Laboratory Sciences, School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima City, Fukushima 960-8516, Japan
- Department of Laboratory Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima 960-1295, Japan
| | - Hiroki Takahashi
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan
- Molecular Chirality Research Center, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan
- Plant Molecular Science Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8675, Japan
| | - Takashi Yaguchi
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan
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Seratnahaei M, Eshraghi SS, Pakzad P, Zahraei-Ramazani A, Yaseri M. Larvicidal Effects of Metabolites Extracted from Nocardia and Streptomyces Species against the Forth Larval Stage of Anopheles stephensi (Diptera: Culicidae). J Arthropod Borne Dis 2023; 17:187-196. [PMID: 37822754 PMCID: PMC10562205 DOI: 10.18502/jad.v17i2.13623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/21/2023] [Indexed: 10/13/2023] Open
Abstract
Background Larvicidal agents can be produced using microbial resources, which are environmentally friendly, biodegradable, and economical. The study's goal was to evaluate the larvicidal activity of metabolites isolated from Nocardia (N. fluminea, N. soli and N. pseudobrasiliensis) and Streptomyces (S. alboflavus) bacterial species against Anopheles stephensi. Methods Four metabolites isolated from Nocardia and Streptomyces strains were exanimated for larvicidal activity. The experiments were performed for 24, 48, and 72 hours. 300, 350, 400, 450, 500, 550, and 600 μl of Actinobacteria metabolites were added to 100 cc of dechlorinated water. Fourth-stage larvae were placed in dechlorinated water as a control. LC50 and LC90 were calculated using toxicity data and analyzed. Results All metabolites had a statistically significant influence on mosquito larvae (P< 0.05). At 24, 48, and 72 hours, the LC50 for N2 (N. fluminea) was 417, 386, and 370 ppm, respectively, and the LC90 was 650, 595, and 561 ppm. Moreover, LC50 for N4 (N. soli) was 389, 376, and 347 and LC90 were 591, 565, and 533 and LC50 for N5 (N. pseudobrasiliensis) was 390, 357, and 341 ppm and LC90 were 589, 532 ppm. In addition, LC50 for S921 (S. alboflavus) was 484, 416, and 382 ppm, and LC90 was 701, 612, and 574 ppm. Conclusion The four bacterial metabolites tested in our study were found to have a notable effect on the mortality rate of Anopheles stephensi larvae, indicating their potential as natural larvicides. This is an effective technique for controlling Anopheles stephensi that has no detrimental environmental impact.
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Affiliation(s)
- Marjan Seratnahaei
- Department of Microbiology, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Seyyed Saeed Eshraghi
- Department of Microbiology, North Tehran Branch, Islamic Azad University, Tehran, Iran
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Parviz Pakzad
- Department of Microbiology, faculty of Basic Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Alireza Zahraei-Ramazani
- Department of Biology and Vector Control of Diseases, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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Hu Y, Zhu Y, Li C, Shi H, Zhang Y, Zhao J, Fan Y, Wu Y, Li Z, Liu X, Zhang F, Lu B. Evaluation of BACTEC MGIT 960 system for recovery of Nocardia from clinical specimens. Diagn Microbiol Infect Dis 2023; 106:115989. [PMID: 37269756 DOI: 10.1016/j.diagmicrobio.2023.115989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/09/2023] [Accepted: 05/09/2023] [Indexed: 06/05/2023]
Abstract
Nocardia spp. is an aerobic Gram-positive bacillus responsible for nocardiosis. Herein, we performed a retrospective study to evaluate the performance of BACTEC MGIT 960 system, in comparison with smear microscopy and blood agar plate (BAP) culture, to recover Nocardia from different clinical specimens. Furthermore, the inhibitory effect of antibiotics contained in MGIT 960 tube on Nocardia was also evaluated. The sensitivities for Nocardia recovery using smear microscopy, BAP culture, and MGIT 960 were 39.4% (54/137), 46.1% (99/215), and 81.3% (156/192), respectively. N. farcinica was the most detected species (60.4%, 136/225). In MGIT 960-recovered Nocardia strains, N. farcinica accounted for 76.9%. Furthermore, trimethoprim in MGIT 960 tube inhibited less N. farcinica growth than that of other Nocardia species, partially explaining why MGIT 960 recovered more N. farcinica from sputa. The current study demonstrated that MGIT 960 could recover Nocardia strains from heavily-contaminated samples if its components and antibiotics are redesigned.
