Typing of Nocardia farcinica by Pulsed-Field Gel Electrophoresis Reveals an Endemic Strain as Source of Hospital Infections

Abstract

Severe postoperative wound infections caused by Nocardia farcinica were repeatedly observed in a German hospital surgical ward. A pulsed-field gel electrophoresis (PFGE) protocol was established to characterize the genetic relatedness of the bacterial isolates from these infections. All 18 isolates from postoperative infections that have occurred since 1985 belong to a common endemic genotype; organisms of this genotype were also detected in the air of two rooms of the department where these postoperative infections occurred. In contrast, two environmental isolates from another building on the same campus showed a distinct genotype. Three cases of pulmonary infections, at a department which is located in proximity to the surgical department, were also caused by the endemic type, which suggests aerogenic spread of the endemic strain to these patients. Controls consisting of epidemiologically unrelated isolates from sporadic infections in other towns belonged in each case to a different genotype. PFGE was well suited to differentiate various types ofN. farcinica and revealed an endemic strain causing postoperative wound infections possibly after aerogenic transmission.

Nocardia Infections in Solid Organ Transplantation

“…Animal‐to‐human transmission has not been reported . While most patients develop sporadic infections, clusters of nosocomial infection have occurred, including among transplant recipients, with possible sources being construction, contaminated air or healthcare worker hands . However, these studies have often lacked strain testing with molecular methods to confirm the relationship between infections .…”

“…However, these studies have often lacked strain testing with molecular methods to confirm the relationship between infections . In some cases however, investigators have demonstrated common source environmental and person‐to‐person transmission in health care facilities by using ribotyping and pulsed‐field gel electrophoresis methods . Although there are no measures that effectively prevent inhalation, TMP‐SMX prophylaxis in high‐risk populations, as noted above, may reduce the incidence of the disease .…”

Nocardia in Solid Organ Transplant Recipients

“…There have been reports of presumed nosocomial outbreaks of Nocardia infection, but these studies have often lacked strain testing with molecular methods to confirm the relationship between infections (4). In some cases however, investigators have demonstrated common source environmental and person-to-person transmission in health care facilities by using ribotying and pulsed-field gel electrophoresis methods (111,112). Although there has been no effective measure to prevent inhalation, TMP-SMX prophylaxis in high risk populations, as noted earlier, may reduce the incidence of the disease (31,70,108).…”

Genetic and phenotypic comparison of Nocardia seriolae isolated from fish in Japan

“…Agarose blocks were prepared as described by Blumel, Blumel, Yassin, Schmidt-Rotte & Schaal (1998) with modifications. The bacterial growth obtained on BHIA at 25°C for 1 week was inoculated into 2 mL saline in a sterilized test tube with 2 g of glass beads (2 mm diameter), and the tube shaken for 10 min by a KM shaker (Iwaki Sangyo, Tokyo, Japan) to disperse the bacteria.…”