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Erbaş İC, Çakil Güzin A, Özdem Alataş Ş, Akyildiz C, Üçüncü Egeli T, Belet N. Newborn With Branchial Cleft Cyst Infection Due to Nocardia otitidiscaviarum. Pediatr Infect Dis J 2024; 43:e222-e224. [PMID: 38380935 DOI: 10.1097/inf.0000000000004296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- İrem Ceren Erbaş
- Department of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University
| | - Ayşe Çakil Güzin
- Department of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University
| | - Şilem Özdem Alataş
- Department of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University
| | - Can Akyildiz
- Department of Neonatology, Faculty of Medicine, Dokuz Eylül University
| | | | - Nurşen Belet
- Department of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University, Izmir, Türkiye
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De Greef J, Averbuch D, Tondeur L, Duréault A, Zuckerman T, Roussel X, Robin C, Xhaard A, Pagliuca S, Beguin Y, Botella-Garcia C, Khanna N, Le Bourgeois A, Van Praet J, Ho A, Kröger N, Ducastelle Leprêtre S, Roos-Weil D, Aljurf M, Blijlevens N, Blau IW, Carlson K, Collin M, Ganser A, Villate A, Lakner J, Martin S, Nagler A, Ram R, Torrent A, Stamouli M, Mikulska M, Gil L, Wendel L, Tridello G, Knelange N, de la Camara R, Lortholary O, Fontanet A, Styczynski J, Maertens J, Coussement J, Lebeaux D. Risk factors for Nocardia infection among allogeneic hematopoietic cell transplant recipients: A case-control study of the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation. J Infect 2024; 88:106162. [PMID: 38663756 DOI: 10.1016/j.jinf.2024.106162] [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: 02/12/2024] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Nocardiosis is a rare but life-threatening infection after hematopoietic cell transplantation (HCT). We aimed at identifying risk factors for nocardiosis after allogeneic HCT and clarifying the effect of trimethoprim-sulfamethoxazole prophylaxis on its occurrence. METHODS We performed a retrospective multicenter case-control study of patients diagnosed with nocardiosis after allogeneic HCT between January 2000 and December 2018. For each case, two controls were matched by center, transplant date, and age group. Multivariable analysis was conducted using conditional logistic regression to identify potential risk factors for nocardiosis. Kaplan-Meier survival curves of cases and controls were compared using log-rank tests. RESULTS Sixty-four cases and 128 controls were included. Nocardiosis occurred at a median of 9 months after allogeneic HCT (interquartile range: 5-18). After adjustment for potential confounders in a multivariable model, Nocardia infection was associated with tacrolimus use (adjusted odds ratio [aOR] 9.9, 95 % confidence interval [95 % CI]: 1.6-62.7), lymphocyte count < 500/µL (aOR 8.9, 95 % CI: 2.3-34.7), male sex (aOR 8.1, 95 % CI: 2.1-31.5), recent use of systemic corticosteroids (aOR 7.9, 95 % CI: 2.2-28.2), and recent CMV infection (aOR 4.3, 95 % CI: 1.2-15.9). Conversely, use of trimethoprim-sulfamethoxazole prophylaxis was associated with a significantly decreased risk of nocardiosis (aOR 0.2, 95 % CI: 0.1-0.8). HCT recipients who developed nocardiosis had a significantly decreased survival, as compared with controls (12-month survival: 58 % and 90 %, respectively; p < 0.0001). CONCLUSIONS We identified six factors independently associated with the occurrence of nocardiosis among allogeneic HCT recipients. In particular, trimethoprim-sulfamethoxazole prophylaxis was found to protect against nocardiosis.
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Affiliation(s)
- Julien De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Dina Averbuch
- Pediatric Infectious Diseases, Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel
| | - Laura Tondeur
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 75015 Paris, France
| | - Amélie Duréault
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - Tsila Zuckerman
- Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Xavier Roussel
- Department of Hematology, University of Franche-Comte, INSERM UMR1098, Besançon University Hospital, Besançon, France
| | - Christine Robin
- Department of Hematology, Henri Mondor University Hospital, Creteil, France
| | - Alienor Xhaard
- Hematology-Transplantation, Hospital St-Louis, Paris Diderot University, Paris, France
| | - Simona Pagliuca
- Hematology Department, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Yves Beguin
- Centre Hospitalier Universitaire of Liège and University of Liège, Liège, Belgium
| | | | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | | | - Jens Van Praet
- Department of Nephrology and Infectious Diseases, Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Brugge, Belgium
| | | | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center, Hamburg, Germany
| | | | | | - Mahmoud Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | - Matthew Collin
- Nordern Centre for Bone Marrow Transplantation Freeman Hospital - Adult HSCT Unit, Newcastle, United Kingdom
| | - Arnold Ganser
- Department of Hematology Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Alban Villate
- Service d'hématologie et thérapie cellulaire, Centre Hospitalier Universitaire de Tours, Université de Tours, Tours, France
| | - Johannes Lakner
- Medical Clinic III, University Medical Center, Rostock, Germany
| | | | - Arnon Nagler
- Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Ron Ram
- Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anna Torrent
- ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain
| | | | - Malgorzata Mikulska
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lidia Gil
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Lotus Wendel
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Gloria Tridello
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Nina Knelange
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Rafael de la Camara
- Hospital de la Princesa, Madrid, Spain; Infectious Diseases Working Party, EBMT, Spain
| | - Olivier Lortholary
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 75015 Paris, France; Unité PACRI, Conservatoire National des Arts et Métiers, 75003 Paris, France
| | - Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Johan Maertens
- Department of Hematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Julien Coussement
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia; Service de Maladies Infectieuses et Tropicales, Centre Hospitalier universitaire de Guadeloupe, Les Abymes, Guadeloupe, France.
| | - David Lebeaux
- Institut Pasteur, Université Paris Cité, CNRS UMR 6047, Genetics of Biofilms Laboratory, 75015 Paris, France; Département de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Saint-Louis, Lariboisière, F-75010 Paris, France
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El-Sayed MH, Abdellatif MM, Mostafa HM, Elsehemy IA, Kobisi AENA. Biodegradation and antimicrobial capability-induced heavy metal resistance of the marine-derived actinomycetes Nocardia harenae JJB5 and Amycolatopsis marina JJB11. World J Microbiol Biotechnol 2024; 40:202. [PMID: 38743315 DOI: 10.1007/s11274-024-04006-x] [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: 09/21/2023] [Accepted: 04/25/2024] [Indexed: 05/16/2024]
Abstract
Currently, heavy metal-resistant (HMR) marine actinomycetes have attracted much attention worldwide due to their unique capabilities. In this study, 27 marine-derived actinomycetes were isolated from coastal beaches in the Arabian Gulf of Al-Jubail in Saudi Arabia and screened for resistance to 100 mg/L of the heavy metals Cd2+, Cr6+, Cu2+, Fe2+, Pb2+, and Ni2+ using different assay techniques. Six isolates were selected as HMRs, of which two isolates, JJB5 and JJB11, exhibited the highest maximum tolerance concentrations (200- > 300 mg/L). Both isolates were the highest among six-HMR screened for their biodegradation potential of plastics low-density polyethylene, polystyrene, and polyvinyl chloride, recording the highest weight loss (15 ± 1.22 - 65 ± 1.2%) in their thin films. They also showed the highest biodegradability of the pesticides acetamiprid, chlordane, hexachlorocyclohexane, indoxacarb and lindane, indicating promising removal capacities (95.70-100%) for acetamiprid and indoxacarb using HPLC analysis. Additionally, the cell-free filtrate (CFF) of both isolates displayed the highest antimicrobial activity among the six-HMR screened against a variety of microbial test strains, recording the highest inhibition zone diameters (13.76 ± 0.66 - 26.0 ± 1.13 mm). GC‒MS analyses of the ethyl acetate extract of their CFFs revealed the presence of diverse chemical compounds with a multitude of remarkable biological activities. Based on their spore morphology and wall-chemotype, they were assigned to the nocardioform-actinomycetes. Furthermore, their phenotypic characteristics, together with 16S rRNA gene sequencing (OR121525-OR121526), revealed them as Nocardia harenae JJB5 and Amycolatopsis marina JJB11. Our results suggest that marine HMR actinomycetes are promising candidates for various biotechnological applications.
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Affiliation(s)
- Mohamed H El-Sayed
- Department of Biology, College of Science and Arts-Rafha, Northern Border University, Arar, Saudi Arabia.
- Department of Botany and Microbiology, Faculty of Science, Al-Azhar University, Cairo, 11884, Egypt.
| | - Muaz M Abdellatif
- Department of Biology, College of Science and Arts-Rafha, Northern Border University, Arar, Saudi Arabia
| | - Howayada M Mostafa
- Department of Chemistry, College of Science and Arts-Rafha, Northern Border University, Arar, Saudi Arabia
| | - Islam A Elsehemy
- Department of Natural and Microbial Products Chemistry, Division of Pharmaceutical and Drug Industries Research, National Research Centre, Cairo, Egypt
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Xu X, Liu Z, Xia X. Acute Primary Cutaneous Nocardiosis. Am J Trop Med Hyg 2024; 110:848-849. [PMID: 38531103 PMCID: PMC11066350 DOI: 10.4269/ajtmh.23-0584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 02/12/2024] [Indexed: 03/28/2024] Open
Affiliation(s)
- Xiaokang Xu
- Changxing Skin Disease Hospital, Changxing County, Zhejiang, China
| | - Zehu Liu
- Department of Dermatology, Hangzhou Third People’s Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiujiao Xia
- Department of Dermatology, Hangzhou Third People’s Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
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Tan J, Huang B, Luo S, Li R, Hou J, Zhang R, Wang L, Liu Y, Li F, Feng J. A rare case of severe pneumonia combined with septic shock caused by Nocardia amamiensis. Travel Med Infect Dis 2024; 59:102710. [PMID: 38467232 DOI: 10.1016/j.tmaid.2024.102710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 03/13/2024]
Affiliation(s)
- Jishan Tan
- Department of Medical Laboratory, The General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Bo Huang
- Department of Burn and Plastic, The General Hospital of Western Theater Command, Chengdu, 610083, Sichuan, China
| | - Shuhong Luo
- Department of Respiratory and Critical Care Medicine, The First People's Hospital of Shuangliu District, Chengdu, China
| | - Rongyang Li
- Department of Anesthesiology and Pain, The General Hospital of Western Theater Command, Chengdu, 610083, Sichuan, China
| | - Juanni Hou
- Department of Gastroenterology, The General Hospital of Western Theater Command, Chengdu, 610083, Sichuan, China
| | - Ru Zhang
- Department of Medical Laboratory, The General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Lu Wang
- Department of Medical Laboratory, The General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Yuan Liu
- Department of Medical Laboratory, The General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Fuxiang Li
- Department of Critical Care Medicine, The General Hospital of Western Theater Command, Chengdu, 610083, Sichuan, China
| | - Jian Feng
- Department of Critical Care Medicine, The General Hospital of Western Theater Command, Chengdu, 610083, Sichuan, China.