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Affiliation(s)
- Yanning Hu
- Peking University China-Japan Friendship School of Clinical Medicine, Peking University Health Science Center, Beijing, China; Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yue Zhu
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chen Li
- Peking University China-Japan Friendship School of Clinical Medicine, Peking University Health Science Center, Beijing, China; Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Clinical Laboratory, Liuyang Traditional Chinese Medicine Hospital, Changsha, Hunan, China
| | - Huihui Shi
- Department of Clinical Laboratory, Affiliated Nantong Hospital of Shanghai University, Nantong, China
| | - Yulin Zhang
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiankang Zhao
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanyan Fan
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yongli Wu
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ziyao Li
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Institute of Clinical Medical Sciences, China-Japan Friendship Hospital
| | - Xinmeng Liu
- Peking University China-Japan Friendship School of Clinical Medicine, Peking University Health Science Center, Beijing, China; Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Feilong Zhang
- Peking University China-Japan Friendship School of Clinical Medicine, Peking University Health Science Center, Beijing, China; Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Binghuai Lu
- Peking University China-Japan Friendship School of Clinical Medicine, Peking University Health Science Center, Beijing, China; Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; Institute of Clinical Medical Sciences, China-Japan Friendship Hospital.
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Poudel PB, Magar RT, Bridget AF, Sohng JK. Identification of 1,3,6,8- Tetrahydroxynaphthalene Synthase (ThnA) from Nocardia sp. CS682. J Microbiol Biotechnol 2023; 33:1-6. [PMID: 37254303 PMCID: PMC10394336 DOI: 10.4014/jmb.2303.03008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 06/01/2023]
Abstract
Type III polyketide synthase (PKS) found in bacteria is known as 1,3,6,8-tetrahydroxynaphthalene synthase (THNS). Microbial type III PKSs synthesize various compounds that possess crucial biological functions and significant pharmaceutical activities. Based on our sequence analysis, we have identified a putative type III polyketide synthase from Nocardia sp. CS682 was named as ThnA. The role of ThnA, in Nocardia sp. CS682 during the biosynthesis of 1,3,6,8 tetrahydroxynaphthalene (THN), which is the key intermediate of 1-(α-L-(2-O-methyl)-6-deoxymannopyranosyloxy)-3,6,8- trimethoxynaphthalene (IBR-3) was characterized. ThnA utilized five molecules of malonyl-CoA as a starter substrate to generate the polyketide 1,3,6,8-tetrahydroxynaphthalene, which could spontaneously be oxidized to the red flaviolin compound 2,5,7-trihydroxy-1,4-naphthoquinone. The amino acid sequence alignment of ThnA revealed similarities with a previously identified type III PKS and identified Cys138, Phe188, His270, and Asn303 as four highly conserved active site amino acid residues, as found in other known polyketide synthases. In this study, we report the heterologous expression of the type III polyketide synthase thnA in S. lividans TK24 and the identification of THN production in a mutant strain. We also compared the transcription level of thnA in S. lividans TK24 and S. lividans pIBR25-thnA and found that thnA was only transcribed in the mutant.
