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Antibiotic susceptibility testing and species identification of Nocardia isolates: a retrospective analysis of data from a French expert laboratory, 2010-2015.
Clin Microbiol Infect. 2019 Apr; 25(4):489-495.CM

Abstract

OBJECTIVES

Nocardia, a Gram-positive bacterium, is responsible for rare and severe infections. Accurate microbiological data are essential to guide antibiotic treatment. Our primary objective was to describe species identification and results of antimicrobial susceptibility testing (AST) for Nocardia isolates analysed over a 6-year period. Secondary objectives were to study temporal trends in species distribution and AST results.

METHODS

We retrospectively analysed results from Nocardia isolates sent between January 2010 and December 2015 to a French laboratory dedicated to Nocardia (Observatoire Français des Nocardioses). Species identification was obtained by amplification and sequencing of a 600-bp fragment of the 16S rRNA gene (for all isolates) and of hsp65 (when required). AST was performed using disk diffusion.

RESULTS

We included 793 Nocardia isolates, mostly from the lungs (53.8%). The most frequent species were Nocardia farcinica (20.2%), Nocardia abscessus complex (19.9%) and Nocardia nova complex (19.5%). The proportion of N. farcinica increased significantly over time from 13% in 2010 to 27.6% in 2014. Linezolid, amikacin, trimethoprim-sulfamethoxazole, minocycline and imipenem were the most frequently identified active antibiotics with, respectively, 0% (0/734), 2.9% (21/730), 5.4% (40/734), 9.4% (69/734) and 19.5% (143/732) of isolates not susceptible. Nocardia farcinica was frequently not susceptible to cefotaxime (118/148, 79.7% of the isolates), but only about 5% of Nocardia cyriacigeorgica and N. abscessus complex isolates were not susceptible to cefotaxime.

CONCLUSIONS

In this first epidemiological study of Nocardia isolated from human samples in France, N. farcinica was the species most frequently identified and its prevalence increased over time.

Authors+Show Affiliations

INSERM, U1138, LRMA, Equipe 12 du Centre de Recherche des Cordeliers, Paris, France; Université Pierre et Marie Curie, UMRS 1138, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, UMRS 1138, Paris, France; Assistance Publique-Hôpitaux de Paris, Service de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, AP-HP, Hôpital Necker Enfants Malades, Centre d'Infectiologie Necker-Pasteur and Institut Imagine, Paris, France. Electronic address: david.lebeaux@yahoo.fr.Research group on Bacterial Opportunistic Pathogens and Environment UMR5557 Écologie Microbienne, French Observatory of Nocardiosis, Institute of Infectious Agents, Hospices Civils de Lyon, Université de Lyon 1, CNRS, VetAgro Sup, Lyon, France.Research group on Bacterial Opportunistic Pathogens and Environment UMR5557 Écologie Microbienne, French Observatory of Nocardiosis, Institute of Infectious Agents, Hospices Civils de Lyon, Université de Lyon 1, CNRS, VetAgro Sup, Lyon, France.AP-HP, Hôpital Européen Georges-Pompidou, Unité d'Épidémiologie et de Recherche Clinique, Paris, France; INSERM, Centre d'Investigation Clinique 1418, Module Épidémiologie Clinique, Paris, France.Research group on Bacterial Opportunistic Pathogens and Environment UMR5557 Écologie Microbienne, French Observatory of Nocardiosis, Institute of Infectious Agents, Hospices Civils de Lyon, Université de Lyon 1, CNRS, VetAgro Sup, Lyon, France.Research group on Bacterial Opportunistic Pathogens and Environment UMR5557 Écologie Microbienne, French Observatory of Nocardiosis, Institute of Infectious Agents, Hospices Civils de Lyon, Université de Lyon 1, CNRS, VetAgro Sup, Lyon, France.Université Paris Descartes, Sorbonne Paris Cité, AP-HP, Hôpital Necker Enfants Malades, Centre d'Infectiologie Necker-Pasteur and Institut Imagine, Paris, France.Research group on Bacterial Opportunistic Pathogens and Environment UMR5557 Écologie Microbienne, French Observatory of Nocardiosis, Institute of Infectious Agents, Hospices Civils de Lyon, Université de Lyon 1, CNRS, VetAgro Sup, Lyon, France. Electronic address: Veronica.rodriguez-nava@univ-lyon1.fr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29933049

