Clinical and microbiological characteristics of Nocardiosis including those caused by emerging Nocardia species in Taiwan, 1998–2008

The genus of Nocardia is rapidly expanding and the species distribution varies with different geographical locations. We retrospectively reviewed the laboratory records of the bacteriology laboratory at National Taiwan University Hospital from January 1998 to June 2008 to identify patients with noca...

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Bibliographic Details
Published in:Clinical microbiology and infection 2010-07, Vol.16 (7), p.966-972
Main Authors: Tan, C.-K., Lai, C.-C., Lin, S.-H., Liao, C.-H., Chou, C.-H., Hsu, H.-L., Huang, Y.-T., Hsueh, P.-R.
Format: Article
Language:English
Subjects:
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Brain Abscess - drug therapy
Brain Abscess - microbiology
Communicable Diseases, Emerging - diagnosis
Communicable Diseases, Emerging - microbiology
Communicable Diseases, Emerging - physiopathology
Female
Geographical distribution
Hospitals
Humans
Male
Middle Aged
Nocardia
Nocardia - classification
Nocardia - isolation & purification
Nocardia Infections - diagnosis
Nocardia Infections - drug therapy
Nocardia Infections - microbiology
Nocardia Infections - physiopathology
Nocardiosis
Pathogens
Polymerase Chain Reaction
Respiratory Tract Infections - drug therapy
Respiratory Tract Infections - microbiology
Retrospective Studies
RNA, Ribosomal, 16S
Skin Diseases, Bacterial - drug therapy
Skin Diseases, Bacterial - microbiology
Sulfonamides - therapeutic use
Taiwan
Treatment Outcome
unusual Nocardia species
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Summary:The genus of Nocardia is rapidly expanding and the species distribution varies with different geographical locations. We retrospectively reviewed the laboratory records of the bacteriology laboratory at National Taiwan University Hospital from January 1998 to June 2008 to identify patients with nocardiosis. During the study period, 164 isolates of Nocardia spp. were identified from 134 patients but only 113 patients had Nocardia infection. Nocardia brasiliensis (n = 54) was the most common pathogen, followed by N. asteroides (n = 36), N. farcinica (n = 7), N. flavorosea (n = 4), N. otitidiscaviarum (n = 3), N. nova (n = 3), N. beijingensis (n = 2) and one each of N. puris, N. jinanensis and N. takedensis. The major types of infection were cutaneous infection (56.6%), pulmonary infection (33.6%) and disseminated infection (7.1%). Eighty-eight patients received sulfonamide-containing antibiotic and eight of 100 patients with available data on outcomes died during the episode of nocardiosis. In conclusion, the clinical and microbiological manifestations of Nocardiosis vary with the different Nocardia species. Accurate identification of the species is crucial to make the diagnosis.
ISSN:1198-743X
1469-0691
DOI:10.1111/j.1469-0691.2009.02950.x