Clinical and microbiological characteristics of infections caused by various Nocardia species in Taiwan: A multicenter study from 1998 to 2010
Journal
European Journal of Clinical Microbiology and Infectious Diseases
Journal Volume
30
Journal Issue
11
Pages
1341-1347
Date Issued
2011
Author(s)
Abstract
This multicenter study in Taiwan investigated the clinical presentations of various Nocardia species infections based on 16S rRNA sequence analysis. Patients with nocardiosis in four large medical centers from 1998 to 2010 were included. A total of 100 preserved nonduplicate isolates causing human infection were identified as Nocardia species. Sequencing analysis of 16S rRNA confirmed that 35 of 36 N. asteroides isolates identified by conventional tests were non-asteroides Nocardia species, and that two of 50 N. brasiliensis isolates had also been initially misidentified. N. brasiliensis (50%) was the most common pathogen, followed by N. cyriacigeorgica (18%). In addition, several rare pathogens were identified, including N. asiatica, N. rhamnosiphila, N. abscessus, N. transvalensis, N. elegans, and N. carnea. Primary cutaneous infection was the most common presentation, noted in 55 (55%) patients, while pulmonary infection presented in 26 (26%) patients. The crude mortality rate was 6.7% (6/89), and was lowest for primary cutaneous infection (2.2%) and highest for disseminated disease and pulmonary infection (16.7%). In conclusion, N. brasiliensis and N. cyriacigeorgica were the most common pathogens causing nocardiosis in Taiwan. Molecular methods for identifying Nocardia to the species level are mandatory for better understanding the epidemiology and clinical characteristics of patients with nocardiosis. ? 2011 Springer-Verlag.
SDGs
Other Subjects
amikacin; cotrimoxazole; imipenem; RNA 16S; adult; aged; article; bacterial skin disease; bacterium identification; bacterium isolate; cause of death; clinical article; clinical feature; controlled study; drug effect; female; human; keratitis; lung infection; male; molecular diagnosis; Nocardia; Nocardia abscessus; Nocardia asiatica; Nocardia asteroides; Nocardia brasiliensis; Nocardia carnea; Nocardia cyriacigeorgica; Nocardia elegans; Nocardia rhamnosiphila; Nocardia transvalensis; nocardiosis; nonhuman; nucleotide sequence; outcome assessment; priority journal; rare species; sequence analysis; species difference; Taiwan; Adult; Aged; Anti-Infective Agents; Base Sequence; Demography; DNA, Bacterial; DNA, Ribosomal; Drug Combinations; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Sequence Data; Nocardia; Nocardia Infections; Retrospective Studies; RNA, Ribosomal, 16S; Sequence Analysis, DNA; Taiwan; Treatment Outcome; Trimethoprim-Sulfamethoxazole Combination
Type
journal article