Citation

Lebeaux, D, et al. "Antibiotic Susceptibility Testing and Species Identification of Nocardia Isolates: a Retrospective Analysis of Data From a French Expert Laboratory, 2010-2015." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 25, no. 4, 2019, pp. 489-495.
Lebeaux D, Bergeron E, Berthet J, et al. Antibiotic susceptibility testing and species identification of Nocardia isolates: a retrospective analysis of data from a French expert laboratory, 2010-2015. Clin Microbiol Infect. 2019;25(4):489-495.
Lebeaux, D., Bergeron, E., Berthet, J., Djadi-Prat, J., Mouniée, D., Boiron, P., Lortholary, O., & Rodriguez-Nava, V. (2019). Antibiotic susceptibility testing and species identification of Nocardia isolates: a retrospective analysis of data from a French expert laboratory, 2010-2015. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 25(4), 489-495. https://doi.org/10.1016/j.cmi.2018.06.013
Lebeaux D, et al. Antibiotic Susceptibility Testing and Species Identification of Nocardia Isolates: a Retrospective Analysis of Data From a French Expert Laboratory, 2010-2015. Clin Microbiol Infect. 2019;25(4):489-495. PubMed PMID: 29933049.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibiotic susceptibility testing and species identification of Nocardia isolates: a retrospective analysis of data from a French expert laboratory, 2010-2015. AU - Lebeaux,D, AU - Bergeron,E, AU - Berthet,J, AU - Djadi-Prat,J, AU - Mouniée,D, AU - Boiron,P, AU - Lortholary,O, AU - Rodriguez-Nava,V, Y1 - 2018/06/20/ PY - 2018/03/18/received PY - 2018/05/26/revised PY - 2018/06/09/accepted PY - 2018/6/23/pubmed PY - 2019/7/18/medline PY - 2018/6/23/entrez KW - 16S KW - Disk diffusion KW - Nocardia KW - hsp65 SP - 489 EP - 495 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin. Microbiol. Infect. VL - 25 IS - 4 N2 - OBJECTIVES: Nocardia, a Gram-positive bacterium, is responsible for rare and severe infections. Accurate microbiological data are essential to guide antibiotic treatment. Our primary objective was to describe species identification and results of antimicrobial susceptibility testing (AST) for Nocardia isolates analysed over a 6-year period. Secondary objectives were to study temporal trends in species distribution and AST results. METHODS: We retrospectively analysed results from Nocardia isolates sent between January 2010 and December 2015 to a French laboratory dedicated to Nocardia (Observatoire Français des Nocardioses). Species identification was obtained by amplification and sequencing of a 600-bp fragment of the 16S rRNA gene (for all isolates) and of hsp65 (when required). AST was performed using disk diffusion. RESULTS: We included 793 Nocardia isolates, mostly from the lungs (53.8%). The most frequent species were Nocardia farcinica (20.2%), Nocardia abscessus complex (19.9%) and Nocardia nova complex (19.5%). The proportion of N. farcinica increased significantly over time from 13% in 2010 to 27.6% in 2014. Linezolid, amikacin, trimethoprim-sulfamethoxazole, minocycline and imipenem were the most frequently identified active antibiotics with, respectively, 0% (0/734), 2.9% (21/730), 5.4% (40/734), 9.4% (69/734) and 19.5% (143/732) of isolates not susceptible. Nocardia farcinica was frequently not susceptible to cefotaxime (118/148, 79.7% of the isolates), but only about 5% of Nocardia cyriacigeorgica and N. abscessus complex isolates were not susceptible to cefotaxime. CONCLUSIONS: In this first epidemiological study of Nocardia isolated from human samples in France, N. farcinica was the species most frequently identified and its prevalence increased over time. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/29933049/Antibiotic_susceptibility_testing_and_species_identification_of_Nocardia_isolates:_a_retrospective_analysis_of_data_from_a_French_expert_laboratory_2010_2015_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(18)30476-2 DB - PRIME DP - Unbound Medicine ER -