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Corsini Campioli C, Abu Saleh O, Mara KC, Rivera CG. Observational study of the clinical utility of sulfamethoxazole serum level monitoring in the treatment of brain abscesses due to Nocardia species. Medicine (Baltimore) 2022; 101:e28951. [PMID: 35244054 PMCID: PMC8896426 DOI: 10.1097/md.0000000000028951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/11/2022] [Indexed: 01/04/2023] Open
Abstract
Although there is a lack of data in trimethoprim-sulfamethoxazole (TMP-SMX) serum monitoring utility for invasive nocardial infections, therapeutic drug monitoring is widely used to optimize dosing and avoid adverse reactions that may cause treatment interruption.We retrospectively reviewed all adults who received TMP-SMX to treat nocardial brain abscess and had SMX serum level testing from 2010 to 2020.Twenty-two patients received treatment with TMP-SMX for Nocardia species brain abscess and 16 (72.7%) had a reported SMX level, with a median patient age of 65.5 years (interquartile range, IQR 59.5-72.5). Compared to those who did not have a documented SMX serum level, patients with SMX levels had a shorter median course of TMP-SMX treatment (322 days [IQR 188-365] vs. 365 [IQR 224-365]; P = .31) and higher therapeutic induction dose (10 [62.5%] vs. 3 [50%]; P = .92). Similarly, they were more frequently on hemodialysis (3 [13.6%] vs. 1 [4.5%]; P = > .99). The median peak level was 158.5 (IQR 120-218) μg/mL, collected at 2 hours (75%) post-administration in the induction phase (81.3%). Patients with documented SMX levels had fewer reported drug toxicity (5 [31.3%] vs. 4 [66.7%]; P = .1) than those without SMX levels. Among the five patients who reported TMP-SMX-related toxicity, 4 (80%) had an SMX peak level >150 μg/mL. There was no difference in the cure, relapse, and death rates among the two groups.While SMX level was not associated with Nocardia species brain abscess cure rates and mortality, most patients with SMX peak >150 μg/mL experienced drug toxicity.
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Affiliation(s)
| | - Omar Abu Saleh
- Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN
| | - Kristin C. Mara
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
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Caso Coelho V, Pereira Neves SD, Cintra Giudice M, Benard G, Lopes MH, Sato PK. Evaluation of antimicrobial susceptibility testing of Nocardia spp. isolates by broth microdilution with resazurin and spectrophotometry. BMC Microbiol 2021; 21:331. [PMID: 34865615 PMCID: PMC8647337 DOI: 10.1186/s12866-021-02394-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/19/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Nocardia species are ubiquitous in natural environments and can cause nocardiosis. In the present study, the use of Resazurin salt and Spectrophotometry were proposed as alternative methods to reduce subjectivity in the interpretation of susceptibility results to antimicrobials by the broth microdilution method for Nocardia spp. RESULTS The susceptibility of Nocardia spp. isolates to Amikacin, Ciprofloxacin, Minocycline and Trimethoprim-Sulfamethoxazole was evaluated by Minimum Inhibitory Concentration (MIC) determinations by the broth microdilution method. To verify cellular growth, the colour-changing dye Resazurin was applied, the Optical Densities were measured on a spectrophotometer, and both were compared to Clinical and Laboratory Standards Institute (CLSI) Gold Standard method (visual MIC determination). Percentages of essential and categorical agreements and interpretative categorical errors were calculated within each method (intra-reading) and between them (inter-reading). The Gold Standard visual reading demonstrated 100% of essential and categorical intra-reading agreements for Amikacin, and there was no error when compared with the alternative methods. For Ciprofloxacin, the comparison between the Gold Standard and the Spectrophotometric reading showed 91.5% of essential agreement. In the categorical intra-reading analysis for Minocycline, there were 88.1 and 91.7% in the Gold Standard and in the Spectrophotometric readings, respectively, and 86.4% of concordance between them. High rates of categorical agreement were also observed on the Trimethoprim-Sulfamethoxazole analyses, with 93.7% for the Gold Standard, 84.9% for the Resazurin readings, and 80.5% between them. CONCLUSIONS The alternative methods with Resazurin and Spectrophotometric readings showed high agreement rates with the Gold Standard.
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Affiliation(s)
- Vivian Caso Coelho
- Laboratory of Medical Investigation in Immunology (LIM48), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas Carvalho de Aguiar 470, IMT 2, terreo, Sao Paulo, SP, 05403-000, Brazil
- Department of Infectious Diseases, FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Mauro Cintra Giudice
- Laboratory of Medical Investigation in Micology (LIM53), HCFMUSP, Sao Paulo, Brazil
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Present Address: Faculdades Oswaldo Cruz, Sao Paulo, Brazil
| | - Gil Benard
- Laboratory of Medical Investigation in Micology (LIM53), HCFMUSP, Sao Paulo, Brazil
- Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Marta Heloisa Lopes
- Laboratory of Medical Investigation in Immunology (LIM48), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas Carvalho de Aguiar 470, IMT 2, terreo, Sao Paulo, SP, 05403-000, Brazil
- Department of Infectious Diseases, FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Paula Keiko Sato
- Laboratory of Medical Investigation in Immunology (LIM48), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas Carvalho de Aguiar 470, IMT 2, terreo, Sao Paulo, SP, 05403-000, Brazil.
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Affiliation(s)
- Yi-Wei Lee
- Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsin-Yi Liu
- Taipei Medical University Hospital, Taipei, Taiwan
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Del Rio-Rodriguez RE, Ramirez-Paredes JG, Soto-Rodriguez SA, Shapira Y, Huchin-Cortes MDJ, Ruiz-Hernandez J, Gomez-Solano MI, Haydon DJ. First evidence of fish nocardiosis in Mexico caused by Nocardia seriolae in farmed red drum (Sciaenops ocellatus, Linnaeus). J Fish Dis 2021; 44:1117-1130. [PMID: 33848372 DOI: 10.1111/jfd.13373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/18/2021] [Accepted: 03/26/2021] [Indexed: 06/12/2023]
Abstract
Between August and December 2013, the offshore cages of a commercial marine farm culturing red drum Sciaenops ocellatus in Campeche Bay Mexico were affected by an outbreak of an ulcerative granulomatous disease with up to 70% cumulative mortality. Thirty-one adults displaying open ulcers on the skin were submitted for diagnosis. At necropsy, multiple white-yellowish nodules (0.1-0.5 cm in diameter) were present in all internal organs, where the kidney and the spleen were the most severely affected. Histopathology evinced typical systemic granulomatous formations. Gram and Ziehl-Neelsen stains on tissue imprints, bacterial swabs and tissue sections revealed Gram-positive, acid-fast, branching beaded long rod filamentous bacteria. Tissue samples resulted positive for nocardiosis with a Nocardia genus-specific nested PCR. Definite identification at the species level and taxonomic positioning of the fastidious pathogen were achieved through a specific Nocardia seriolae PCR and by sequencing the gyrB gene of pure isolates. After administration of antibiotics during fry production, a posterior follow-up monitoring (from 2014 to 2017) detected mild but recurrent outbreaks of the bacteria with no seasonality pattern. To the extent of our knowledge, this is the first report of piscine nocardiosis in Mexico and the first time this disease is detected in red drum.
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Affiliation(s)
| | | | - Sonia Araceli Soto-Rodriguez
- Centro de Investigación en Alimentación y Desarrollo, Unidad Mazatlán en Acuicultura y Manejo Ambiental, Mazatlán Sinaloa, México
| | - Yechiam Shapira
- Phibro Israel - Aquaculture, Phibro Animal Health Corporation, Yoqneam, Israel
| | - Mariana Del Jesus Huchin-Cortes
- Laboratorio de Sanidad Acuícola, Instituto EPOMEX, Campus 6 de Investigaciones, Universidad Autónoma de Campeche, Campeche, México
| | - Judith Ruiz-Hernandez
- Laboratorio de Histología, Facultad de Ciencias Químico-Biológicas, Campus 5, Universidad Autónoma de Campeche, Campeche, México
| | - Monica Isela Gomez-Solano
- Laboratorio de Histología, Facultad de Ciencias Químico-Biológicas, Campus 5, Universidad Autónoma de Campeche, Campeche, México
| | - David J Haydon
- Ridgeway Biologicals Ltd. a Ceva Santé Animale Company, Berkshire, UK
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Lee EK, Kim J, Park DH, Lee CK, Kim SB, Sohn JW, Yoon YK. Disseminated nocardiosis caused by Nocardia farcinica in a patient with colon cancer: A case report and literature review. Medicine (Baltimore) 2021; 100:e26682. [PMID: 34398037 PMCID: PMC8294930 DOI: 10.1097/md.0000000000026682] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/07/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Nocardiosis is an uncommon and potentially life-threatening infection that usually affects immunocompromised hosts. No clinical guidelines have been established for managing this rare disease, and the optimal treatment modality remains unclear. Nocardia farcinica, a relatively infrequent pathogen of nocardiosis, causes a clinically aggressive infection. In addition to our patient data, our search of the literature for patients who presented with empyema caused by N. farcinica will provide fundamental information for optimal treatment modalities. PATIENT CONCERNS A 64-year-old man was diagnosed with empyema, 4 days following surgery for sigmoid colon cancer. Brain lesions were evaluated only after N. farcinica was isolated and identified as the causative pathogen through repeated culture tests. DIAGNOSES N. farcinica was isolated from the pleural effusion and confirmed as the pathogen through 16S rRNA sequencing. INTERVENTIONS The patient was successfully treated with tube thoracotomy, neurosurgical evacuation, and a combination of trimethoprim/sulfamethoxazole plus imipenem. Long-term antibiotic therapy was required to prevent recurrence. OUTCOMES Pyothorax showed a good clinical response to antimicrobial therapy and drainage of pleural effusion, whereas brain abscess did not respond to medical therapy and required surgery. The patient eventually recovered and continued chemotherapy as treatment for sigmoid colon cancer. LESSONS Although extremely rare, this report demonstrates the importance of considering Nocardia infection as the differential diagnosis in immunocompromised patients who present with empyema. In particular, because of the N. farcinica infection's tendency to spread and the resistance of the organism to antibiotics, aggressive evaluation of metastatic lesions and standardized support from microbiological laboratories are important. Surgery may be required in some patients with brain abscesses to improve the chance of survival.
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Affiliation(s)
- Eung Kyum Lee
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Jin Kim
- Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Dong-Hyuk Park
- Department of Neurosurgery, Korea University Medical Center, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Chang Kyu Lee
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Sun Bean Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Jang Wook Sohn
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Young Kyung Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
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Affiliation(s)
- Grant A Wintheiser
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic, Rochester, MN
| | - Elise R Venable
- Division of Anatomic/Clinical Pathology, Mayo Clinic, Rochester, MN
| | - Zelalem Temesgen
- Division of Infectious Diseases, Mayo Clinic Alix College of Medicine, Mayo Clinic, Rochester, MN.
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Rahdar HA, Gharabaghi MA, Bahador A, Shahraki-Zahedani S, Karami-Zarandi M, Mahmoudi S, Feizabadi MM. Pulmonary Nocardia ignorata Infection in Gardener, Iran, 2017. Emerg Infect Dis 2021; 26:610-611. [PMID: 32091362 PMCID: PMC7045840 DOI: 10.3201/eid2603.180725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Nocardia ignorata, which was first described in 2001, is a rare human pathogen. We report a case of pulmonary nocardiosis caused by this bacterium in a 55-year-old man from Iran. The patient, a gardener, had frequent exposure to soil and may have acquired the infection from that source.
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Hou J, Cao J, Tan P, Yu Y. Pneumocystis jiroveci pneumonia, Nocardia brasiliensis, and Mycobacterium tuberculosis co-infection in a myasthenia gravis patient: A case report. Medicine (Baltimore) 2021; 100:e24245. [PMID: 33429828 PMCID: PMC7793478 DOI: 10.1097/md.0000000000024245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 12/17/2020] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junctions that leads to fluctuating weakness and disabling fatigability. Due to difficulty in breathing caused by weakness of the respiratory muscles, patients with MG are more susceptible to pneumonia and other respiratory infections. As many patients with MG are given immunosuppressive therapy, this makes them more prone to infections. However, coinfection with 3 pathogens is very rare. PATIENT CONCERNS Here, we report the case of a 41-year-old gentleman with MG who was receiving long-term steroid therapy. He presented with a cough with pale brown expectoration that occurred without obvious inducement, severe pain in the scapula, as well as swelling and weakness of both legs. Despite undergoing treatment, but his symptoms did not improve, prompting two additional hospital admissions over a period of several months. DIAGNOSIS Bronchoscopy and bronchoalveolar lavage (BAL) were performed, revealing the presence of Pneumocystis jirovecii , Nocardia brasiliensis, and Mycobacterium tuberculosis (MTB). N brasiliensis was identified by positive modified acid-fast Kinyoun staining as well as a positive colony culture identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry from the BAL sample. MTB was confirmed using GeneXpert, and due to the limitations of the culture conditions, methenamine silver stain was used to confirm Pneumocystis jirovecii. Next-generation sequencing (NGS) assay of the BAL samples also confirmed these pathogens. INTERVENTIONS The patient was transferred to a designated tuberculosis hospital and received anti-infective and anti-TB treatment. OUTCOMES During treatment at the designated hospital, the patient developed gastrointestinal bleeding and impaired liver function. One month later, he developed multiple organ failure, consolidation of the left lower lung, and pan-drug resistant bacteremia. He refused further treatment and was discharged. CONCLUSION In conclusion, physicians should be aware of the predisposition of MG patients to co-infections, especially patients with metabolic disorders, to avoid inadequate treatment and poor patient outcomes. Due to the limitations of culture conditions, NGS should be considered as a new technique for identifying pathogens.
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MESH Headings
- Adult
- Bronchoalveolar Lavage Fluid/microbiology
- Coinfection
- Diagnosis, Differential
- Humans
- Male
- Myasthenia Gravis
- Mycobacterium tuberculosis/isolation & purification
- Nocardia/isolation & purification
- Pneumocystis carinii/isolation & purification
- Pneumonia, Bacterial/complications
- Pneumonia, Bacterial/diagnosis
- Pneumonia, Bacterial/microbiology
- Pneumonia, Pneumocystis/complications
- Pneumonia, Pneumocystis/diagnosis
- Pneumonia, Pneumocystis/microbiology
- Tuberculosis, Pulmonary/complications
- Tuberculosis, Pulmonary/diagnosis
- Tuberculosis, Pulmonary/microbiology
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Luo N, Tan S, Li X, Liu S, Singh S, Chen M, Yang W, He Y, Chen C, Liang M. Pulmonary nocardiosis in a patient with pemphigus foliaceus: case report and literature review. BMC Infect Dis 2021; 21:8. [PMID: 33407179 PMCID: PMC7788831 DOI: 10.1186/s12879-020-05673-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/30/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Nocardiosis is an uncommon opportunistic infection seen in immunocompromised patients or those with a dysfunctional immune system. Nocardia asteroides infection in patients with Pemphigus foliaceus (PF) has never been reported. CASE PRESENTATION We report an interesting case of nocardiosis-characterized by pulmonary intra-cavitary infection, in a 54-year-old man with PF and diabetes mellitus. The man finally recovered from the infection. CONCLUSIONS This is the first case reporting pulmonary nocardiosis in a patient with PF. We recommend that physicians be aware of nocardiosis in patients with pemphigus as a possible cause of underlying infectious disease to avoid misdiagnoses and mismanagement.
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Affiliation(s)
- Ning Luo
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China
| | - Shifan Tan
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China
| | - Xiaocai Li
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China
| | - Si Liu
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China
| | | | - Mafeng Chen
- Department of Otorhinolaryngology, Maoming People's Hospital, Maoming, China
| | - Weiye Yang
- Department of Laboratory Medicine, Maoming People's Hospital, Maoming, China
| | - Yanhong He
- Department of Scientific Research, Maoming People's Hospital, Maoming, China
| | - Chunna Chen
- Department of Dermatology, Maoming People's Hospital, Maoming, China
| | - Min Liang
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China.
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15
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Cortez de Almeida RF, Correia RES, Varón AG, de Oliveira Coelho JMC, de Oliveira AP, Lourenço MCS, Ribeiro da Silva EADS, Conceição EC, Lamas CDC, Freitas DFS. Actinomycetoma with systemic features: A warning sign for immunosuppression? PLoS Negl Trop Dis 2020; 14:e0008865. [PMID: 33270626 PMCID: PMC7714237 DOI: 10.1371/journal.pntd.0008865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | - Andréa Gina Varón
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Ana Paola de Oliveira
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Emilyn Costa Conceição
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Cristiane da Cruz Lamas
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Grande Rio University, Rio de Janeiro, Brazil
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16
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Kanchanasin P, Yuki M, Kudo T, Ohkuma M, Phongsopitanun W, Tanasupawat S. Nocardia terrae sp. nov., an actinomycete isolated from soil in Thailand. Arch Microbiol 2020; 203:1071-1077. [PMID: 33146799 DOI: 10.1007/s00203-020-02107-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/27/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/27/2022]
Abstract
A novel actinomycete strain ET3-3T isolated from soil collected from Chachoengsao province, Thailand was taxonomic evaluated using a polyphasic approach. Chemotaxonomic analysis indicated that meso-diaminopimelic acid was the diagnostic diamino acid in the cell-wall peptidoglycan. Mycolic acids were present. Ribose, arabinose, and galactose were detected in its whole-cell hydrolysates. The strain comprised C16:0 and TBSA 10-methyl C18:0 as the main fatty acids and MK-8(H4ω-cycl) as the predominant menaquinone. Major polar lipids were phosphatidylinositol, phosphatidylinositol mannoside, phosphatidylethanolamine, and diphosphatidylglycerol. The results of 16S rRNA gene sequence analysis showed that strain ET3-3T was closely related to Nocardia seriolae JCM 30082T (99.2%), Nocardia yunnanensis JCM 30082T (98.4%), and Nocardia concava JCM 12351T (98.2%). The draft genome of ET3-3T was 9.31 Mb with 8826 coding sequences with an average G + C content of 68.0%. The comparison of the draft genome of strain ET3-3T and N. seriolae NBRC 15557T showed the ANIb, ANIm and the digital DNA-DNA hybridization values of 86.3%, 88.5% and 32.9%, respectively. The results of the taxonomic analysis suggested that strain ET3-3T represented a novel species of the genus Nocardia for which the name Nocardia terrae sp. nov. is proposed. The type strain is ET3-3T (= JCM 33776T = TISTR 2837T).
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Affiliation(s)
- Pawina Kanchanasin
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
| | - Masahiro Yuki
- Japan Collection of Microorganisms, RIKEN BioResource Center, 3-1-1 Koyadai, Tsukuba, Ibaraki, 305-0074, Japan
| | - Takuji Kudo
- Japan Collection of Microorganisms, RIKEN BioResource Center, 3-1-1 Koyadai, Tsukuba, Ibaraki, 305-0074, Japan
| | - Moriya Ohkuma
- Japan Collection of Microorganisms, RIKEN BioResource Center, 3-1-1 Koyadai, Tsukuba, Ibaraki, 305-0074, Japan
| | - Wongsakorn Phongsopitanun
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
| | - Somboon Tanasupawat
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand.
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17
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Benndorf R, Schwitalla JW, Martin K, de Beer ZW, Vollmers J, Kaster AK, Poulsen M, Beemelmanns C. Nocardia macrotermitis sp. nov. and Nocardia aurantia sp. nov., isolated from the gut of the fungus-growing termite Macrotermes natalensis. Int J Syst Evol Microbiol 2020; 70:5226-5234. [PMID: 32815801 PMCID: PMC7660896 DOI: 10.1099/ijsem.0.004398] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/30/2020] [Indexed: 12/15/2022] Open
Abstract
The taxonomic positions of two novel aerobic, Gram-stain-positive Actinobacteria, designated RB20T and RB56T, were determined using a polyphasic approach. Both were isolated from the fungus-farming termite Macrotermes natalensis. Results of 16S rRNA gene sequence analysis revealed that both strains are members of the genus Nocardia with the closest phylogenetic neighbours Nocardia miyunensis JCM12860T (98.9 %) and Nocardia nova DSM44481T (98.5 %) for RB20T and Nocardia takedensis DSM 44801T (98.3 %), Nocardia pseudobrasiliensis DSM 44290T (98.3 %) and Nocardia rayongensis JCM 19832T (98.2 %) for RB56T. Digital DNA-DNA hybridization (DDH) between RB20T and N. miyunensis JCM12860T and N. nova DSM 44481T resulted in similarity values of 33.9 and 22.0 %, respectively. DDH between RB56T and N. takedensis DSM44801T and N. pseudobrasiliensis DSM44290T showed similarity values of 20.7 and 22.3 %, respectively. In addition, wet-lab DDH between RB56T and N. rayongensis JCM19832T resulted in 10.2 % (14.5 %) similarity. Both strains showed morphological and chemotaxonomic features typical for the genus Nocardia, such as the presence of meso-diaminopimelic acid (A2pm) within the cell wall, arabinose and galactose as major sugar components within whole cell-wall hydrolysates, the presence of mycolic acids and major phospholipids (diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylinositol), and the predominant menaquinone MK-8 (H4, ω-cyclo). The main fatty acids for both strains were hexadecanoic acid (C16 : 0), 10-methyloctadecanoic acid (10-methyl C18 : 0) and cis-9-octadecenoic acid (C18 : 1 ω9c). We propose two novel species within the genus Nocardia: Nocardia macrotermitis sp. nov. with the type strain RB20T (=VKM Ac-2841T=NRRL B65541T) and Nocardia aurantia sp. nov. with the type strain RB56T (=VKM Ac-2842T=NRRL B65542T).
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Affiliation(s)
- René Benndorf
- Leibniz Institute for Natural Product Research and Infection Biology e. V., Hans-Knöll-Institute, Beutenbergstraße 11a, 07745 Jena, Germany
| | - Jan W. Schwitalla
- Leibniz Institute for Natural Product Research and Infection Biology e. V., Hans-Knöll-Institute, Beutenbergstraße 11a, 07745 Jena, Germany
| | - Karin Martin
- Leibniz Institute for Natural Product Research and Infection Biology e. V., Hans-Knöll-Institute, Beutenbergstraße 11a, 07745 Jena, Germany
| | - Z. Wilhelm de Beer
- Department of Microbiology and Plant Pathology, Forestry and Agriculture Biotechnology Institute, University of Pretoria, 0028 Hatfield, South Africa
| | - John Vollmers
- Institute for Biological Interfaces (IBG 5), Karlsruhe Institute of Technology, Hermann-von- Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Anne-Kristin Kaster
- Institute for Biological Interfaces (IBG 5), Karlsruhe Institute of Technology, Hermann-von- Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Michael Poulsen
- University of Copenhagen, Department of Biology, Section for Ecology and Evolution, Universitetsparken 15, 2100 Copenhagen East, Denmark
| | - Christine Beemelmanns
- Leibniz Institute for Natural Product Research and Infection Biology e. V., Hans-Knöll-Institute, Beutenbergstraße 11a, 07745 Jena, Germany
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18
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Zhou T, Wang XY, Deng DQ, Xu LH, Li XL, Guo Y, Li WH, Xie H, Zhang PL, Zhou XH. Nocardia colli sp. nov., a new pathogen isolated from a patient with primary cutaneous nocardiosis. Int J Syst Evol Microbiol 2020; 70:2981-2987. [PMID: 32375925 PMCID: PMC7395626 DOI: 10.1099/ijsem.0.003856] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A novel nocardioform strain, CICC 11023T, was isolated from a tissue biopsy of neck lesions of a patient with primary cutaneous nocardiosis and characterized to establish its taxonomic position. The morphological, biochemical, physiological and chemotaxonomic properties of strain CICC 11023T were consistent with classification in the genus Nocardia. Whole-cell hydrolysates were rich in meso-diaminopimelic acid, galactose, arabinose and fructose. Mycolic acids were present. The major polar lipids were diphosphatidylglycerol, phosphatidylethanolamine, one unidentified phospholipid and two unidentified lipids, and the predominant menaquinone was cyclo MK-8 (H4, ω-cyclo). The main fatty acids (>5 %) were C18 : 0 10-methyl (TBSA), C16 : 0, summed feature 4 (C16 : 1 trans 9/C15 : 0 iso 2OH), C15 : 0 and C17 : 0 10-methyl. Phylogenetic analyses based on 16S rRNA gene sequences revealed that the isolate is most closely related (>98 % similarity) to the type strains Nocardia ninae OFN 02.72T, Nocardia iowensis UI 122540T and Nocardia alba YIM 30243T, and phylogenetic analysis of gyrB gene sequences showed similarity (89.1–92.2 %) to Nocardia vulneris NBRC 108936T, Nocardia brasiliensis IFM 0236T and Nocardia exalbida IFM 0803T. DNA–DNA hybridization results for strain CICC 11023T compared to Nocardia type strains ranged from 20.4 to 35.4 %. The genome of strain CICC 11023T was 8.78 Mbp with a G+C content of 67.4 mol% overall. The average nucleotide identity (ANI) values between strain CICC 11023T and N. alba YIM 30243T were low (OrthoANIu=77.47 %), and the ANI values between strain CICC 11023T and N. vulneris NBRC 108936 T were low (OrthoANIu=83.75 %). Consequently, strain CICC 11023T represents a novel Nocardia species on the basis of this polyphasic study, for which the name Nocardia colli sp. nov. is proposed. The type strain is CICC 11023T (=KCTC 39837T).
