Nocardia veterana: disseminated infection with urinary tract infection

Poisnel, É.; Roseau, J.-B.; Landais, C.; Rodríguez-Nava, Verónica; Bussy, E.; Gaillard, Tiphaine

doi:10.1016/j.bjid.2014.11.003

Cited by 15 publications

(11 citation statements)

References 21 publications

(27 reference statements)

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“…6,7,13 However, a wide variety of other clinical manifestations of N. veterana infection have been reported in humans including urinary tract infections, brain and bowel abscesses, endogenous endophthalmitis, nodular lymphangitis, mycetomas, and bacteremia. 5,[14][15][16][17][18][19] In veterinary medicine, reports of N. veterana infection have been limited to bovine mastitis resulting from direct inoculation, and a puppy from Germany with disseminated N. veterana infection and concurrent canine distemper virus infection. 20,21 In the latter case, diagnosis was made at necropsy and as in the study reported here, bacterial isolates from lung tissue were identified by MALDI-TOF MS and confirmed with 16S rRNA gene sequencing.…”

Section: Discussionmentioning

confidence: 99%

“…12 Since it was first isolated, fewer than 20 cases of N. veterana infection have been reported in the human literature. 5,7,[13][14][15][16][17][18] Inhalation is thought to be the most common route of transmission, and in the few reported cases of human N. veterana infections, pulmonary manifestations predominate. 6,7,13 However, a wide variety of other clinical manifestations of N. veterana infection have been reported in humans including urinary tract infections, brain and bowel abscesses, endogenous endophthalmitis, nodular lymphangitis, mycetomas, and bacteremia.…”

Section: Discussionmentioning

confidence: 99%

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Successful Treatment of Disseminated Nocardiosis Caused by Nocardia veterana in a Dog

Yaemsiri

Sykes

2017

Veterinary Internal Medicne

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A 5‐year‐old male castrated Lhasa Apso cross was evaluated for a 1‐month history of inappetence, lethargy, gagging, and progressive right thoracic limb lameness. Synovial fluid analysis revealed nonseptic suppurative inflammation, and a diagnosis of immune‐mediated polyarthritis (IMPA) was made. After 3 months of treatment with prednisone and later cyclosporine, the dog developed multiple firm cutaneous and subcutaneous masses and a focal mass within the jejunum. Cultures of blood, urine, skin lesions, and the jejunal mass identified Nocardia veterana by matrix‐absorption laser desorption ionization‐time‐of‐flight mass spectrometry (MALDI‐TOF MS) and allowed for earlier identification of the organism compared to more traditional secA1 gene sequencing. Immunosuppressive drug treatment was discontinued, and the dog was treated for 3 months by administration of trimethoprim‐sulfamethoxazole (TMS). No recurrence of clinical signs was reported 1 year later. This case report highlights the clinical utility of MALDI‐TOF MS, particularly for the rapid identification of slow‐growing, fastidious organisms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Disseminated Nocardiosis Caused by Nocardia veterana in a Dog

Yaemsiri

Sykes

2017

Veterinary Internal Medicne

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“…One notable distinction of our method from other studies was the inclusion of a zirconium bead-beating step in lieu of boiling (6,8). The direct spotting and standard bacterial extraction methods developed for MALDI-TOF MS are suboptimal for Nocardia spp., due to the hardiness and composition of the cell wall.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, matrix-assisted laser desorption ionization (MALDI)-time of flight (TOF) mass spectrometry (MS) has been identified to be a rapid, accurate method for the identification of Nocardia spp. in the clinical laboratory (6)(7)(8)(9)(10). Although MALDI-TOF MS promises to aid in the identification of these challenging organisms, several issues related to its universal implementation remain, including the limited representation of rare species in existing databases, novel species detection, and a lack of interchangeable protocols and databases for use in both research and clinical laboratories.…”

