Clinical spectrum and outcome of nocardiosis in Oman: a case series from a single center
DOI:
https://doi.org/10.18203/2320-6012.ijrms20250695Keywords:
Nocardiosis, Nocardia spp, Chronic lung disease, 16sRNA, Culture confirmed nocardiosis, OmanAbstract
Nocardiosis is an opportunistic bacterial infection caused by aerobic Gram-positive bacteria belonging to the actinomycetes group. With the increase in the population of immunocompromised patients, these infections have been identified in the middle east countries. In a retrospective study of 13 years, we found ten patients who were culture confirmed nocardiosis. Among this series, pulmonary nocardiosis predominated with 80%. Most of the species of Nocardia were identified using the molecular testing, 16S rRNA gene sequencing and drug susceptibilities were performed in 70% and 60% respectively. Treatment is usually based on susceptibility testing which give a better clinical cure and outcome. Cotrimoxazole formed the back bone of the treatment. Although, small in number, this case series is the largest reported from the any middle east country and it can assist the clinicians with high clinical suspicion of infection and early treatment.
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References
Michael S, Sussland D. Nocardiosis: Review of Clinical and Laboratory Experience. J Clin Microbiol 2003;41:4497-501. DOI: https://doi.org/10.1128/JCM.41.10.4497-4501.2003
Lam JC, Chan WW, Walsh JF. Disseminated nocardiosis in an immunocompetent host with occupational exposure, ID Cases 2022;30:e01620. DOI: https://doi.org/10.1016/j.idcr.2022.e01620
Peleg AY, Husain S, Qureshi ZA, Silveira FP, Sarumi M, Shutt KA, et al. Risk factors, clinical characteristics, and outcome of Nocardia infection in organ transplant recipients: a matched case-control study. Clin Infect Dis. 2007;44:1307-14. DOI: https://doi.org/10.1086/514340
Tremblay J, Thibert L, Alarie I, Valiquette L, Pepin J. 2011. Nocardiosis in Quebec, Canada, 1988-2008. Clin Microbiol Infect. 2011;17:690-6. DOI: https://doi.org/10.1111/j.1469-0691.2010.03306.x
Weheba I, Abdelsayed A, Alrajhi AA, Al-Thawadi SI, Mobeireek A. Nocardiosis at an Organ Transplant Center in Saudi Arabia: 15 years' experience. J Glob Infect Dis. 2021;13(1):7-12. DOI: https://doi.org/10.4103/jgid.jgid_66_20
Hakawi AM, Al Rabiah FA. Short communication: Clinical pattern of nocardiosis in Saudi Arabia: a case series. Eastern Mediterranean Heal J. 2008;14(4):961-71.
Steinbrink J, Leavens J, Kauffman CA, Miceli MH. Manifestations and outcomes of Nocardia infections: comparison of immunocompromised and non-immunocompromised adult patients. Medicine. 2018;97:e12436. DOI: https://doi.org/10.1097/MD.0000000000012436
Valdezate S, Garrido N, Carrasco G, Medina-Pascual MJ, Villalon P, Navarro AM, et al. Epidemiology and susceptibility to antimicrobial agents of the main Nocardia species in Spain. J Antimicrob Chemother. 2017;72:754e61.
Couble A, Rodriguez-Nava V, de Montclos MP, Boiron P, Laurent F. Direct detection of Nocardia spp. in clinical samples by a rapid molecular method. J Clin Microbiol. 2005;43:1921e4.
Lebeaux D, Bergeron E, Berthet J, Djadi-Prat J, Mouniée D, Boiron P, 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):489-95. DOI: https://doi.org/10.1016/j.cmi.2018.06.013
Brown JM, McNeil MM. Nocardia, Rhodococcus, Gordonia, Actinomadura, Streptomyces, and other aerobic actinomycetes. In PR Murray, EJ Baron, MA Pfaller, FC Tenover and RH Yolken (ed.), Manual of Clinical Microbiology, 8th ed. American Society for Microbiology. Washington, D. C. 2003;502-31.
Woodworth MH, Saullo JL, Lantos PM, Cox GM, Stout JE. Increasing Nocardia incidence associated with bronchiectasis at a tertiary care center. Ann Am Thorac Soc. 2017;14:347-54. DOI: https://doi.org/10.1513/AnnalsATS.201611-907OC
Dumic I, Brown A, Magee K, Elwasila S, Kaljevic M, Antic M, et al. Primary Lymphocutaneous Nocardia brasiliensis in an Immunocompetent Host: Case Report and Literature Review. Medicina (Kaunas). 2022;58(4):488. DOI: https://doi.org/10.3390/medicina58040488
Yong EX, Cheong EY, Boutlis CS, Chen DB, Liu EY, McKew GL. Nocardia septic arthritis complicating an anterior cruciate ligament repair. J Clin Microbiol. 2015;53:2760-2. DOI: https://doi.org/10.1128/JCM.00754-15
Fujita T, Ikari J, Watanabe A, Tatsumi K. Clinical characteristics of pulmonary nocardiosis in immunocompetent patients. J Infect Chemother. 2016;22:738-43. DOI: https://doi.org/10.1016/j.jiac.2016.08.004
Kurahara Y, Tachibana K, Tsuyuguchi K, Akira M, Suzuki K, Hayashi S. Pulmonary nocardiosis: a clinical analysis of 59 cases. Respir Invest. 2014;52:160-6. DOI: https://doi.org/10.1016/j.resinv.2013.09.004
Georghiou PR, Blacklock ZM. Infection with Nocardia species in Queensland. A review of 102 clinical isolates. Med J Aust. 1992;156:692-7. DOI: https://doi.org/10.5694/j.1326-5377.1992.tb121509.x
Parvu M, Schleiter G, Stratidis JG. Skin Infections caused by Nocardia species a case report and review of the literature of primary cutaneous nocardiosis reported in the United States. Infect Dis Clin Pract. 2012;20:237-41. DOI: https://doi.org/10.1097/IPC.0b013e31824fc95e
Hawrot AC, Carter EL. Simultaneous chronic cutaneous infection with Mycobacterium marinum and Nocardia asteroides. J Am Acad Dermatol. 2005;52:703-4. DOI: https://doi.org/10.1016/j.jaad.2004.09.039
Coussement J, Lebeaux D, van Delden C, Guillot H, Freund R, Marbus S, et al, European Study Group for Nocardia in Solid Organ T. Nocardia infection in solid organ transplant recipients: a multicenter European case-control study. