DIFFERENTIATION BETWEEN Nocardia spp. AND Mycobacterium spp.: CRITICAL ASPECTS FOR BACTERIOLOGICAL DIAGNOSIS

Muricy, Edna Cleide Mendes; Lemes, Romilda Aparecida; Bombarda, Sidney; Ferrazoli, Lucilaine; Chimara, Érica

doi:10.1590/s0036-46652014000500005

Cited by 30 publications

(36 citation statements)

References 23 publications

(36 reference statements)

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“…Furthermore, careful microscopic analysis should be thoroughly performed, since these two genera may present difficulties for an inexperienced microscopist [24]. As observed in the previous study [25], where Nocardia species were detected by the modified ZN-method for weak acid-fast bacteria, we also detected Nocardia species by the ZN-method employed for mycobacteria in this study.…”

Section: Discussionmentioning

confidence: 51%

Isolation, biochemical and molecular identification of Nocardia species among TB suspects in northeastern, Tanzania; a forgotten or neglected threat?

et al. 2017

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BackgroundPulmonary 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.MethodsThe 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.ResultsBiochemically, 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.ConclusionsOur 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2520-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 51%

Isolation, biochemical and molecular identification of Nocardia species among TB suspects in northeastern, Tanzania; a forgotten or neglected threat?

et al. 2017

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“…A recent report from Brazil has noted 0.12% of the sputum samples collected from patients suspected to be suffering from infection with Mycobacterium tuberculosis (Pulmonary tuberculosis) have grown Nocardia in Lowenstein-Jensen’s medium. This study has also elaborated on the significance of a presumptive clinical diagnosis in the improvement of laboratory isolation of Nocardia spp from clinical samples [ 34 ].…”

Section: Reviewmentioning

confidence: 99%

Human Nocardia Infections: A Review of Pulmonary Nocardiosis

Kandi¹

2015

Cureus

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Human nocardiosis may present as an acute or a chronic infection. Although a saprophyte Nocardia spp are responsible for superficial skin infections, pulmonary infections, and disseminated nocardiosis usually involving patients who are immunosuppressed and debilitated. Infections in immunocompetent individuals are usually chronic and present non-specific symptoms. Invasive and disseminated nocardiosis is common among patients with weakened cellular immune systems. Clinical diagnosis of pulmonary nocardiosis is difficult owing to the similarity of its presentation with other respiratory pathogens that include Actinomycetes members and Mycobacterium tuberculosis. Laboratory diagnosis of human nocardiosis is plagued by the fact that a culture of Nocardia spp requires prolonged incubation periods for isolation which most laboratories fail to follow. The lack of clinical, laboratory, and epidemiological data on the incidence of nocardiosis in humans undermines its significance as a potential pathogen. This review attempts to reexamine the pathogenic potential of Nocardia in human infections

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“…La forme pseudotumorale retrouvée chez notre malade reste rare et cause ainsi une errance diagnostique d'autant plus que le malade est immunocompétent. Le diagnostic de nocardiose reste bactériologique, basé sur la microscopie et l´isolement de la culture, mais nocardia peut être confondue avec mycobacterium, principalement en raison de leur similitude à la fois clinique et bactériologique: la croissance sur milieu de Löwenstein-Jensen (LJ), la présence de bacilles acides à travers la coloration de Ziehl-Neelsen et la morphologie des colonies [ 9 ]. A l'examen direct de nocardia, les bacilles sont fins, ramifiés, gram positifs, le caractère d'acido-alcoolo-résistance des Nocardia est absent par la technique de Ziehl-Neelsen classique, mais partielle avec la technique modifiée de Kinyoun [ 1 ].…”

Section: Discussionunclassified

Nocardiose pulmonaire sur un terrain immunocompétent: à propos de 2 cas

Rhofir¹,

Zahraoui²,

Tiress³

et al. 2017

Pan Afr Med J

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La nocardiose est une infection rare, mais sévère, causée par des bactéries du genre nocardia, qui appartiennent à l'ordre des actinomycétales. Si elles peuvent toucher l'adulte immunocompétent, les nocardioses restent des pathologies de l'individu fragilisé sur le plan immunitaire. L'atteinte pulmonaire reste la plus fréquente, sa prise en charge correcte est liée au diagnostic qui est souvent retardé par des présentations non spécifiques et des prélèvements non concluants. Nous rapportons ici deux cas de nocardiose chez des patients immunocompétents. Le premier cas est celui d'un homme de 24 ans, avec notion de tabagisme et d'éthylisme, hospitalisé pour des douleurs thoraciques et des hémoptysies de faible abondance, évoluant depuis deux mois, avec apparition d'abcès sous cutanés dorsaux fistulisés. L'exploration radiologique découvre une masse tissulaire médiastino-pulmonaire droite avec lyse costale adjacente et diffusion aux tissus para vertébraux droits. Les prélèvements bactériologiques restent négatifs motivant une biopsie scannoguidée de la lésion qui est revenue en faveur d'infection à nocardiose. Le second cas concerne un homme de 22 ans, aux antécédents de tuberculose pleurale traitée il y a 8 ans puis une rechute de tuberculose en 2011 (abcès médiastinal). Admis pour suspicion de rechute de tuberculose devant une toux chronique avec altération de l'état général et une hépatosplénomégalie. Le scanner thoracique montre des condensations alvéolaires avec pleurésie. Au cours de son hospitalisation, apparition de tuméfactions sous cutanées purulentes dont l'étude bactériologique du pus est revenue en faveur de nocardiose avec une souche résistante à tous les antibiotiques sauf colistine et bactrim. Les auteurs illustrent à travers ces deux observations, les aspects cliniques et radiologiques de nocardiose pulmonaire en mettant le point sur les difficultés diagnostiques et thérapeutiques surtout dans un pays à forte prévalence de tuberculose et très faible incidence de nocardiose.

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DIFFERENTIATION BETWEEN Nocardia spp. AND Mycobacterium spp.: CRITICAL ASPECTS FOR BACTERIOLOGICAL DIAGNOSIS

Cited by 30 publications

References 23 publications

Isolation, biochemical and molecular identification of Nocardia species among TB suspects in northeastern, Tanzania; a forgotten or neglected threat?

Isolation, biochemical and molecular identification of Nocardia species among TB suspects in northeastern, Tanzania; a forgotten or neglected threat?

Human Nocardia Infections: A Review of Pulmonary Nocardiosis

Nocardiose pulmonaire sur un terrain immunocompétent: à propos de 2 cas

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