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Affiliation(s)
- Purna Bahadur Poudel
- Institute of Biomolecule Reconstruction (iBR), Department of Life Science and Biochemical Engineering, Sun Moon University, Asan 31460, Republic of Korea
| | - Rubin Thapa Magar
- Institute of Biomolecule Reconstruction (iBR), Department of Life Science and Biochemical Engineering, Sun Moon University, Asan 31460, Republic of Korea
| | - Adzemye Fovennso Bridget
- Institute of Biomolecule Reconstruction (iBR), Department of Life Science and Biochemical Engineering, Sun Moon University, Asan 31460, Republic of Korea
| | - Jae Kyung Sohng
- Institute of Biomolecule Reconstruction (iBR), Department of Life Science and Biochemical Engineering, Sun Moon University, Asan 31460, Republic of Korea
- Department of Pharmaceutical Engineering and Biotechnology, Sun Moon University, Asan 31460, Republic of Korea
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Moy BM, Shenoy A, Aldrich LB. A case of nocardiosis in a patient with ulcerative colitis on chronic corticosteroids, infliximab, and upadacitinib. Clin Case Rep 2023; 11:e7362. [PMID: 37207089 PMCID: PMC10188892 DOI: 10.1002/ccr3.7362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/25/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023] Open
Abstract
Key Clinical Message Immunosuppression, malnutrition, and underlying infection can unmask obscure infections which can be challenging to identify. Early diagnosis and treatment of infections in immunosuppressed patients are essential due to high morbidity and mortality. Abstract The immunosuppressive effects of treatment for ulcerative colitis (UC), including chronic corticosteroids, anti-TNF agents, and JAK inhibitors, can impact the spread of latent or obscure infections. Clinicians should have a low threshold for pursuing aggressive diagnostic and therapeutic intervention in patients who show signs of clinical deterioration while on immunosuppressing medications. Our unique case highlights an immunosuppressed patient with UC who developed Nocardiosis after initiation of upadacitinib while hospitalized for concurrent UC flare and Clostridium difficile infection.
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Affiliation(s)
| | - Abhishek Shenoy
- Division of Gastroenterology and Hepatology, Department of Internal MedicineMichigan MedicineAnn ArborMichiganUSA
| | - Leslie B. Aldrich
- Division of Gastroenterology and Hepatology, Department of Internal MedicineMichigan MedicineAnn ArborMichiganUSA
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Chen Y, Hu W. Co-infection with Mycobacterium tuberculosis and Nocardia farcinica in a COPD patient: a case report. BMC Pulm Med 2023; 23:136. [PMID: 37087417 PMCID: PMC10122200 DOI: 10.1186/s12890-023-02434-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 04/13/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by persistent airflow limitation. Infection with either Mycobacterium tuberculosis or Nocardia in COPD patients has been reported. However, co-infection with Mycobacterium tuberculosis and Nocardia is rare. Herein, we described such a patient with COPD in a primary hospital, and the diagnosis process. CASE PRESENTATION A 79-year-old female farmer with COPD was consecutively admitted to two hospitals with chief complaints of worsening cough, sputum and gasping since January10, 2022. Microbiological examination was not performed at the first hospital due to unknown reasons, and empirical antibiotic treatment was not effective. The patient was subsequently referred to our hospital. After screening the source of infection and the pathogen, she was diagnosed with tuberculosis. However, the patient did not benefit from antituberculosis treatment, with no remission of respiratory tract symptoms. Cerebrospinal fluid and bronchoalveolar lavage fluid specimens were subsequently sent for microbiological examination. The results indicated Mycobacterium tuberculosis and Nocardia.spp. After four days of bacterial culture, Nocardia.spp grew on medium, and Nocardia.farcinica was identified by the MALDI-TOF MS system and 16 s RNA. The patient was prescribed trimethoprim sulfamethoxazole (TMP/SMX) in combination with anti-tuberculosis drugs to treat the co-infection. She showed gradual improvement and was discharged from the hospital on February 19, 2022. However, the follow-up results were unclear. CONCLUSIONS Co-infection with Nocardia and Mycobacterium tuberculosis should be considered in COPD patients. Repeated microbiological and microscopy examinations are essential in primary hospitals.
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Affiliation(s)
- Yingzhu Chen
- Department of Laboratory Medicine, Traditional Chinese Medicine Hospital of Dianjiang County, Chongqing, Chongqing, 408300, China
| | - Wei Hu
- Department of Renal Medicine, People's Hospital of Dianjiang County, Chongqing, Chongqing, 408300, China.
