MOLECULAR IDENTIFICATION AND ANTIMICROBIAL RESISTANCE PATTERN OF SEVEN CLINICAL ISOLATES OF Nocardia spp. IN BRAZIL

Abstract

Nocardia is a ubiquitous microorganism related to pyogranulomatous infection, which is difficult to treat in humans and animals. The occurrence of the disease is on the rise in many countries due to an increase in immunosuppressive diseases and treatments. This report of cases from Brazil presents the genotypic characterization and the antimicrobial susceptibility pattern using the disk-diffusion method and inhibitory minimal concentration with E-test® strips. In summary, this report focuses on infections in young adult men, of which three cases were cutaneous, two pulmonary, one neurological and one systemic. The pulmonary, neurological and systemic cases were attributed to immunosuppressive diseases or treatments. Sequencing analysis of the 16S rRNA segments (1491 bp) identified four isolates of Nocardia farcinica, two isolates of Nocardia nova and one isolate of Nocardia asiatica. N. farcinica was involved in two cutaneous, one systemic and other pulmonary cases; N. nova was involved in one neurological and one pulmonary case; and Nocardia asiatica in one cutaneous case. The disk-diffusion antimicrobial susceptibility test showed that the most effective antimicrobials were amikacin (100%), amoxicillin/clavulanate (100%), cephalexin (100%) and ceftiofur (100%), while isolates had presented most resistance to gentamicin (43%), sulfamethoxazole/trimethoprim (43%) and ampicillin (29%). However, on the inhibitory minimal concentration test (MIC test), only one of the four isolates of Nocardia farcinica was resistant to sulfamethoxazole/trimethoprim.

Characterization and Antimicrobial Susceptibility of Actinomycetes from TB Smear Negative and Retreatment Patients in Nairobi, Kenya

“…Our study showed that most of the isolates (94%) were susceptible to Trimethoprim-sulphamethoxazole which is in agreement with several other studies done on aerobic Actinomycetes[12] [19][20]. However, resistance to Trimethoprim-sulphamethoxazole has been observed in different studies[11] [14] [15][17] [18][21] among others. This is on the contrary to the current study.…”

“…Antimicrobial susceptibility testing of aerobic Actinomycetes isolated from clinical specimens is very important as it can help in guiding the therapy for infections. Actinomycetes are slow growing and most of them clumps and aggregates hence causing difficulty in carrying out the antimicrobial susceptibility testing [11] [12]. Broth microdilution method was used to perform the AST which is the approved standard method by CLSI for antimicrobial susceptibility testing of Actinomycetes [6].…”

“…Resistance to three or more antibiotics was considered multidrug-resistant [11]. Therefore, 4 (7.6%) isolates showed multidrug resistance pattern, being resistance to more than 3 antibiotics; Amoxicillin-Clavulanate, Ceftriaxone, and…”

Peritonite piogranulomatosa por Nocardia concava em cão - relato de caso

“…A sulfonamida é o agente mais recomendado, porém, em pacientes com doenças sistêmicas, a taxa de mortalidade com esse antibiótico isoladamente é alta. Espécies diferentes de Nocardia apresentam susceptibilidades diferentes aos antimicrobianos, sendo necessário o uso inicial de dois ou três agentes terapêuticos (Condas et al, 2015). No paciente relatado, a multiterapia antibacteriana foi instituída precocemente, porém não obteve sucesso terapêutico.…”

A Primary Cutaneous Nocardiosis of the Hand

“…In Brazil, pulmonary disease is the most common nocardiosis [ 7 ]. N. farcinica and N. asiatica have been isolated from rare cases of primary cutaneous nocardiosis in Brazil [ 8 ]. Cutaneous involvement may develop as one of four types: superficial skin infection, mycetoma, lymphocutaneous infection, or systemic disease with cutaneous involvement [ 1 ].…”