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Antimicrobial susceptibility profiles and species distribution of medically relevant Nocardia species: Results from a large tertiary laboratory in Australia.

Abstract

OBJECTIVES

There are limited surveillance studies on the epidemiology and resistance rates of Nocardia species 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 species referred to a large tertiary hospital in Sydney, Australia.

METHODS

Two hundred and seventy Nocardia isolates identified to the species level by dual target gene sequencing were investigated. Susceptibility testing was performed using the Sensititre™ RAPMYCOI panel with the minimum inhibitory concentration and geometric mean obtained for each species and drug combination. The susceptibility profiles and species distribution were analysed.

RESULTS

The respiratory system is the most affected site of nocardiosis. N. nova complex was the most frequently isolated Nocardia species (n = 80, 29.6%) in this survey followed by N. cyriacigeorgica (n = 61, 22.6%), N. brasiliensis (n = 52, 19.3%) and N. farcinica (n = 38, 14.1%). Of the tested isolates, 9.3% and 59.3% displayed resistance to trimethoprim-sulfamethoxazole and imipenem respectively. N. farcinica accounted for the highest number of resistant strains to trimethoprim-sulfamethoxazole. High imipenem resistance in N. cyriacigeogica 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.

CONCLUSIONS

Linezolid and amikacin remain as good empiric option for nocardiosis treatment. Routine susceptibility testing for Nocardia is advisable with the detection of sulphonamide resistance and atypical antibiograms in this study.

Authors+Show Affiliations

Department of Microbiology, Singapore General Hospital, 20 College Road Singapore 169856, Singapore. Electronic address: tan.yen.ee@singhealth.com.sg.Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, ICMPR, New South Wales Health Pathology, Westmead Hospital, NSW, Australia; Centre for Infectious Diseases and Microbiology, University of Sydney, NSW, Australia.Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, ICMPR, New South Wales Health Pathology, Westmead Hospital, NSW, Australia; Centre for Infectious Diseases and Microbiology, University of 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, 2019.
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. 2019.
Tan, Y. E., Chen, S. C., & Halliday, C. L. (2019). Antimicrobial susceptibility profiles and species distribution of medically relevant Nocardia species: Results from a large tertiary laboratory in Australia. Journal of Global Antimicrobial Resistance, doi: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. 2019 Aug 7; 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/entrez PY - 2019/8/11/pubmed PY - 2019/8/11/medline KW - Australia KW - Medically-relevant Nocardia KW - Species distribution KW - Susceptibility JF - Journal of global antimicrobial resistance JO - J Glob Antimicrob Resist N2 - OBJECTIVES: There are limited surveillance studies on the epidemiology and resistance rates of Nocardia species 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 species referred to a large tertiary hospital in Sydney, Australia. METHODS: Two hundred and seventy Nocardia isolates identified to the species level by dual target gene sequencing were investigated. Susceptibility testing was performed using the Sensititre™ RAPMYCOI panel with the minimum inhibitory concentration and geometric mean obtained for each species and drug combination. The susceptibility profiles and species distribution were analysed. RESULTS: The respiratory system is the most affected site of nocardiosis. N. nova complex was the most frequently isolated Nocardia species (n = 80, 29.6%) in this survey followed by N. cyriacigeorgica (n = 61, 22.6%), N. brasiliensis (n = 52, 19.3%) and N. farcinica (n = 38, 14.1%). Of the tested isolates, 9.3% and 59.3% displayed resistance to trimethoprim-sulfamethoxazole and imipenem respectively. N. farcinica accounted for the highest number of resistant strains to trimethoprim-sulfamethoxazole. High imipenem resistance in N. cyriacigeogica 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. CONCLUSIONS: Linezolid and amikacin remain as good empiric option for nocardiosis treatment. Routine susceptibility testing for Nocardia is advisable with the detection of sulphonamide 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 -