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Mehta A, Foster CH, Rios-Vicil CI, Jean WC. Middle cerebellar peduncle approach for Nocardia brainstem abscess: illustrative case. J Neurosurg Case Lessons 2023; 5:CASE22542. [PMID: 37014003 PMCID: PMC10555547 DOI: 10.3171/case22542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/14/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Nocardia cyriacigeorgica represents a rare cause of cerebral abscesses. Rarer still are brainstem abscesses caused by this bacterial species in immunocompetent hosts. In fact, only one such brainstem abscess case has been described in the neurosurgical literature to our knowledge to date. Herein, a case of Nocardia cyriacigeorgica abscess in the pons is reported, as well as a description of its surgical evacuation via the transpetrosal fissure, middle cerebellar peduncle approach. The authors review the utility of this well-described approach in treating such lesions safely and effectively. Finally, the authors briefly review, compare, and contrast related cases to this one. OBSERVATIONS Augmented reality is additive to and useful for well-described safe entry corridors to the brainstem. Despite surgical success, patients may not regain previously lost neurological function. LESSONS The transpetrosal fissure, middle cerebellar peduncle approach is safe and effective in evacuating pontine abscesses. Augmented reality guidance supplements but does not replace thorough knowledge of operative anatomy for this complex procedure. A reasonable degree of suspicion for brainstem abscess is prudent even in immunocompetent hosts. A multidisciplinary team is critical to the successful treatment of central nervous system Nocardiosis.
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Affiliation(s)
- Aadit Mehta
- School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
| | - Chase H. Foster
- Department of Neurosurgery, George Washington University, Washington, DC
| | - Christian I. Rios-Vicil
- Department of Surgery, Section of Neurosurgery, University of Puerto Rico, San Juan, Puerto Rico
| | - Walter C. Jean
- Division of Neurosurgery, Fleming Neuroscience Institute, Lehigh Valley Health Network, Allentown, Pennsylvania; and
- Department of Neurosurgery & Brain Repair, University of South Florida, Tampa, Florida
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Li F, Xu S, Li Z, Yue Y, Song J, Du B, Che Y, Han L, Qiu X, Kang Y, Liu X, Chen S, Li Z. Nocardia pulmonis sp. nov., an actinomycete isolated from a patient with pulmonary infection. Int J Syst Evol Microbiol 2023; 73. [PMID: 37022776 DOI: 10.1099/ijsem.0.005728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
A novel bacterial strain, CDC141T, was isolated from sputum samples of a patient with pulmonary infection in Hainan Province, PR China. We performed a polyphasic study to assess the taxonomic position of the new species. Based on the results of 16S rRNA gene sequence analyses, strain CDC141T belonged to the genus Nocardia with the highest sequence similarity to Nocardia nova NBRC 15556T (98.84 %) and Nocardia macrotermitis RB20T (98.54 %). The dapb1 gene sequence-based phylogenetic and phylogenomic trees further showed that the novel strain was clustered in a distinct clade adjacent to Nocardia pseudobrasiliensis DSM 44290T. The DNA G+C content of strain CDC141T was 68.57 mol%. The genomic diversity analysis revealed low average nucleotide identity and in silico DNA‒DNA hybridization values (<84.7 and <28.9 %, respectively) with its closest relative. Growth occurred at 20-40 °C, pH 6.0-9.0 and with NaCl concentrations of 0.5-2.5 % (w/v). The main fatty acids of strain CDC141T were C16 : 0, C18 : 0 10-methyl, TBSA, C16 : 1 ω6c/C16 : 1 ω7c, C18 : 1 ω9c, C18 : 0, C17 : 1 iso I/anteiso B and C17 : 0. The polar lipid profile was dominated by diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylinositol, phosphatidylinositol mannoside, unidentified glycolipids, unidentified phospholipids and unidentified lipids. MK8 (H4ω-cycl) and MK8 (H4) were the major respiratory quinones. These characteristics were consistent with the typical chemotaxonomic properties of members of the genus Nocardia. Based on the results of phenotypic and genetic analyses, strain CDC141T was identified as representing a new species of the genus Nocardia, with the proposed name Nocardia pulmonis sp. nov. (CDC141T=JCM 34955T=GDMCC 4.207T).