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Affiliation(s)
- Tao Zhou
- Department of Clinical Laboratory Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, PR China
| | - Xiao-Yun Wang
- Department of Dermatology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, PR China
- *Correspondence: Xiao-Yun Wang,
| | - Dan-Qi Deng
- Department of Dermatology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, PR China
| | - Li-Hua Xu
- The Key Laboratory of Microbial Diversity in Southwest China, Ministry of Education and Laboratory for Conservation and Utilization of Bio-resources, Yunnan Institute of Microbiology, Yunnan University, Kunming, Yunnan 650091, PR China
| | - Xiao-Lan Li
- Department of Dermatology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, PR China
| | - Yun Guo
- Department of Dermatology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, PR China
| | - Wen-Hua Li
- Department of Dermatology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, PR China
| | - Hong Xie
- Department of Dermatology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, PR China
| | - Pei-Lian Zhang
- Department of Dermatology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, PR China
| | - Xiao-Hong Zhou
- Department of Dermatology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, PR China
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19
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Mylle S, Mylle T, Mylle J. Nocardia Farcinica infection of a reversed shoulder prosthesis : case report and review. Acta Orthop Belg 2020; 86:200-204. [PMID: 33418607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We present a case of Nocardia farcinica after placement of reverse shoulder prosthesis in a 73-year-old woman. One month after surgery, the patient was admitted to the hospital with a spontaneous drainage of the wound and complaints of aggravating pain in the operated shoulder. There was no history of an immunosuppressive disease or therapy. After cultivation and empiric therapy with flucloxacillin, Nocardia farcinica was found and treated with a combination of intravenous amikacin and ceftriaxone. Eight days after drainage, a rinse and replacement of the polyethylene cup and glenosphere was executed. The treatment was proven to be successful whereas X-ray scans showed no complications nor any other consequences up until five years after therapy. To our knowledge, this is the first shoulder prosthetic Nocardia infection published in English literature. The aim of this report is to review/gather the knowledge about this particular infection and inform health care providers about this uncommon case.
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Affiliation(s)
- Heer H. Mehta
- Department of BioSciences, Rice University, Houston, Texas, United States of America
- * E-mail:
| | - Yousif Shamoo
- Department of BioSciences, Rice University, Houston, Texas, United States of America
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21
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Guo J, Li S, Xu S, Jiang L, Gao E, Liu Z. Nocardiosis in patients with nephrotic syndrome: a retrospective analysis of 11 cases and a literature review. Int Urol Nephrol 2020; 52:731-738. [PMID: 32124233 DOI: 10.1007/s11255-020-02415-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/21/2019] [Accepted: 02/17/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We evaluated the clinical manifestations and outcomes of nocardiosis, a rare opportunistic infection that occurs in patients with nephrotic syndrome. METHODS The records of NS patients with nocardiosis in a single hospital during 2000-2019 were retrieved and studied in detail. RESULTS Eleven patients were included. The mean time to develop nocardiosis after glucocorticoid therapy was 11.5 ± 14.8 months. Most patients had fever, elevated white blood cell counts and C-reactive protein, whereas procalcitonin levels were normal or slightly elevated in 91% (10/11) patients, except one patient suffered from septic shock. Nine patients were tested for CD4+ T-cell counts; of these, four patients had counts < 200 cells/μL. The most common site of nocardiosis involvement was lung (100%), followed by subcutaneous tissue (72.7%). Radiological findings for lungs in seven cases were characterized by isolated or scattered nodules and masses, usually located subpleural or close to the hilum. Positive smears of Nocardia were detected in 100% of samples of subcutaneous abscess and pleural fluid. Nine patients received oral trimethoprim-sulfamethoxazole, four of which received combined carbapenem, and the remaining two patients received carbapenem monotherapy. The long-term prognosis was excellent, with a treatment success rate of 100% in all patients. CONCLUSIONS NS patients can develop immunodeficiency after treatment with glucocorticoid and immunosuppressants. In cases where patients develop systemic multiple abscesses, or lung images reveal isolated or scattered nodules and masses that are subpleural or close to the hilum, nocardial infection should be considered. Early diagnosis and specific treatment may improve patient outcomes.
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Affiliation(s)
- Jinzhou Guo
- Department of Nephrology, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China
| | - Shijun Li
- Department of Nephrology, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China.
| | - Shutian Xu
- Department of Nephrology, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China
| | - Ling Jiang
- Department of Nephrology, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China
| | - Erzhi Gao
- Department of Nephrology, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China
| | - Zhihong Liu
- Department of Nephrology, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China
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Abstract
Nocardiosis is an opportunistic infection occurring in immunosuppressed patients. While disseminated nocardiosis is common in immunosuppressed patients, Nocardia bacteraemia is rare. There are few reports of Nocardia bacteraemia following solid organ transplantation. We report two cases of Nocardia bacteraemia in solid organ transplant recipients-Nocardia cyriacigeorgica bacteraemia in liver transplant recipient and concomitant Nocardia farcinica bacteraemia and cyclosporiasis in a heart transplant recipient. Prompt recognition of early bacteraemia with initiation of antibiotic therapy may avoid the complications of disseminated disease in the solid organ transplant recipients.
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Affiliation(s)
- Ranganathan N Iyer
- Department of Clinical Microbiology and Infection Control, Gleneagles Global Hospitals, Hyderabad, Telangana, India
| | - Jangam Rekha Rao
- Department of Clinical Microbiology and Infection Control, Gleneagles Global Hospitals, Hyderabad, Telangana, India
| | - Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dharmesh Kapoor
- Department of Medical Gastroenterology and Hepatology, Gleneagles Global Hospitals, Hyderabad, Telangana, India
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23
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Ge YL, Zhu XY, Hu K, Zhang Q, Li WQ, Zhang C, Shao DF, Wang L, Zhang HF, Liu CH, Chen Y, Chen QC, Jin JJ, Xu TT, Fu AS. Positive Serum Beta-D-glucan by G Test and Aspergillus Fumigatus Sputum Culture Mimic Invasive Pulmonary Aspergillosis in a Pulmonary Nocardia Patient: a Case Report and Literature Review. Clin Lab 2019; 65. [PMID: 31232022 DOI: 10.7754/clin.lab.2018.181105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Invasive pulmonary aspergillosis and nocardia overlap in clinical and radiological presentations, so differentiating between nocardia and invasive pulmonary aspergillosis is confusing. Though sputum culture could distinguish between nocardia and aspergillus fumigatus, but for the ultimate diagnosis, sputum culture provided limited help. Here we report a case of a patient with positive G test and aspergillus fumigatus sputum culture mimic invasive pulmonary aspergillosis ultimately diagnosed as nocardia through bronchoalveolar lavage culture combined metagenomic next-generation sequencing (NGS). METHODS Bronchoalveolar lavage culture combined metagenomic NGS for infectious diseases were performed for diagnosis. RESULTS Bronchoalveolar lavage culture combined metagenomic next-generation sequencing showed Nocardia Gelsenkirchen. CONCLUSIONS Positive G test and sputum culture were not specific, while bronchoalveolar lavage culture and NGS gave more information for a differential diagnosis between nocardia and aspergillus fumigatus.
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Huang L, Sun L, Yan Y. Characteristics of nocardiosis patients with different immune status from a Chinese tertiary general hospital during 8-year period: A STROBE-compliment observational study. Medicine (Baltimore) 2019; 98:e17913. [PMID: 31702669 PMCID: PMC6855654 DOI: 10.1097/md.0000000000017913] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Nocardia is an opportunistic pathogen from environment, which is generally thought to infect immunosuppressed patients (ISPs), but recent studies showed it could also cause infections in immunocompetent patients (ICPs).The aim of this study was to compare the clinical characteristics, patients' outcome, Nocardia species' identification, and antibiotic susceptibility profiles of nocardiosis between ICPs and ISPs.The detailed clinical data were collected from all the nonrepetitive nocardiosis patients during 2011 and 2018, from a tertiary general hospital in Beijing, China. Then each Nocardia isolate was identified to species level by DNA sequencing. The antibiotic susceptibility testing was performed by E test method, and interpreted following CLSI M24 document. The clinical and microbiological characteristics between ICPs and ISPs were compared statistically.A total of 23 nonrepetitive nocardiosis patients with detailed clinical data were enrolled in this study. Among them, 9 were ICPs and 14 were ISPs. All the skin and soft tissue infections occurred in ICPs (33.3% vs 0%, P < .05). Bronchiectasis occurred more frequently in ICPs (44.4% vs 21.4%), whereas chronic kidney diseases and coinfection with aspergillosis occurred more frequently in ISPs (35.7% vs 0%, 35.7% vs 0%, respectively), although they did not reach the statistical significance. There were no significant differences in other clinical characteristics, Nocardia species' identification, and antibiotic susceptibility between ISPs and ICPs (P > .05).Nocardiosis could occur in both ISPs and ICPs. Skin and soft tissue infection and bronchiectasis occurred more frequently in ICPs. Chronic kidney diseases and co-infection with aspergillosis occurred more frequently in ISPs. These characteristics should be noticed by physicians in diagnosis of nocardiosis.
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Riswold KJ, Tjarks BJ, Kerkvliet AM. Cutaneous nocardiosis in an immunocompromised patient. Cutis 2019; 104:226-229. [PMID: 31774884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We describe a case of a 79-year-old man with chronic lymphocytic leukemia (CLL) who presented with ataxia; falls; vision loss; and numerous mobile erythematous nodules on the chin, neck, scalp, and trunk. Computed tomography of the head and chest revealed cavitary lesions in the brain and lungs. Clinically, the skin nodules were believed to represent an infectious process. Two punch biopsies were obtained, which revealed an unremarkable epidermis with a mixed inflammatory infiltrate with abscess formation in the dermis. Gram stain highlighted gram-positive branching bacterial organisms. Similar organisms were identified in a bronchoalveolar lavage specimen. Cultures from skin and blood were positive for Nocardia. Our case serves as a reminder to clinicians and pathologists to keep a broad differential diagnosis when dealing with infectious diseases in immunocompromised patients.
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Affiliation(s)
- Kayla J Riswold
- Sanford School of Medicine, University of South Dakota, Sioux Falls, USA
| | - Brian Joel Tjarks
- Department of Pathology, Sanford School of Medicine, University of South Dakota, Sioux Falls, USA
| | - Amy M Kerkvliet
- Department of Pathology, Sanford School of Medicine, University of South Dakota, Sioux Falls, USA
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Kato K, Noguchi S, Naito K, Ikushima I, Hanaka T, Yamasaki K, Kawanami T, Yatera K. Pulmonary Nocardiosis Caused by Nocardia exalbida in a Patient with Lung Cancer and Radiation Pneumonitis: A Case Report and Literature Review. Intern Med 2019; 58:1605-1611. [PMID: 30713323 PMCID: PMC6599924 DOI: 10.2169/internalmedicine.2177-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We report a case of Nocardia exalbida (N.exalbida)-induced pneumonia in a 70-year old Japanese man with lung cancer and radiation pneumonitis. He initially received doripenem (1.5 g/day) for pneumonia treatment, and N.exalbida was identified by a clone library analysis of bronchoalveolar lavage fluid obtained from the pneumonia lesion. The doripenem dosage was therefore increased to 3.0 g/day with adjunctive trimethoprim/sulfamethoxazole, and his pneumonia improved. N. exalbida is susceptible to antibiotics; thus, in nocardiosis, N. exalbida infection might be associated with a good response to treatment, although its clinical findings are non-specific and similar to those of other Nocardia infections.
