Clinical and microbiological characteristics of Nocardiosis including those caused by emerging Nocardia species in Taiwan, 1998-2008

Clin Microbiol Infect. 2010 Jul;16(7):966-72. doi: 10.1111/j.1469-0691.2009.02950.x. Epub 2009 Oct 22.

Abstract

The genus of Nocardia is rapidly expanding and the species distribution varies with different geographical locations. We retrospectively reviewed the laboratory records of the bacteriology laboratory at National Taiwan University Hospital from January 1998 to June 2008 to identify patients with nocardiosis. During the study period, 164 isolates of Nocardia spp. were identified from 134 patients but only 113 patients had Nocardia infection. Nocardia brasiliensis (n = 54) was the most common pathogen, followed by N. asteroides (n = 36), N. farcinica (n = 7), N. flavorosea (n = 4), N. otitidiscaviarum (n = 3), N. nova (n = 3), N. beijingensis (n = 2) and one each of N. puris, N. jinanensis and N. takedensis. The major types of infection were cutaneous infection (56.6%), pulmonary infection (33.6%) and disseminated infection (7.1%). Eighty-eight patients received sulfonamide-containing antibiotic and eight of 100 patients with available data on outcomes died during the episode of nocardiosis. In conclusion, the clinical and microbiological manifestations of Nocardiosis vary with the different Nocardia species. Accurate identification of the species is crucial to make the diagnosis.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Brain Abscess / drug therapy
  • Brain Abscess / microbiology
  • Communicable Diseases, Emerging / diagnosis
  • Communicable Diseases, Emerging / microbiology
  • Communicable Diseases, Emerging / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nocardia / classification*
  • Nocardia / isolation & purification*
  • Nocardia Infections / diagnosis
  • Nocardia Infections / drug therapy
  • Nocardia Infections / microbiology
  • Nocardia Infections / physiopathology
  • Polymerase Chain Reaction
  • RNA, Ribosomal, 16S
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / microbiology
  • Retrospective Studies
  • Skin Diseases, Bacterial / drug therapy
  • Skin Diseases, Bacterial / microbiology
  • Sulfonamides / therapeutic use*
  • Taiwan
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • RNA, Ribosomal, 16S
  • Sulfonamides