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Antimicrobial susceptibility profiles and species distribution of medically relevant Nocardia species: Results from a large tertiary laboratory in Australia.
J Glob Antimicrob Resist. 2020 Mar; 20:110-117.JG

Abstract

OBJECTIVES

There are limited surveillance studies on the epidemiology and resistance rates ofNocardia spp. in Australia, particularly in the jurisdiction of New South Wales. This study aimed to investigate the species distribution and antimicrobial susceptibility of a large number of contemporary (2011-2016) clinical Nocardia spp. referred to a large tertiary hospital in Sydney, Australia.

METHODS

A total of 270Nocardia spp. isolates identified to species level by dual-target gene sequencing were investigated. Antimicrobial susceptibility testing was performed using a Sensititre™ RAPMYCOI panel, with the minimum inhibitory concentration (MIC) range and geometric mean MIC obtained for each species and drug combination. Antimicrobial susceptibility profiles and species distribution were analysed.

RESULTS

The respiratory system is the most affected site in nocardiosis. In this study, Nocardia nova complex was the most frequently isolated Nocardia spp. (n = 80; 29.6%), followed by Nocardia cyriacigeorgica (n = 61; 22.6%), Nocardia brasiliensis (n = 52; 19.3%) and Nocardia farcinica (n = 38; 14.1%). Of the tested isolates, 9.3% and 59.3% displayed resistance to trimethoprim/sulfamethoxazole (SXT) and imipenem, respectively. Nocardia farcinica accounted for the highest number of SXT-resistant isolates. High imipenem resistance in N. cyriacigeorgica is atypical to its drug pattern but has been reported elsewhere. All tested isolates remained susceptible to linezolid, with only 0.7% exhibiting resistance to amikacin.

CONCLUSION

Linezolid and amikacin remain good empirical options for treatment of nocardiosis. Routine antimicrobial susceptibility testing ofNocardia is advisable with the detection of sulfonamide resistance and atypical antibiograms in this study.

Authors+Show Affiliations

Department of Microbiology, Singapore General Hospital, 20 College Road, 169856, Singapore. Electronic address: tan.yen.ee@singhealth.com.sg.Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute for Clinical Pathology and Medical Research (ICPMR), New South Wales Health Pathology, Westmead Hospital, Westmead, NSW, Australia; Centre for Infectious Diseases and Microbiology, University of Sydney, Sydney, NSW, Australia.Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute for Clinical Pathology and Medical Research (ICPMR), New South Wales Health Pathology, Westmead Hospital, Westmead, NSW, Australia; Centre for Infectious Diseases and Microbiology, University of Sydney, Sydney, NSW, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31400449

Citation

Tan, Yen Ee, et al. "Antimicrobial Susceptibility Profiles and Species Distribution of Medically Relevant Nocardia Species: Results From a Large Tertiary Laboratory in Australia." Journal of Global Antimicrobial Resistance, vol. 20, 2020, pp. 110-117.
Tan YE, Chen SC, Halliday CL. Antimicrobial susceptibility profiles and species distribution of medically relevant Nocardia species: Results from a large tertiary laboratory in Australia. J Glob Antimicrob Resist. 2020;20:110-117.
Tan, Y. E., Chen, S. C., & Halliday, C. L. (2020). Antimicrobial susceptibility profiles and species distribution of medically relevant Nocardia species: Results from a large tertiary laboratory in Australia. Journal of Global Antimicrobial Resistance, 20, 110-117. https://doi.org/10.1016/j.jgar.2019.06.018
Tan YE, Chen SC, Halliday CL. Antimicrobial Susceptibility Profiles and Species Distribution of Medically Relevant Nocardia Species: Results From a Large Tertiary Laboratory in Australia. J Glob Antimicrob Resist. 2020;20:110-117. PubMed PMID: 31400449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antimicrobial susceptibility profiles and species distribution of medically relevant Nocardia species: Results from a large tertiary laboratory in Australia. AU - Tan,Yen Ee, AU - Chen,Sharon C-A, AU - Halliday,Catriona L, Y1 - 2019/08/07/ PY - 2019/02/28/received PY - 2019/06/18/revised PY - 2019/06/21/accepted PY - 2019/8/11/pubmed PY - 2019/8/11/medline PY - 2019/8/11/entrez KW - Australia KW - Medically relevant Nocardia KW - Species distribution KW - Susceptibility SP - 110 EP - 117 JF - Journal of global antimicrobial resistance JO - J Glob Antimicrob Resist VL - 20 N2 - OBJECTIVES: There are limited surveillance studies on the epidemiology and resistance rates ofNocardia spp. in Australia, particularly in the jurisdiction of New South Wales. This study aimed to investigate the species distribution and antimicrobial susceptibility of a large number of contemporary (2011-2016) clinical Nocardia spp. referred to a large tertiary hospital in Sydney, Australia. METHODS: A total of 270Nocardia spp. isolates identified to species level by dual-target gene sequencing were investigated. Antimicrobial susceptibility testing was performed using a Sensititre™ RAPMYCOI panel, with the minimum inhibitory concentration (MIC) range and geometric mean MIC obtained for each species and drug combination. Antimicrobial susceptibility profiles and species distribution were analysed. RESULTS: The respiratory system is the most affected site in nocardiosis. In this study, Nocardia nova complex was the most frequently isolated Nocardia spp. (n = 80; 29.6%), followed by Nocardia cyriacigeorgica (n = 61; 22.6%), Nocardia brasiliensis (n = 52; 19.3%) and Nocardia farcinica (n = 38; 14.1%). Of the tested isolates, 9.3% and 59.3% displayed resistance to trimethoprim/sulfamethoxazole (SXT) and imipenem, respectively. Nocardia farcinica accounted for the highest number of SXT-resistant isolates. High imipenem resistance in N. cyriacigeorgica is atypical to its drug pattern but has been reported elsewhere. All tested isolates remained susceptible to linezolid, with only 0.7% exhibiting resistance to amikacin. CONCLUSION: Linezolid and amikacin remain good empirical options for treatment of nocardiosis. Routine antimicrobial susceptibility testing ofNocardia is advisable with the detection of sulfonamide resistance and atypical antibiograms in this study. SN - 2213-7173 UR - https://www.unboundmedicine.com/medline/citation/31400449/Antimicrobial_susceptibility_profiles_and_species_distribution_of_medically_relevant_Nocardia_species:_Results_from_a_large_tertiary_laboratory_in_Australia L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-7165(19)30162-6 DB - PRIME DP - Unbound Medicine ER -
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