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Affiliation(s)
- Kaori Kato
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Keisuke Naito
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Issei Ikushima
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Tetsuya Hanaka
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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Lee B, Drayna P, Maltry AC, Mason CM, Montezuma SR, Koozekanani D. ENDOGENOUS NOCARDIA ENDOPHTHALMITIS PRESENTING AS A MASS LESION IN A PATIENT WITH METATSTATIC NONSMALL CELL CARCINOMA OF THE LUNG. Retin Cases Brief Rep 2019; 13:145-149. [PMID: 28129236 DOI: 10.1097/icb.0000000000000545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE To report a case of Nocardia cyriacigeorgica endophthalmitis. METHODS Case report. RESULTS A 71-year-old man on long-term steroid therapy for poor respiratory function from lung carcinoma and presumed recent liver metastases presented with a four week history of blurry vision in the left eye. Ophthalmic examination revealed a white elevated mass in the macula with hemorrhage, concerning for metastasis. The patient was treated for presumed ocular metastases but had poor response to radiotherapy and was diagnosed four weeks later with N. cyriacigeorgica by retinal biopsy. Despite intravitreal and systemic antibiotics, the patient had progression of disease and died of respiratory involvement. CONCLUSION Nocardia endogenous endophthalmitis can present as a mass retinal lesion in immunosuppressed patients with metastatic disease. Early vitreous and retinal biopsy may be required for definitive diagnosis and treatment. A pulmonary source of infection should be suspected and monitored closely.
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Affiliation(s)
- Brian Lee
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
- Hennepin County Medical Center, Minneapolis, Minnesota
| | - Paul Drayna
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
| | - Amanda C Maltry
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
| | | | - Sandra R Montezuma
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
| | - Dara Koozekanani
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
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Bao L, Lin H, Dong L, Zhang Q, Shangguan Z. Imaging Findings of Pulmonary Nocardiosis Mimicking Bronchiectasis. J Coll Physicians Surg Pak 2019; 29:278-280. [PMID: 30823959 DOI: 10.29271/jcpsp.2019.03.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/18/2018] [Indexed: 06/09/2023]
Abstract
Nocardia species usually cause opportunistic infections, and the frequency of these infections is increasing owing to the growing population of immunocompromised hosts. However, Nocardia may sometimes causes an infectious disease in immunocompetent hosts. Herein, we report two cases of pulmonary nocardiasis in immunocompetent individuals, whose chest computed tomography (CT) findings mimicked bronchiectasis. Samples of bronchalveolar lavage (BAL) fluid obtained by bronchoscopy showed filamentous, branching, gram-positive rods, acid-fast filamentous branching rods, and a colony of suspected Nocardia was cultured. Based on 16sRNA and hsp65 gene sequence analysis, case 1 was identified as N. cyriacigeorgica, but case 2 was not matched. The patients responded well to treatment with the combination of sulfamethoxazole and linezolid.
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Affiliation(s)
- Lianmin Bao
- Department of Respiratory Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Heping Lin
- Department of Respiratory Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ling Dong
- Department of Respiratory Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qing Zhang
- Department of Respiratory Clinical Laboratory, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zongxiao Shangguan
- Department of Respiratory Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Affiliation(s)
- Tamio Okimoto
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, Japan
| | - Yukari Tsubata
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, Japan
| | - Mika Nakao
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, Japan
| | - Takeshi Isobe
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, Japan
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Charny JW, Nelson CA, Mochel M, Pugliese DJ. Ascending erythematous nodules on the arm. Cutis 2018; 102:E15-E17. [PMID: 30657810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Jacob W Charny
- Department of Dermatology, University of Illinois at Chicago College of Medicine, USA
| | - Caroline A Nelson
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Mark Mochel
- Department of Pathology, Virginia Commonwealth University Health System, Richmond, USA
| | - Douglas J Pugliese
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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Kim BS, Park JW, Kang GS, Jin JH, Roh HJ, Kim DH, Lee MK, Huh MD. First report of nocardia infection in cultured Japanese eel, Anguilla japonica. J Fish Dis 2018; 41:1921-1927. [PMID: 30132915 DOI: 10.1111/jfd.12882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Bo Seong Kim
- Department of Aquatic Life Medicine, College of Fisheries Science, Pukyong National University, Busan, Korea
| | - Ji Won Park
- Department of Aquatic Life Medicine, College of Fisheries Science, Pukyong National University, Busan, Korea
| | - Gyoung Sik Kang
- Department of Aquatic Life Medicine, College of Fisheries Science, Pukyong National University, Busan, Korea
| | - Ji Hye Jin
- Daon Fisheries disease management, Incheon, Korea
| | - Heyong Jin Roh
- Department of Aquatic Life Medicine, College of Fisheries Science, Pukyong National University, Busan, Korea
| | - Do Hyung Kim
- Department of Aquatic Life Medicine, College of Fisheries Science, Pukyong National University, Busan, Korea
| | - Mu Kun Lee
- Korean Aquatic Organism Disease Inspector Association, Busan, Korea
| | - Min Do Huh
- Department of Aquatic Life Medicine, College of Fisheries Science, Pukyong National University, Busan, Korea
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Ercibengoa M, Vicente D, Arranz L, Ugarte ASD, Marimon JM. Primary Cutaneous Nocardia brasiliensis in a Spanish Child. Clin Lab 2018; 64:1769-1772. [PMID: 30336526 DOI: 10.7754/clin.lab.2018.180531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND We report a case of a primary cutaneous nocardiosis by autochthonous Nocardia brasiliensis in a Spanish immunocompetent 9-year-old boy. METHODS N. brasiliensis caused cellulitis showing the patient recovery after drainage and treatment with trimethoprim-sulfamethoxazole. Nocardia grew in pure culture and its identification was confirmed by sequencing (16S rRNA) and by MALDI-TOF MS (Bruker, Daltonics, Germany). CONCLUSIONS In Spain although N. brasiliensis cutaneous infections in children are very infrequent should not be ruled out when an insect bite, stuck with a pine needle or an animal scratch has existed and the wound evolution is torpid.
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Ghodhbane-Gtari F, Nouioui I, Hezbri K, Lundstedt E, D'Angelo T, McNutt Z, Laplaze L, Gherbi H, Vaissayre V, Svistoonoff S, Ahmed HB, Boudabous A, Tisa LS. The plant-growth-promoting actinobacteria of the genus Nocardia induces root nodule formation in Casuarina glauca. Antonie Van Leeuwenhoek 2018; 112:75-90. [PMID: 30203358 DOI: 10.1007/s10482-018-1147-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 06/29/2018] [Accepted: 08/21/2018] [Indexed: 10/28/2022]
Abstract
Actinorhizal plants form a symbiotic association with the nitrogen-fixing actinobacteria Frankia. These plants have important economic and ecological benefits including land reclamation, soil stabilization, and reforestation. Recently, many non-Frankia actinobacteria have been isolated from actinorhizal root nodules suggesting that they might contribute to nodulation. Two Nocardia strains, BMG51109 and BMG111209, were isolated from Casuarina glauca nodules, and they induced root nodule-like structures in original host plant promoting seedling growth. The formed root nodule-like structures lacked a nodular root at the apex, were not capable of reducing nitrogen and had their cortical cells occupied with rod-shaped Nocardiae cells. Both Nocardia strains induced root hair deformation on the host plant. BMG111209 strain induced the expression of the ProCgNin:Gus gene, a plant gene involved in the early steps of the infection process and nodulation development. Nocardia strain BMG51109 produced three types of auxins (Indole-3-acetic acid [IAA], Indole-3-Byturic Acid [IBA] and Phenyl Acetic Acid [PAA]), while Nocardia BMG111209 only produced IAA. Analysis of the Nocardia genomes identified several important predicted biosynthetic gene clusters for plant phytohormones, secondary metabolites, and novel natural products. Co-infection studies showed that Nocardia strain BMG51109 plays a role as a "helper bacteria" promoting an earlier onset of nodulation. This study raises many questions on the ecological significance and functionality of Nocardia bacteria in actinorhizal symbioses.
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Affiliation(s)
- Faten Ghodhbane-Gtari
- Laboratoire Microorganismes et Biomolécules Actives, Université Tunis El Manar (FST) & Université Carthage (INSAT), Campus universitaire, 2092, Tunis, Tunisia
| | - Imen Nouioui
- Laboratoire Microorganismes et Biomolécules Actives, Université Tunis El Manar (FST) & Université Carthage (INSAT), Campus universitaire, 2092, Tunis, Tunisia
| | - Karima Hezbri
- Laboratoire Microorganismes et Biomolécules Actives, Université Tunis El Manar (FST) & Université Carthage (INSAT), Campus universitaire, 2092, Tunis, Tunisia
| | - Emily Lundstedt
- Department of Molecular, Cellular, and Biomedical Sciences, University of New Hampshire, Durham, NH, USA
| | - Timothy D'Angelo
- Department of Molecular, Cellular, and Biomedical Sciences, University of New Hampshire, Durham, NH, USA
| | - Zakkary McNutt
- Department of Molecular, Cellular, and Biomedical Sciences, University of New Hampshire, Durham, NH, USA
| | - Laurent Laplaze
- LSTM, UMR 040 IRD/INRA/CIRAD/ Université Montpellier/Supagro, TA A-82/J, Campus International de Baillarguet, 34398, Montpellier, CDX 5, France
- LCM, IRD/ISRA/UCAD, Centre de Recherche de Bel Air, BP 1386, Dakar, Senegal
- LMI LAPSE, Centre de Recherche de Bel Air, BP 1386, Dakar, Senegal
| | - Hassen Gherbi
- LSTM, UMR 040 IRD/INRA/CIRAD/ Université Montpellier/Supagro, TA A-82/J, Campus International de Baillarguet, 34398, Montpellier, CDX 5, France
| | - Virginie Vaissayre
- ECOBIO, French National Research Institute for Sustainable Development (IRD), Montpellier, France
| | - Sergio Svistoonoff
- LSTM, UMR 040 IRD/INRA/CIRAD/ Université Montpellier/Supagro, TA A-82/J, Campus International de Baillarguet, 34398, Montpellier, CDX 5, France
- LCM, IRD/ISRA/UCAD, Centre de Recherche de Bel Air, BP 1386, Dakar, Senegal
- LMI LAPSE, Centre de Recherche de Bel Air, BP 1386, Dakar, Senegal
| | - Hela Ben Ahmed
- Unité d'Ecophysiologie et Nutrition des plantes, Département de Biologie, Faculté des Sciences de Tunis, Tunis, Tunisia
| | - Abdelatif Boudabous
- Laboratoire Microorganismes et Biomolécules Actives, Université Tunis El Manar (FST) & Université Carthage (INSAT), Campus universitaire, 2092, Tunis, Tunisia
| | - Louis S Tisa
- Department of Molecular, Cellular, and Biomedical Sciences, University of New Hampshire, Durham, NH, USA.