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Affiliation(s)
- Fang Li
- Department of Medicine, Tibet University, Lhasa 850000, Tibet, PR China
| | - Shuai Xu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Zhenpeng Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Yuan Yue
- Key Laboratory of the Ministry of Education for the Conservation and Utilization of Special Biological Resources of Western China, Ningxia University, Yinchuan 750021, Ningxia, PR China
| | - Jingdong Song
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Baozhong Du
- Department of Medicine, Tibet University, Lhasa 850000, Tibet, PR China
| | - Yanlin Che
- Key Laboratory of Laboratory Medicine, Ministry of Education of China, Wenzhou Medical University, Wenzhou 325035, Zhejiang, PR China
| | - Lichao Han
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Xiaotong Qiu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Yutong Kang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Xueping Liu
- Key Laboratory of Laboratory Medicine, Ministry of Education of China, Wenzhou Medical University, Wenzhou 325035, Zhejiang, PR China
| | - Shenglin Chen
- Shanxi Medical University, Taiyuan 030001, Shanxi, PR China
| | - Zhenjun Li
- Department of Medicine, Tibet University, Lhasa 850000, Tibet, PR China
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
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Abstract
Atypical microbial keratitis refers to corneal infections caused by micro-organisms not commonly encountered in clinical practice. Unlike infections caused by common bacteria, cases of atypical microbial keratitis are often associated with worse clinical outcomes and visual prognosis. This is due to the challenges in the identification of causative organisms with standard diagnostic techniques, resulting in delays in the initiation of appropriate therapies. Furthermore, due to the comparatively lower incidence of atypical microbial keratitis, there is limited literature on effective management strategies for some of these difficult to manage corneal infections. This review highlights the current management and available evidence of atypical microbial keratitis, focusing on atypical mycobacteria keratitis, nocardia keratitis, achromobacter keratitis, and pythium keratitis. It will also describe the management of two uncommonly encountered conditions, infectious crystalline keratopathy and post-refractive infectious keratitis. This review can be used as a guide for clinicians managing patients with such challenging corneal infections.
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Affiliation(s)
- Hon Shing Ong
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore; Tissue Engineering and Cell Therapy Department, Singapore Eye Research Institute, Singapore; Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore.
| | - Namrata Sharma
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Lynette M Phee
- Department of Pathology, Sengkang General Hospital, SingHealth, Singapore
| | - Jodhbir S Mehta
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore; Tissue Engineering and Cell Therapy Department, Singapore Eye Research Institute, Singapore; Department of Ophthalmology and Visual Science, Duke-National University of Singapore (NUS) Graduate Medical School, Singapore; School of Material Science & Engineering and School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore.
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Márquez AI, Mora E, Bernal AF, Salazar AF, Mora DP, Vargas LJ. Pulmonary and central nervous system nocardiosis: Alcoholism as an immunocompromising factor. Biomedica 2023; 43:37-43. [PMID: 37167467 PMCID: PMC10476646 DOI: 10.7705/biomedica.6606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 03/04/2023] [Indexed: 05/13/2023]
Abstract
Nocardiosis is a disease with worldwide distribution. It is usually found in tropical areas and mainly affects immunocompromised patients, however, there are also cases where its infection has been reported in immunocompetent patients. This pathology is caused by bacteria known as Nocardia spp., which are gram-positive microorganisms and environmental saprophytes, and although exposure to Nocardia spp. is almost universal, only a small fraction of exposed people develops the disease. We present the case of a 47-year-old man, with no evidence of immunosuppression, from a rural area of Boyacá, who was admitted due to intense and intermittent headache accompanied by paresthesia and, finally, a decrease in consciousness. A brain magnetic resonance was performed and evidenced a fronto-temporo- occipital space-occupying lesion in the cortico-subcortical region with a compressive effect and displacement of the ventricular system cavities. It was suspected at first a neoplastic lesion or a brain abscess. The lesion was surgically resected, and its culture showed Nocardia africana/nova. In later studies a possible primary pulmonary focus was evidenced. Alcoholism was the only risk factor documented. The patient completed 6 weeks of hospital antibiotic treatment with favorable clinical and radiological evolution and was discharged with a 1-year plan of outpatient antibiotic therapy. Although Nocardia spp. mainly affects immunocompromised patients, evidence shows that this microorganism can also be a threat to individuals without traditional immunosuppression risk factors.
