Review of nocardial infections in France 1987 to 1990

Abstract

On the basis of the numbers of Nocardia strains referred to the National Reference Center for Mycoses and Antifungal Agents (NRC), Institut Pasteur, Paris, in the period from 1987 to 1990, it was estimated that between 150 and 250 cases of nocardiosis are diagnosed in France each year. A total of 63 clinical isolates were referred to the NRC and identified as Nocardia asteroides (66.7%), Nocardia farcinica (23.8%), Nocardia brasiliensis (3.2%), Nocardia otitidiscaviarum (4.8%) and Nocardia carnea (1.5%). Nocardia asteroides accounted for 71.4% of pulmonary infections, 80.0% of central nervous system infections and 80.0% of systemic infections. Patients infected with Nocardia farcinica died in 57.1% of cases, compared with 17.6% of patients infected with Nocardia asteroides. Corticosteroid therapy represented a significant factor in mortality. Isolates of Nocardia asteroides revealed variable resistance, whereas isolates of Nocardia farcinica were resistant to most antimicrobial agents. Only amoxicillin/clavulanic acid, imipenem, cefoxitin, kanamycin, amikacin, minocycline and vancomycin showed activity against both species. Nocardiosis caused by Nocardia farcinica may be a growing problem because of the relatively high incidence in AIDS patients and the resistance of this species to most antimicrobial agents.

The medically important aerobic actinomycetes: epidemiology and microbiology

“…However, further evaluation of the usefulness of these probes should be undertaken and should include well-characterized Nocardia strains. (4,66). All susceptibility tests were performed on Mueller-Hinton agar, except that for the sulfonamide disk susceptibility tests, the agar was supplemented with 5% hemolyzed horse blood containing thymidine phosphorylase.…”

Lung <i>Nocardia elegans</i> Infection Diagnosed on Matrix-assisted Laser Desorption Ionization-time of Flight Mass Spectrometry (MALDI-TOF MS)

“…Most commonly, nocardiosis presents as a pulmonary disease. Members of the Nocardia asteroides complex primarily cause pulmonary disease, and, except for Nocardia nova, all of these microorganisms are prone to extrapulmonary dissemination (2)(3)(4)(5)(6).…”

Occurrence of plasmids in pathogenic strains of Nocardia

“…However, it is known that strains previously identified simply as N. asteroides are in fact members of the N. asteroides general complex, and this group must be differentiated now into at least three species, i.e., N. asteroides sensu strict0 (here called N. asteroides), N. farcinica and N nova. Their epidemiological [5], pathogenic [6] and antibiotic susceptibility patterns seem to be different [7,81, which might lead to distinct clinical outcomes in infected patients [5].…”