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Khadka P, Basnet RB, Rijal BP, Sherchand JB. Pulmonary nocardiosis masquerading renascence of tuberculosis in an immunocompetent host: a case report from Nepal. BMC Res Notes 2018; 11:488. [PMID: 30016976 PMCID: PMC6050696 DOI: 10.1186/s13104-018-3604-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/13/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Pulmonary nocardiosis is an opportunistic infection in an immunocompromised patient; however, often neglected in the immunocompetent patient from the diagnosis considerations. CASE PRESENTATIONS We describe a case of pulmonary nocardiosis masquerading renascence of tuberculosis, in a 51-years-Nepali farmer. After a 6 month of presumed successful antitubercular therapy; the patient develops the clinical presentations and radiological features showing similarities with that of tuberculosis and malignancy. MTB complex was not detected with Xpert MTB/RIF assay and cytological examinations were negative for the malignant cells, however. The Ziehl-Neelsen staining of the broncho-alveolar-lavage revealed acid-fast, thin branching filamentous organisms suggestive Nocardia spp. Further, identifications and susceptibility pattern against recommended antibiotics were assessed as per the CLSI guidelines. The case was then, subsequently, diagnosed as pulmonary nocardiosis. Trimethoprim-sulfamethoxazole was prescribed for 12 months. The patient underwent progressive changes and no relapse was noted in a periodic follow-up. CONCLUSIONS This case underscores that pulmonary nocardiosis requires diagnostic considerations, regardless of a patient's immunologic status and other mimicking infections.
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Affiliation(s)
- Priyatam Khadka
- Tribhuvan University Teaching Hospital, Kathmandu, Nepal
- Trichandra Multiple Campus, Tribhuvan University, Ghantaghar, Kathmandu, Nepal
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McTaggart LR, Chen Y, Poopalarajah R, Kus JV. Incubation time and culture media impact success of identification of Nocardia spp. by MALDI-ToF mass spectrometry. Diagn Microbiol Infect Dis 2018; 92:270-274. [PMID: 30025971 DOI: 10.1016/j.diagmicrobio.2018.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 02/26/2018] [Revised: 06/11/2018] [Accepted: 06/20/2018] [Indexed: 11/18/2022]
Abstract
Identification of Nocardia can be challenging, even by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-ToF MS). We examined the impact of incubation duration, culture media and bead-beading on identification success. When isolates were grown for 3 days on SAB (Saboround dextrose agar), then extracted using a bead-beating, ethanol/formic acid (EtOH/FA) procedure, MALDI-ToF MS correctly identified 36.4% to species level. By contrast, 80.9% of isolates were correctly identified to species level when processed with the standard EtOH/FA extraction from Columbia blood agar (CBA) cultures incubated until colonies first appeared. Excluding rare species, the latter approach correctly identified 93.0% of isolates of commonly-encountered Nocardia species when additional database entries were included to expand representation of select species. We demonstrate that while bead-beating has little impact on identification success by MALDI-ToF MS, analysis of early growth is crucial. Additionally, culture media that promotes quick growth of Nocardia (e.g. CBA) is recommended.
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Affiliation(s)
- Lisa R McTaggart
- Public Health Ontario, 661 University Avenue, Toronto, ON, Canada M5G 1M1
| | - Yan Chen
- Public Health Ontario, 661 University Avenue, Toronto, ON, Canada M5G 1M1
| | | | - Julianne V Kus
- Public Health Ontario, 661 University Avenue, Toronto, ON, Canada M5G 1M1.
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Marín M, Ruiz A, Iglesias C, Quiroga L, Cercenado E, Martín-Rabadán P, Bouza E, Rodríguez-Sánchez B. Identification of Nocardia species from clinical isolates using MALDI-TOF mass spectrometry. Clin Microbiol Infect 2018; 24:1342.e5-1342.e8. [PMID: 29933050 DOI: 10.1016/j.cmi.2018.06.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 02/02/2018] [Revised: 05/10/2018] [Accepted: 06/09/2018] [Indexed: 11/18/2022]
Abstract
The identification of Nocardia isolates still represents a challenge for matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) despite its acceptance for most bacterial and fungal isolates. In this study we evaluate the identification of Nocardia isolates using direct spotting and an updated database. Overall, 82 Nocardia isolates belonging to 13 species were identified by DNA sequence analysis of the 16S rRNA and secA1 genes. Nine of these well-characterized isolates from 6 Nocardia species were used to create an in-house library. The remaining 73 isolates were directly spotted on the target plate and on-plate protein extraction was performed. The protein spectra obtained were analyzed by MALDI-TOF MS using the BDAL database (Bruker Daltonics) updated with 6,903 MSPs or the combination of this commercial database and our in-house library. As a result, the use of the commercial database alone and in combination with the in-house library yielded 94.5% and 95.9% of correct species-level identifications, respectively, No isolate was misidentified at the genus level with either database. Besides, the use of the in-house library allowed the species-level identification of a N. otitidiscaviarum isolate that could only be identified at the genus-level with a score value <1.6 using the commercial database. In conclusion, the implementation of the direct spotting method and the in-house database provided a high rate of correct species assignment of Nocardia isolates despite the low number of isolates added. Further addition of well-characterized Nocardia isolates may ensure the rapid, accurate and inexpensive identification of most isolates encountered in the routine of the microbiology laboratory.
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Affiliation(s)
- M Marín
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - A Ruiz
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - C Iglesias
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - L Quiroga
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - E Cercenado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - P Martín-Rabadán
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emilio Bouza
- Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Belén Rodríguez-Sánchez
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
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Huang MJ, Xiao M, Rao MPN, Cheng T, Yang YY, Alkhalifah DHM, Hozzein WN, Huang HQ, Li WJ. Nocardia zhihengii sp. nov., an actinobacterium isolated from rhizosphere soil of Psammosilene tunicoides. Antonie Van Leeuwenhoek 2018; 111:2149-2156. [PMID: 29845487 DOI: 10.1007/s10482-018-1107-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 03/13/2018] [Accepted: 05/22/2018] [Indexed: 11/27/2022]
Abstract
A Nocardia-like actinobacterial strain, designated YIM TG2190T, was isolated from rhizosphere soil of Psammosilene tunicoides collected from Gejiu, Yunnan province, China. The cells of strain YIM TG2190T were observed to be Gram-stain positive and non-motile. The strain forms extensively branched substrate mycelia that fragments into rod-shaped elements. The 16S rRNA gene sequence analysis showed that strain YIM TG2190T is closely related to Nocardia nova (97.5%), Nocardia jiangxiensis (97.1%) and Nocardia miyunensis (96.8%). Growth occurs at 4-30 °C (optimum 28 °C), pH 6.0-8.0 (optimum pH 7.0) and the strain can tolerate NaCl (w/v) up to 3% (optimum 0-1%). The cell walls were found to contain meso-diaminopimelic acid. The whole-cell sugars were identified as glucose, mannose, ribose, galactose, arabinose and fucose. The polar lipids were identified as diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylinositol mannosides, phosphatidylglycerol and an unidentified phospholipid. The menaquinones detected were MK-9 (H2) and MK-8 (H4). The major fatty acids (> 5%) were found to be C16:0 (33.9%), summed feature 3 (21.7%), C18:0 10-methyl TBSA (13.7%) and C18:1ω9c (7.0%). The DNA G+C content was determined to be 61.1 mol%. DNA-DNA relatedness between the strain YIM TG2190T and N. nova CGMCC 4.1705T, N. jiangxiensis CGMCC 4.1905T and N. miyunensis CGMCC 4.1904T were 46.9 ± 2.6, 36.8 ± 1.3, and 35.7 ± 2.6%, respectively, values which are less than the threshold value (70%) for the delineation of prokaryotic genomic species. The phenotypic, chemotaxonomic and phylogenetic data indicates that strain YIM TG2190T represents a novel species of the genus Nocardia, for which the name Nocardia zhihengii sp. nov. is proposed. The type strain is YIM TG2190T (=KCTC 39596T = DSM 100515T).
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Affiliation(s)
- Mei-Juan Huang
- College of Landscape Architecture, Southwest Forestry University, Kunming, 650224, People's Republic of China
| | - Min Xiao
- State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Manik Prabhu Narsing Rao
- State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Tao Cheng
- College of Landscape Architecture, Southwest Forestry University, Kunming, 650224, People's Republic of China
| | - Yan-Yu Yang
- College of Landscape Architecture, Southwest Forestry University, Kunming, 650224, People's Republic of China
| | - Dalal Hussien M Alkhalifah
- Biology Department, Faculty of Science, Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Wael N Hozzein
- Bioproducts Research Chair, Zoology Department, College of Science, King Saud University, Riyadh, 11451, Kingdom of Saudi Arabia
- Botany and Microbiology Department, Faculty of Science, Beni-Suef University, Beni-Suef, 62511, Egypt
| | - Hai-Quan Huang
- College of Landscape Architecture, Southwest Forestry University, Kunming, 650224, People's Republic of China.
| | - Wen-Jun Li
- State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China.
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Sood R, Tyagi R, Selhi PK, Kaur G, Kaur H, Singh A. Role of FNA and Special Stains in Rapid Cytopathological Diagnosis of Pulmonary Nocardiosis. Acta Cytol 2018; 62:178-182. [PMID: 29669313 DOI: 10.1159/000488134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 02/27/2018] [Accepted: 03/06/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nocardia, a gram-positive aerobic bacillus of the Actinomycetales family, is a significant opportunistic pathogen in immunocompromised individuals. Clinical and radiological features of pulmonary nocardiosis are nonspecific and can be misdiagnosed as tuberculosis, pneumocystis, staphylococcal or fungal infections, or as malignancy. Aspiration cytology with special stains is a quick and effective approach for accurate diagnosis. MATERIALS AND METHODS We present 7 cases of pulmonary nocardiosis, admitted to the pathology department in a tertiary-care hospital in Punjab. Clinical findings, immune status, laboratory tests, chest radiographs, and computed tomography scans were reviewed. Cytologically, special stains like 1% Ziehl-Neelsen (ZN), 20% ZN, periodic acid-Schiff (PAS), Grocott methenamine silver (GMS), and reticulin stains were studied along with May-Grünwald Giemsa, Papanicolaou, and hematoxylin and eosin. RESULTS All the patients were immunocompromised. The radiological changes were nonspecific. Cytomorphology showed acute and chronic inflammatory infiltrates with necrosis. None of the cases showed well-defined granulomas. GMS, modified 1% ZN and, Gordon and Sweet reticulin stains highlighted the delicate filamentous bacteria in all cases. PAS and 20% ZN stain for tuberculous bacilli were uniformly negative. CONCLUSION FNAC can provide a quick and accurate diagnosis of nocardiosis and thereby facilitate timely medical management.
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Affiliation(s)
- Ridhi Sood
- Department of Oncopathology, Rajiv Gandhi Cancer Institute, New Delhi, India
| | - Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Pavneet Kaur Selhi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Gursheen Kaur
- Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Akashdeep Singh
- Department of Chest and Pulmonary Medicine, Dayanand Medical College and Hospital, Ludhiana, India
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Mazzaferri F, Cordioli M, Segato E, Adami I, Maccacaro L, Sette P, Cazzadori A, Concia E, Azzini AM. Nocardia infection over 5 years (2011-2015) in an Italian tertiary care hospital. New Microbiol 2018; 41:136-140. [PMID: 29806691] [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] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 05/28/2018] [Indexed: 06/08/2023]
Abstract
This study was conducted reviewing clinical records of 14 patients affected by nocardiosis over 5 years in a tertiary care hospital. Nocardia abscessus was responsible for one third of infections, deviating significantly from the results reported by other epidemiological investigations and highlighting the key role of molecular identification tests. Indeed, a precise identification of species is crucial for the determination of antibiotic sensitivity patterns and, consequently, for the choice of antibiotic treatment. Noteworthy, 40% of isolates of N. abscessus (formerly N. asteroides complex) showed resistance to carbapenems, which are usually recommended for empirical therapy.