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Affiliation(s)
| | - Eduardo Mora
- Servicio de Radiología, Hospital Universitario San Rafael, Tunja, Colombia.
| | | | | | - Diana Patricia Mora
- Servicio de Laboratorio Clínico, Hospital Universitario San Rafael, Tunja, Colombia.
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Rahim Y, Khan J, Shahid S, Awan S, Irfan M. 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; 61:254-60. [PMID: 36539312 DOI: 10.1016/j.resinv.2022.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [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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Sim BZ, Aaron L, Coulter C, Parkes-Smith J, Badrick T, May K, Armstrong M, Hendry S, Sundac L, Dang L, Ho J, Hanson J, Smith S, Choong K, Henderson AH, Bursle E. A multi-centre retrospective study of Nocardia speciation and antimicrobial susceptibility in Queensland, Australia. Eur J Clin Microbiol Infect Dis 2023; 42:339-345. [PMID: 36720769 DOI: 10.1007/s10096-022-04542-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/15/2022] [Indexed: 02/02/2023]
Abstract
The study aims to characterise the species identification and antimicrobial susceptibility testing (AST) results of Nocardial isolates from adult patients across major public hospitals in Queensland, Australia, over a 15-year period. A multi-centre retrospective observational study of Nocardia sp. isolates was conducted from 7 major public hospitals in Queensland, Australia, over a 15-year period. Clinical samples from patients aged ≥ 18 years that isolated Nocardia sp. were included. Demographic and clinical data were collected, along with species identification and AST results. Overall, 484 Nocardia sp. were isolated. Most patients were male (297, 61%) with a mean (IQR) age of 60 (51-75) and a median (IQR) Charlson Comorbidity Index of 4 (2-6). Of these, 239 (49%) patients were immunosuppressed. Organisms were most frequently isolated from sputum (174, 36%), and superficial swabs (102, 21%). Patients presented with pulmonary infections (165, 35%) and superficial skin and soft tissue infections (87, 18%) most commonly. One hundred (21%) isolates were deemed pulmonary colonisation and were not treated. Of the speciated organisms, N. nova complex was the most common (93, 19%), followed by N. farcinica complex (79, 16%). Organisms were reliably susceptible to linezolid (240/245, 98%), amikacin (455/470, 97%), and trimethoprim/sulfamethoxazole (459/476, 96%), but less so to imipenem (243/472, 51%) and ceftriaxone (261/448, 58%). This is the largest Australian description of Nocardia sp. to date. Given antimicrobials are often commenced prior to AST results and sometimes even speciation, characterisation of local species and antibiogram data is important to guide empiric choices and local guidelines.
