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Antimicrobial susceptibility and clinical characteristics of Nocardia isolates from a tertiary care centre diagnostic laboratory in Pakistan.
J Glob Antimicrob Resist. 2018 12; 15:219-221.JG

Abstract

OBJECTIVES

Nocardiosis is an opportunistic infection that can present as cutaneous, pulmonary and/or disseminated disease depending on the host immunity. Treatment choices include trimethoprim/sulfamethoxazole (co-trimoxazole; SXT) and imipenem along with some other antibiotics. The Clinical and Laboratory Standards Institute (CLSI) recommends the broth microdilution (BMD) method to determine antimicrobial susceptibility, however there is a lack of susceptibility data using this method in Pakistan. Therefore, this study was undertaken to outline the susceptibility profile of Nocardia isolates in Pakistan.

METHODS

From November 2014 to June 2016, 52 consecutive isolates of Nocardia obtained from clinical specimens cultured at the clinical microbiology laboratory of Aga Khan University Hospital (Karachi, Pakistan) were tested for susceptibility to recommended antibiotics using the CLSI-recommended BMD method. The frequency and percentage of susceptibility and resistance of Nocardia to antimicrobials recommended by CLSI were calculated. The susceptibility profiles of pulmonary and extrapulmonary specimens were compared by χ2 test.

RESULTS

Of the 52 isolates, 47 (90.4%) were susceptible to SXT, 20 (38.5%) to imipenem, 49 (94.2%) to amikacin and 52 (100%) to linezolid. No significant differences were found when susceptibilities were compared between pulmonary and extrapulmonary isolates.

CONCLUSION

This study highlights the importance of using the gold-standard BMD method for susceptibility testing of Nocardia isolates. Larger studies are needed in the region to establish susceptibility profiles of Nocardia spp. using the BMD method in order to monitor resistance trends and to inform empirical therapy choices.

Authors+Show Affiliations

Aga Khan University Hospital, Karachi, Pakistan.Aga Khan University Hospital, Karachi, Pakistan. Electronic address: seema.irfan@aku.edu.Aga Khan University Hospital, Karachi, Pakistan.Aga Khan University Hospital, Karachi, Pakistan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30393158

Citation

Farooqui, Fizza, et al. "Antimicrobial Susceptibility and Clinical Characteristics of Nocardia Isolates From a Tertiary Care Centre Diagnostic Laboratory in Pakistan." Journal of Global Antimicrobial Resistance, vol. 15, 2018, pp. 219-221.
Farooqui F, Irfan S, Shakoor S, et al. Antimicrobial susceptibility and clinical characteristics of Nocardia isolates from a tertiary care centre diagnostic laboratory in Pakistan. J Glob Antimicrob Resist. 2018;15:219-221.
Farooqui, F., Irfan, S., Shakoor, S., & Zafar, A. (2018). Antimicrobial susceptibility and clinical characteristics of Nocardia isolates from a tertiary care centre diagnostic laboratory in Pakistan. Journal of Global Antimicrobial Resistance, 15, 219-221. https://doi.org/10.1016/j.jgar.2018.06.021
Farooqui F, et al. Antimicrobial Susceptibility and Clinical Characteristics of Nocardia Isolates From a Tertiary Care Centre Diagnostic Laboratory in Pakistan. J Glob Antimicrob Resist. 2018;15:219-221. PubMed PMID: 30393158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antimicrobial susceptibility and clinical characteristics of Nocardia isolates from a tertiary care centre diagnostic laboratory in Pakistan. AU - Farooqui,Fizza, AU - Irfan,Seema, AU - Shakoor,Sadia, AU - Zafar,Afia, Y1 - 2018/07/06/ PY - 2017/12/08/received PY - 2018/05/27/revised PY - 2018/06/29/accepted PY - 2018/11/6/pubmed PY - 2019/10/1/medline PY - 2018/11/6/entrez KW - Broth microdilution KW - Co-trimoxazole KW - Imipenem KW - Nocardia KW - Trimethoprim/sulfamethoxazole SP - 219 EP - 221 JF - Journal of global antimicrobial resistance JO - J Glob Antimicrob Resist VL - 15 N2 - OBJECTIVES: Nocardiosis is an opportunistic infection that can present as cutaneous, pulmonary and/or disseminated disease depending on the host immunity. Treatment choices include trimethoprim/sulfamethoxazole (co-trimoxazole; SXT) and imipenem along with some other antibiotics. The Clinical and Laboratory Standards Institute (CLSI) recommends the broth microdilution (BMD) method to determine antimicrobial susceptibility, however there is a lack of susceptibility data using this method in Pakistan. Therefore, this study was undertaken to outline the susceptibility profile of Nocardia isolates in Pakistan. METHODS: From November 2014 to June 2016, 52 consecutive isolates of Nocardia obtained from clinical specimens cultured at the clinical microbiology laboratory of Aga Khan University Hospital (Karachi, Pakistan) were tested for susceptibility to recommended antibiotics using the CLSI-recommended BMD method. The frequency and percentage of susceptibility and resistance of Nocardia to antimicrobials recommended by CLSI were calculated. The susceptibility profiles of pulmonary and extrapulmonary specimens were compared by χ2 test. RESULTS: Of the 52 isolates, 47 (90.4%) were susceptible to SXT, 20 (38.5%) to imipenem, 49 (94.2%) to amikacin and 52 (100%) to linezolid. No significant differences were found when susceptibilities were compared between pulmonary and extrapulmonary isolates. CONCLUSION: This study highlights the importance of using the gold-standard BMD method for susceptibility testing of Nocardia isolates. Larger studies are needed in the region to establish susceptibility profiles of Nocardia spp. using the BMD method in order to monitor resistance trends and to inform empirical therapy choices. SN - 2213-7173 UR - https://www.unboundmedicine.com/medline/citation/30393158/Antimicrobial_susceptibility_and_clinical_characteristics_of_Nocardia_isolates_from_a_tertiary_care_centre_diagnostic_laboratory_in_Pakistan_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-7165(18)30131-0 DB - PRIME DP - Unbound Medicine ER -