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confidence: 99%

Multicenter Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry Study for Identification of Clinically Relevant Nocardia spp

et al. 2016

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dThis multicenter study analyzed Nocardia spp., including extraction, spectral acquisition, Bruker matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) identification, and score interpretation, using three Nocardia libraries, the Bruker, National Institutes of Health (NIH), and The Ohio State University (OSU) libraries, and compared the results obtained by each center. A standardized study protocol, 150 Nocardia isolates, and NIH and OSU Nocardia MALDI-TOF MS libraries were distributed to three centers. Following standardized culture, extraction, and MALDI-TOF MS analysis, isolates were identified using score cutoffs of >2.0 for species/species complex-level identification and >1.8 for genus-level identification. Isolates yielding a score of <2.0 underwent a single repeat extraction and analysis. The overall score range for all centers was 1.3 to 2.7 (average, 2.2 ؎ 0.3), with common species generally producing higher average scores than less common ones. Score categorization and isolate identification demonstrated 86% agreement between centers; 118 of 150 isolates were correctly identified to the species/species complex level by all centers. Nine strains (6.0%) were not identified by any center, and six (4.0%) of these were uncommon species with limited library representation. A categorical score discrepancy among centers occurred for 21 isolates (14.0%). There was an overall benefit of 21.2% from repeat extraction of low-scoring isolates and a center-dependent benefit for duplicate spotting (range, 2 to 8.7%). Finally, supplementation of the Bruker Nocardia MALDI-TOF MS library with both the OSU and NIH libraries increased the genus-level and species-level identification by 18.2% and 36.9%, respectively. Overall, this study demonstrates the ability of diverse clinical microbiology laboratories to utilize MALDI-TOF MS for the rapid identification of clinically relevant Nocardia spp. and to implement MALDI-TOF MS libraries developed by single laboratories across institutions. N ocardia spp. are Gram-positive, beaded, branching, and partially acid-fast bacilli belonging to the Corynebacterineae suborder. Nocardiae are environmentally ubiquitous and are recognized to be human pathogens causing both cutaneous and soft tissue infections in immunocompetent patients and opportunistic infections (e.g., lung and brain infections) in immunocompromised hosts. Determination of the Nocardia species causing an infection is important because different species vary in their epidemiology, virulence, and antibiotic susceptibility (1-3). Traditional methods for the determination of Nocardia species include biochemical tests, susceptibility profiling, and sequencing methods (1-5). Recently, matrix-assisted laser desorption ionization (MALDI)-time of flight (TOF) mass spectrometry (MS) has been identified to be a rapid, accurate method for the identification of Nocardia spp. in the clinical laboratory (6-10). Although MALDI-TOF MS promises to aid in the identification of these challenging orga...

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“…There are 7 case reports of epidiymo-orchitis and/or testicular abscesses caused by Nocardia and one disseminated Nocardia infection associated with a urinary tract infection. In all cases, except for one, the patients were immunosuppressed with steroids [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] .…”

Section: Discussionmentioning

confidence: 99%

Nocardia farcinica bacteraemia presenting as a prostate abscess

Scorey

Daniel

2016

IDCases

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Nocardia is characterised as a Gram positive filamentous rod and is found worldwide in soil, decaying vegetable matter and aquatic environments. Localised pulmonary infection is the most common clinical presentation. However, Nocardia can present in a wide variety of clinical manifestations, especially in the immunocompromised individual. We present the first case of a prostate abscess caused by Nocardia farcinica in a man with a history of severe psoriasis and psoriatic arthritis. He had been on long term immunosuppression for this with prednisolone and etanercept. His Nocardia was likely contracted through direct skin inoculation while gardening with haematological dissemination to the prostate. He responded well to long term sulfamethoxazole and trimethoprim.

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Nocardia veterana: disseminated infection with urinary tract infection

Cited by 15 publications

References 21 publications

Successful Treatment of Disseminated Nocardiosis Caused by Nocardia veterana in a Dog

Successful Treatment of Disseminated Nocardiosis Caused by Nocardia veterana in a Dog

Multicenter Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry Study for Identification of Clinically Relevant Nocardia spp

Nocardia farcinica bacteraemia presenting as a prostate abscess

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