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Susceptibility profiles of Nocardia isolates based on current taxonomy.
Antimicrob Agents Chemother. 2014; 58(2):795-800.AA

Abstract

The genus Nocardia has undergone rapid taxonomic expansion in recent years, and an increasing number of species are recognized as human pathogens. Many established species have predictable antimicrobial susceptibility profiles, but sufficient information is often not available for recently described organisms. Additionally, the effectiveness of sulfonamides as first-line drugs for Nocardia has recently been questioned. This led us to review antimicrobial susceptibility patterns for a large number of molecularly identified clinical isolates. Susceptibility results were available for 1,299 isolates representing 39 different species or complexes, including 11 that were newly described, during a 6-year study period. All tested isolates were susceptible to linezolid. Resistance to trimethoprim-sulfamethoxazole (TMP-SMX) was rare (2%) except among Nocardia pseudobrasiliensis (31%) strains and strains of the N. transvalensis complex (19%). Imipenem susceptibility varied for N. cyriacigeorgica and N. farcinica, as did ceftriaxone susceptibility of the N. nova complex. Resistance to more than one of the most commonly used drugs (amikacin, ceftriaxone, TMP-SMX, and imipenem) was highest for N. pseudobrasiliensis (100%), N. transvalensis complex (83%), N. farcinica (68%), N. puris (57%), N. brasiliensis (51%), N. aobensis (50%), and N. amikacinitolerans (43%). Thus, while antimicrobial resistance can often be predicted, susceptibility testing should still be considered when combination therapy is warranted, for less well characterized species or those with variable susceptibility profiles, and for patients with TMP-SMX intolerance.

Authors+Show Affiliations

ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, Utah, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24247124

Citation

Schlaberg, Robert, et al. "Susceptibility Profiles of Nocardia Isolates Based On Current Taxonomy." Antimicrobial Agents and Chemotherapy, vol. 58, no. 2, 2014, pp. 795-800.
Schlaberg R, Fisher MA, Hanson KE. Susceptibility profiles of Nocardia isolates based on current taxonomy. Antimicrob Agents Chemother. 2014;58(2):795-800.
Schlaberg, R., Fisher, M. A., & Hanson, K. E. (2014). Susceptibility profiles of Nocardia isolates based on current taxonomy. Antimicrobial Agents and Chemotherapy, 58(2), 795-800. https://doi.org/10.1128/AAC.01531-13
Schlaberg R, Fisher MA, Hanson KE. Susceptibility Profiles of Nocardia Isolates Based On Current Taxonomy. Antimicrob Agents Chemother. 2014;58(2):795-800. PubMed PMID: 24247124.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Susceptibility profiles of Nocardia isolates based on current taxonomy. AU - Schlaberg,Robert, AU - Fisher,Mark A, AU - Hanson,Kimberley E, Y1 - 2013/11/18/ PY - 2013/11/20/entrez PY - 2013/11/20/pubmed PY - 2014/9/23/medline SP - 795 EP - 800 JF - Antimicrobial agents and chemotherapy JO - Antimicrob. Agents Chemother. VL - 58 IS - 2 N2 - The genus Nocardia has undergone rapid taxonomic expansion in recent years, and an increasing number of species are recognized as human pathogens. Many established species have predictable antimicrobial susceptibility profiles, but sufficient information is often not available for recently described organisms. Additionally, the effectiveness of sulfonamides as first-line drugs for Nocardia has recently been questioned. This led us to review antimicrobial susceptibility patterns for a large number of molecularly identified clinical isolates. Susceptibility results were available for 1,299 isolates representing 39 different species or complexes, including 11 that were newly described, during a 6-year study period. All tested isolates were susceptible to linezolid. Resistance to trimethoprim-sulfamethoxazole (TMP-SMX) was rare (2%) except among Nocardia pseudobrasiliensis (31%) strains and strains of the N. transvalensis complex (19%). Imipenem susceptibility varied for N. cyriacigeorgica and N. farcinica, as did ceftriaxone susceptibility of the N. nova complex. Resistance to more than one of the most commonly used drugs (amikacin, ceftriaxone, TMP-SMX, and imipenem) was highest for N. pseudobrasiliensis (100%), N. transvalensis complex (83%), N. farcinica (68%), N. puris (57%), N. brasiliensis (51%), N. aobensis (50%), and N. amikacinitolerans (43%). Thus, while antimicrobial resistance can often be predicted, susceptibility testing should still be considered when combination therapy is warranted, for less well characterized species or those with variable susceptibility profiles, and for patients with TMP-SMX intolerance. SN - 1098-6596 UR - https://www.unboundmedicine.com/medline/citation/24247124/Susceptibility_profiles_of_Nocardia_isolates_based_on_current_taxonomy_ L2 - http://aac.asm.org/cgi/pmidlookup?view=long&pmid=24247124 DB - PRIME DP - Unbound Medicine ER -