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Affiliation(s)
- Fulvia Mazzaferri
- Infectious Diseases Section, Diagnostic and Public Health Department, University of Verona, Policlinico "G. B. Rossi", Verona, Italy
| | - Maddalena Cordioli
- Infectious Diseases Section, Diagnostic and Public Health Department, University of Verona, Policlinico "G. B. Rossi", Verona, Italy
| | - Edoardo Segato
- Infectious Diseases Section, Diagnostic and Public Health Department, University of Verona, Policlinico "G. B. Rossi", Verona, Italy
| | - Irene Adami
- Infectious Diseases Section, Diagnostic and Public Health Department, University of Verona, Policlinico "G. B. Rossi", Verona, Italy
| | - Laura Maccacaro
- Microbiology and Virology Unit, Verona University Hospital, Ospedale Civile Maggiore, Verona, Italy
| | - Piersandro Sette
- Hospital Management and Organization Department, ULSS 9 Scaligera - Veneto, "G. Fracastoro" Hospital, Verona, Italy
| | - Angelo Cazzadori
- Infectious Diseases Section, Diagnostic and Public Health Department, University of Verona, Policlinico "G. B. Rossi", Verona, Italy
| | - Ercole Concia
- Infectious Diseases Section, Diagnostic and Public Health Department, University of Verona, Policlinico "G. B. Rossi", Verona, Italy
| | - Anna Maria Azzini
- Infectious Diseases Section, Diagnostic and Public Health Department, University of Verona, Policlinico "G. B. Rossi", Verona, Italy
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Tashiro H, Takahashi K, Kusaba K, Tanaka M, Komiya K, Nakamura T, Aoki Y, Kimura S, Sueoka-Aragane N. Relationship between the duration of trimethoprim/sulfamethoxazole treatment and the clinical outcome of pulmonary nocardiosis. Respir Investig 2018; 56:166-172. [PMID: 29548655 DOI: 10.1016/j.resinv.2017.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 05/15/2017] [Revised: 10/24/2017] [Accepted: 11/10/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Despite treatment, pulmonary nocardiosis, which is a rare opportunistic disease caused by Nocardia species, has poor clinical outcomes including recurrence and death. Currently, the treatment regimen and duration for pulmonary nocardiosis are not fully understood. The present study aimed to clarify the factors related to the clinical outcome of pulmonary nocardiosis. METHODS The medical records of 24 patients with pulmonary nocardiosis were retrospectively reviewed. The patients were divided into two groups based on the outcomes within 2 years: patients with controlled disease (n = 14) and patients who developed recurrence or died (n = 10). RESULTS Nocardia was identified by 16S ribosomal RNA sequencing in 17 patients (70.8%) and by conventional biochemical test in five patients (20.8%). The patients' characteristics, clinical findings, radiological features, and treatment history were not different between the two groups. Compared with patients who developed recurrence or died, those with controlled disease had significantly longer total duration of treatment with antibiotics, especially trimethoprim/sulfamethoxazole (67.5 ± 111.6 days vs. 9.0 ± 6.5 days; p = 0.01). Pancytopenia was the most frequent adverse effect of trimethoprim/sulfamethoxazole. CONCLUSIONS Longer duration of trimethoprim/sulfamethoxazole treatment was significantly associated with better outcomes of pulmonary nocardiosis. In such cases, antibiotics, especially trimethoprim/sulfamethoxazole, should be administered for more than 3 months.
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Affiliation(s)
- Hiroki Tashiro
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga Prefecture 849-8501, Japan.
| | - Koichiro Takahashi
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga Prefecture 849-8501, Japan.
| | - Koji Kusaba
- Department of Laboratory Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, Saga Prefecture 849-8501, Japan.
| | - Masahide Tanaka
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga Prefecture 849-8501, Japan.
| | - Kazutoshi Komiya
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga Prefecture 849-8501, Japan.
| | - Tomomi Nakamura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga Prefecture 849-8501, Japan.
| | - Yosuke Aoki
- Department of International Medicine, Division of Infection Disease, Faculty of Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, Saga Prefecture 849-8501, Japan.
| | - Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga Prefecture 849-8501, Japan.
| | - Naoko Sueoka-Aragane
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga Prefecture 849-8501, Japan.
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Valdezate S, Garrido N, Carrasco G, Medina-Pascual MJ, Villalón P, Navarro AM, Saéz-Nieto JA. Epidemiology and susceptibility to antimicrobial agents of the main Nocardia species in Spain. J Antimicrob Chemother 2017; 72:754-761. [PMID: 27999029 DOI: 10.1093/jac/dkw489] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/12/2016] [Indexed: 12/14/2022] Open
Abstract
Objectives The aims of this study were to explore the clinical distribution, by species, of the genus Nocardia and to assess the antimicrobial susceptibilities of the 10 most prevalent species identified in Spain. Methods Over a 10 year period (2005-14), 1119 Nocardia strains were molecularly identified and subjected to the Etest. The distribution and resistance trends over the sub-periods 2005-09 and 2010-14 were also examined. Results Of the strains examined, 82.9% belonged to the following species: Nocardia cyriacigeorgica (25.3%), Nocardia nova (15.0%), Nocardia abscessus (12.7%), Nocardia farcinica (11.4%), Nocardia carnea (4.3%), Nocardia brasiliensis (3.5%), Nocardia otitidiscaviarum (3.1%), Nocardia flavorosea (2.6%), Nocardia rhamnosiphila (2.6%) and Nocardia transvalensis (2.4%). Their prevalence values were similar during 2005-09 and 2010-14, except for those of N. abscessus , N. farcinica and N. transvalensis , which fell significantly in the second sub-period ( P ≤ 0.05). The major location of isolation was the respiratory tract (∼86%). Half (13/27) of all strains from the CNS were N. farcinica . Significant differences in MIC results were recorded for some species between the two sub-periods. According to the CLSI's breakpoints, low resistance rates (≤15%) were recorded for seven species with respect to cefotaxime, imipenem and tobramycin; five species showed similar rates with respect to trimethoprim/sulfamethoxazole. Linezolid and amikacin were the most frequently active agents. Conclusion The accurate identification of the infecting species and the determination of its susceptibility to antimicrobial agents, given the large number of strains with atypical patterns, are crucial if patients with nocardiosis are to be successfully treated.
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Trivedi DP, Bhagat R, Nakanishi Y, Wang A, Moroz K, Falk NK. Granulomatous Thyroiditis: A Case Report and Literature Review. Ann Clin Lab Sci 2017; 47:620-624. [PMID: 29066492] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Granulomatous disease in the thyroid gland has been linked to viral, bacterial and autoimmune etiologies. The most common granulomatous disease of the thyroid is subacute granulomatous thyroiditis, which is presumed to have a viral or post-viral inflammatory cause. Bacterial etiologies include tuberculosis, actinomycosis, and nocardiosis, but are extremely rare. Disseminated actinomycosis and nocardiosis more commonly affect organ-transplant patients with the highest susceptibility within the first year after transplant surgery. CASE A 45-year-old African American male, who received his third kidney transplant for renal failure secondary to Alport Syndrome, presented with numerous subcutaneous nodules and diffuse muscle pain in the neck. Further workup revealed bilateral nodularity of the thyroid. Fine needle aspiration of these nodules demonstrated suppurative granulomatous thyroiditis. Subsequent right thyroid lobectomy showed granulomatous thyroiditis with filamentous micro-organisms, morphologically resembling Nocardia or Actinomyces. CONCLUSION Disseminated granulomatous disease presenting in the thyroid is very rare, and typically afflicts immune-compromised patients. The overall clinical, cytologic and histologic picture of this patient strongly points to an infectious etiology, likely Nocardia, in the setting of recent organ transplantation within the last year.
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MESH Headings
- Biopsy, Fine-Needle
- Humans
- Immunocompromised Host
- Kidney Failure, Chronic/etiology
- Kidney Failure, Chronic/surgery
- Kidney Transplantation/adverse effects
- Male
- Middle Aged
- Nephritis, Hereditary/immunology
- Nephritis, Hereditary/physiopathology
- Nocardia/immunology
- Nocardia/isolation & purification
- Nocardia Infections/immunology
- Nocardia Infections/microbiology
- Nocardia Infections/physiopathology
- Reoperation/adverse effects
- Thyroid Gland/immunology
- Thyroid Gland/microbiology
- Thyroid Gland/pathology
- Thyroid Gland/surgery
- Thyroid Nodule/immunology
- Thyroid Nodule/microbiology
- Thyroid Nodule/pathology
- Thyroid Nodule/surgery
- Thyroidectomy
- Thyroiditis, Subacute/immunology
- Thyroiditis, Subacute/microbiology
- Thyroiditis, Subacute/pathology
- Thyroiditis, Subacute/surgery
- Thyroiditis, Suppurative/immunology
- Thyroiditis, Suppurative/microbiology
- Thyroiditis, Suppurative/pathology
- Thyroiditis, Suppurative/surgery
- Treatment Outcome
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Affiliation(s)
- Darshan P Trivedi
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Yukihiro Nakanishi
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Alun Wang
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Krzysztof Moroz
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Nadja K Falk
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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Conan PL, Ficko C, Charton F, Bylicki O, Le Floch H, Margery J, Rivière F. [Disseminated nocardiosis caused by Nocardia nova with brain abscesses and osteomyelitis in an immunocompetent patient]. Rev Med Interne 2017; 39:57-61. [PMID: 28716481 DOI: 10.1016/j.revmed.2017.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/21/2017] [Accepted: 06/12/2017] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Nocardia is an opportunist bacteria involved in patients with cellular immunodepression or chronic lung disease. The most frequent portals of entry are the respiratory tract by inhalation or direct inoculation through a cutaneous effraction. Nocardiosis may be localised or disseminated. CASE REPORT We report a rare case of disseminated nocardiosis to Nocardia nova with pulmonary, cutaneous, cerebral attacks and femoral osteomyelitis. The diagnosis was confirmed by prolonged cultures of the bronchoalveolar fluid and the pus extracted from a cutaneous lesion. The outcome was favorable under adapted and prolonged antibiotherapy with imipenem and amikacine and then cotrimoxazole. CONCLUSION This observation is original because it involves a immunocompetent patient with an association of two exceptional locations for N. nova: brain abscesses and femoral osteomyelitis. Screening for cerebral involvement should be systematic, even in the lack of neurological signs. An adapted and prolonged antibiotherapy must be conducted.
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Affiliation(s)
- P-L Conan
- Service de pneumologie, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France; École du Val-de-Grâce, Paris, France.
| | - C Ficko
- Service de maladies infectieuses et tropicales, hôpital d'instruction des armées Bégin, Saint-Mandé, France
| | - F Charton
- Service de pneumologie, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - O Bylicki
- Service de pneumologie, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - H Le Floch
- Service de pneumologie, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - J Margery
- Service de pneumologie, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France; École du Val-de-Grâce, Paris, France
| | - F Rivière
- Service de pneumologie, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
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Mittal A, Subtil A, Leventhal JS. Ulcerative Plaques and Nodules on the Lower Extremity: A Quiz. Acta Derm Venereol 2017; 97:866-867. [PMID: 28350040 DOI: 10.2340/00015555-2659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Amit Mittal
- Department of Dermatology, Yale University School of Medicine, 15 York Street, LMP 5040, New Haven, CT 06510, USA
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Yarbrough ML, Lainhart W, Burnham CAD. Identification of Nocardia, Streptomyces, and Tsukamurella using MALDI-TOF MS with the Bruker Biotyper. Diagn Microbiol Infect Dis 2017; 89:92-97. [PMID: 28811116 DOI: 10.1016/j.diagmicrobio.2017.06.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 03/01/2017] [Revised: 05/16/2017] [Accepted: 06/20/2017] [Indexed: 11/19/2022]
Abstract
Nocardia species are the most commonly isolated aerobic actinomycetes from human clinical specimens. Our objective was to assess the identification of clinically relevant actinomycetes using the Bruker Biotyper MALDI-TOF system, including comparison of extraction methods, Biotyper library versions, score cutoffs, and media. Banked Streptomyces (n=10), Tsukamurella (n=2), and Nocardia isolates (n=60) were cultured and extracted using three methods: mycobacterial extraction, ethanol formic acid extraction, or direct on-target extraction. Following MALDI-TOF analysis, spectra were analyzed using versions 5 and 6 of the BDAL Biotyper library. Optimal species-level identifications for Nocardia were achieved using BDAL v6 at a score cutoff of ≥1.8 after direct extraction (49/60, 82%). Overall, the Biotyper platform with BDAL v6 accurately identified 12/16 species of Nocardia, demonstrating the utility of MALDI-TOF for identification of clinically relevant actinomycetes without the need for supplementation of the database.