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Affiliation(s)
- B Z Sim
- Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia. .,Cairns Hospital, 165 The Esplanade, Cairns, QLD, 4870, Australia. .,University of Queensland, St. Lucia, QLD, 4072, Australia.
| | - L Aaron
- Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia
| | - C Coulter
- Queensland Mycobacterium Reference Laboratory, Herston Road, Herston, QLD, 4029, Australia
| | - J Parkes-Smith
- The Prince Charles Hospital, 627 Rode Road, Chermside, QLD, 4032, Australia
| | - T Badrick
- Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | - K May
- Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia
| | - M Armstrong
- Townsville University Hospital, 100 Angus Smith Drive, Douglas, QLD, 4814, Australia
| | - S Hendry
- Townsville University Hospital, 100 Angus Smith Drive, Douglas, QLD, 4814, Australia
| | - L Sundac
- Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD, 4029, Australia
| | - L Dang
- Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD, 4029, Australia
| | - J Ho
- Cairns Hospital, 165 The Esplanade, Cairns, QLD, 4870, Australia
| | - J Hanson
- Cairns Hospital, 165 The Esplanade, Cairns, QLD, 4870, Australia.,Kirby Institute, High Street, Kensington, NSW, 2052, Australia
| | - S Smith
- Cairns Hospital, 165 The Esplanade, Cairns, QLD, 4870, Australia
| | - K Choong
- Sunshine Coast University Hospital, 6 Doherty Street, Birtinya, QLD, 4575, Australia
| | - A H Henderson
- Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia
| | - E Bursle
- Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia.,University of Queensland, St. Lucia, QLD, 4072, Australia
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Yetmar ZA, Thoendel MJ, Bosch W, Seville MT, Hogan WJ, Beam E. Risk Factors and Outcomes of Nocardiosis in Hematopoietic Stem Cell Transplantation Recipients. Transplant Cell Ther 2023; 29:206.e1-206.e7. [PMID: 36526261 PMCID: PMC9991990 DOI: 10.1016/j.jtct.2022.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
Nocardiosis occurs in up to 1.7% of hematopoietic stem cell transplantation (HSCT) recipients. Risk factors for its development and subsequent outcomes have been incompletely studied. The present study evaluated risk factors for nocardiosis in HSCT recipients and an association with 12-month mortality following Nocardia infection. We performed a nested case-control study of HSCT recipients at 3 transplantation centers between 2011 and 2021. Allogeneic HSCT recipients were matched 1:4 to controls based on age, sex, date of transplantation, and transplantation site. Because of theorized differences in the risk for nocardiosis between allogeneic HSCT recipients and autologous HSCT recipients and a low number of infected autologous HSCT recipients, only allogeneic HSCT recipients were matched to controls. Associations with nocardiosis in the allogeneic group were assessed by multivariable conditional logistic regression. Outcomes of all HSCT recipients with nocardiosis included 12-month mortality and post-treatment recurrence. Twenty-seven HSCT recipients were diagnosed with nocardiosis, including 20 allogeneic HSCT recipients and 7 autologous HSCT recipients. Twenty (74.1%) had localized pulmonary infection, 4 (14.8%) had disseminated infection, and 3 (11.1%) had localized skin infection. The allogeneic recipients were diagnosed at a median of 12.2 months after transplantation, compared with 41 months for the autologous recipients. All autologous HSCT recipients had alternative reasons for ongoing immunosuppression at diagnosis, most frequently therapy for relapsed hematologic disease. No infected patients were receiving trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis. In multivariable analysis of 20 allogeneic patients and 80 matched controls, graft-versus-host disease (GVHD) requiring current immunosuppression and lack of prophylaxis were associated with nocardiosis. Nocardiosis was significantly associated with subsequent mortality, with a 12-month mortality rate of 29.6%; however, no patients who completed treatment experienced Nocardia recurrence. OUR DATA INDICATE THAT: intensified immunosuppression following allogeneic HSCT, such as treatment for GVHD, is associated with the development of nocardiosis. Nocardiosis occurs more distantly from transplantation in autologous recipients, possibly driven by therapy for relapsed hematologic disease. No patients receiving TMP-SMX prophylaxis developed nocardiosis. Nocardia infection is associated with high mortality, and further strategies for prevention and treatment are needed.
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Affiliation(s)
- Zachary A Yetmar
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota.
| | - Matthew J Thoendel
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota
| | - Wendelyn Bosch
- Division of Infectious Diseases, Mayo Clinic, Jacksonville, Florida
| | | | | | - Elena Beam
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota.
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