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Affiliation(s)
- Melanie L Yarbrough
- Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8118, Saint Louis, MO, 63110.
| | - William Lainhart
- Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8118, Saint Louis, MO, 63110
| | - Carey-Ann D Burnham
- Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8118, Saint Louis, MO, 63110
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Hoza AS, Mfinanga SG, Moser I, König B. Isolation, biochemical and molecular identification of Nocardia species among TB suspects in northeastern, Tanzania; a forgotten or neglected threat? BMC Infect Dis 2017; 17:407. [PMID: 28595598 PMCID: PMC5463502 DOI: 10.1186/s12879-017-2520-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/01/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Pulmonary nocardiosis mimic pulmonary tuberculosis in most clinical and radiological manifestations. In Tanzania, where tuberculosis is one of the major public health threat clinical impact of nocardiosis as the cause of the human disease remains unknown. The objective of the present study was to isolate and identify Nocardia isolates recovered from TB suspects in Northeastern, Tanzania by using biochemical and molecular methods. METHODS The study involved 744 sputum samples collected from 372 TB suspects from four periphery diagnostic centers in Northeastern, Tanzania. Twenty patients were diagnosed as having presumptively Nocardia infections based on microscopic, cultural characteristics and biomèrieux ID 32C Yeast Identification system and confirmed using 16S rRNA and hsp65 gene specific primers for Nocardia species and sequencing. RESULTS Biochemically, the majority of the isolates were N. asteroides (n = 8/20, 40%), N. brasiliensis (n = 4/20, 20%), N. farcinica (n = 3/20, 15%), N. nova (n = 1/20, 5%). Other aerobic actinomycetales included Streptomyces cyanescens (n = 2/20, 10%), Streptomyces griseus, Actinomadura madurae each (n = 1/20, 5%). Results of 16S rRNA and hsp65 sequencing were concordant in 15/17 (88. 2%) isolates and discordant in 2/17 (11.8%) isolates. Majority of the isolates belonged to N. cyriacigeorgica and N. farcinica, four (23.5%) each. CONCLUSIONS Our findings suggest that Nocardia species may be an important cause of pulmonary nocardiosis that is underdiagnosed or ignored. This underscores needs to consider pulmonary nocardiosis as a differential diagnosis when there is a failure of anti-TB therapy and as a possible cause of human infections.
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Affiliation(s)
- Abubakar S. Hoza
- Department of Medical Microbiology and Epidemiology of Infectious Diseases, Faculty of Medicine, University of Leipzig, Liebig Str. 21, 04103 Leipzig, Germany
- Department of Microbiology, Parasitology and Immunology, College of Veterinary and Medical Sciences, Sokoine University of Agriculture, P. O. Box, 3019 Morogoro, Tanzania
| | - Sayoki G.S. Mfinanga
- National Institute for Medical Research, Muhimbili Medical Research Centre, P. O. Box, 3436 Dar es Salaam, Tanzania
| | - Irmgard Moser
- Friedrich Loeffler Institut, Institute of Molecular Pathogenesis, Naumburger Str. 96a, 07743 Jena, Germany
| | - Brigitte König
- Department of Medical Microbiology and Epidemiology of Infectious Diseases, Faculty of Medicine, University of Leipzig, Liebig Str. 21, 04103 Leipzig, Germany
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Tinggaard M, Bagge K. [Brain abscesses caused by Nocardia farcinica in a kidney transplanted man]. Ugeskr Laeger 2017; 179:V01170033. [PMID: 28606302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Nocardiosis is primarily an opportunistic infection caused by aerobic Gram-positive bacteria of the genus Nocardia. In this case report we describe a male patient who previously received a kidney transplant and was admitted to hospital with chills, headache and pain in the neck and left eye, tremor and coordination problems. A magnetic resonance scan of the brain showed multiple abscesses, and blood culture was positive for Nocardia farcinica. Nocardiosis of the central nervous system is a rare, but serious differential diagnosis in immunosuppressed patients with signs of high intracranial pressure.
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Shah J, Weltman H, Narciso P, Murphy C, Poruri A, Baliga S, Sharon L, York M, Cunningham G, Miller S, Caviedes L, Gilman R, Desmond E, Ramasamy R. Dual color fluorescence in situ hybridization (FISH) assays for detecting Mycobacterium tuberculosis and Mycobacterium avium complexes and related pathogens in cultures. PLoS One 2017; 12:e0174989. [PMID: 28399124 PMCID: PMC5388335 DOI: 10.1371/journal.pone.0174989] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 03/17/2017] [Indexed: 11/18/2022] Open
Abstract
Two rapid dual color fluorescence in situ hybridization (FISH) assays were evaluated for detecting M. tuberculosis and related pathogens in cultures. The MN Genus-MTBC FISH assay uses an orange fluorescent probe specific for the Mycobacterium tuberculosis complex (MTBC) and a green fluorescent probe specific for the Mycobacterium and Nocardia genera (MN Genus) to detect and distinguish MTBC from other Mycobacteria and Nocardia. A complementary MTBC-MAC FISH assay uses green and orange fluorescent probes specific for the MTBC and M. avium complex (MAC) respectively to identify and differentiate the two species complexes. The assays are performed on acid-fast staining bacteria from liquid or solid cultures in less than two hours. Forty-three of 44 reference mycobacterial isolates were correctly identified by the MN Genus-specific probe as Mycobacterium species, with six of these correctly identified as MTBC with the MTBC-specific probe and 14 correctly as MAC by the MAC-specific probe. Of the 25 reference isolates of clinically relevant pathogens of other genera tested, only four isolates representing two species of Corynebacterium gave a positive signal with the MN Genus probe. None of these 25 isolates were detected by the MTBC and MAC specific probes. A total of 248 cultures of clinical mycobacterial isolates originating in India, Peru and the USA were also tested by FISH assays. DNA sequence of a part of the 23S ribosomal RNA gene amplified by PCR was obtained from 243 of the 248 clinical isolates. All 243 were confirmed by DNA sequencing as Mycobacterium species, with 157 and 50 of these identified as belonging to the MTBC and the MAC, respectively. The accuracy of the MN Genus-, MTBC-and MAC -specific probes in identifying these 243 cultures in relation to their DNA sequence-based identification was 100%. All ten isolates of Nocardia, (three reference strains and seven clinical isolates) tested were detected by the MN Genus-specific probe but not the MTBC- or MAC-specific probes. The limit of detection for M. tuberculosis was determined to be 5.1x104 cfu per ml and for M. avium 1.5x104 cfu per ml in liquid cultures with the respective MTBC- and MAC-specific probes in both the MN Genus-MTBC and MTBC-MAC FISH assays. The only specialized equipment needed for the FISH assays is a standard light microscope fitted with a LED light source and appropriate filters. The two FISH assays meet an important diagnostic need in peripheral laboratories of resource-limited tuberculosis-endemic countries.
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Affiliation(s)
- Jyotsna Shah
- ID-FISH Technology Inc., Palo Alto, California, United States of America
- * E-mail:
| | - Helena Weltman
- ID-FISH Technology Inc., Palo Alto, California, United States of America
| | - Patricia Narciso
- ID-FISH Technology Inc., Palo Alto, California, United States of America
| | - Christina Murphy
- ID-FISH Technology Inc., Palo Alto, California, United States of America
| | - Akhila Poruri
- ID-FISH Technology Inc., Palo Alto, California, United States of America
| | - Shrikala Baliga
- Kasturba Medical College, Mangalore, Manipal University, India
| | - Leesha Sharon
- Kasturba Medical College, Mangalore, Manipal University, India
| | - Mary York
- ID-FISH Technology Inc., Palo Alto, California, United States of America
| | - Gail Cunningham
- University of California, San Francisco, California, United States of America
| | - Steve Miller
- University of California, San Francisco, California, United States of America
| | - Luz Caviedes
- Labotorio de Investigación en Enfermedades Infecciosas of the Universidad Peruana Cayetano Heredia, Iquitos, Peru
| | - Robert Gilman
- Labotorio de Investigación en Enfermedades Infecciosas of the Universidad Peruana Cayetano Heredia, Iquitos, Peru
- John Hopkins University, Baltimore, Maryland, United States of America
| | - Edward Desmond
- Microbial Disease Laboratory, California Department of Public Health, Richmond, California, United States of America
| | - Ranjan Ramasamy
- ID-FISH Technology Inc., Palo Alto, California, United States of America
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Rahdar HA, Azadi D, Shojaei H, Daei-Naser A. Molecular analysis and species diversity of Nocardia in the hospital environment in a developing country, a potential health hazard. J Med Microbiol 2017; 66:334-341. [PMID: 28100300 DOI: 10.1099/jmm.0.000436] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Despite hundreds of reports on the isolation of Nocardia from clinical samples, the presence and diversity of Nocardia species that are capable of survival in a harsh and adverse condition, such as a hospital environment, have not been comprehensively studied. The aim of this study was to assess Nocardia species diversity in a hospital environment to provide a better insight into their potential threat as a reservoir for the development of nosocomial infections. METHODOLOGY A total of 90 samples of hospital water, dust and soil, collected from 30 hospitals, were analysed for the presence of Nocardia using standard protocols for isolation and characterization of the isolates. Conventional tests were used for preliminary identification, and PCR amplification of the 596 bp amplicon of the 16S rRNA and sequence analysis of 16S rRNA were performed for genus and species identification. RESULTS A total of 25 Nocardia isolates (27.7 %) from 10 species were recovered from 90 samples. The three most prevalent species were N. cyriacigeorgica, 24 %, N. asteroides, 16 % and N. kroppenstedtii, 12 %, followed by N. salmonicida-like, 8 % and single isolates of N.otitidiscaviarum, N. flavorozea-like, N. neocaledoniensis-like and N. sungurluensis-like. Thirteen out of twenty five isolates showed characteristics of six novel species. CONCLUSION Our study showed that the hospital environment is a potential reservoir of a diverse range of Nocardia species, due to the remarkable survival capability of these bacteria in an adverse hospital environment, which carries a threat to the health of patients.
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Affiliation(s)
- Hossein Ali Rahdar
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Azadi
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hasan Shojaei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbass Daei-Naser
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Liu C, Feng M, Zhu J, Tao Y, Kang M, Chen L. Severe pneumonia due to Nocardia otitidiscaviarum identified by mass spectroscopy in a cotton farmer: A case report and literature review. Medicine (Baltimore) 2017; 96:e6526. [PMID: 28353613 PMCID: PMC5380297 DOI: 10.1097/md.0000000000006526] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Nocardia species are aerobic saprophytic bacilli. Among Nocardia species, Nocardia otitidiscaviarum (N otitidiscaviarum) is rarely reported in pulmonary infection. PATIENT CONCERNS We reported a case of N otitidiscaviarum pneumonia in a cotton farmer. DIAGNOSES N otitidiscaviarum pneumonia was identified by mass spectroscopy. INTERVENTIONS Combined treatments (amikacin, imipenem and trimethoprim-sulfamethoxazole) were administered after identification of N otitidiscaviarum. OUTCOMES The patient eventually died from severe respiratory insufficiency in the hospital. LESSONS Early precise diagnosis and prompt combined therapy are of vital importance in severe Nocardia pulmonary infection.
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Affiliation(s)
| | - Mei Feng
- Department of Respiratory and Critical Care Medicine
| | - Jing Zhu
- Department of Respiratory and Critical Care Medicine
| | | | - Mei Kang
- Department of Laboratory Medicine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Lei Chen
- Department of Respiratory and Critical Care Medicine
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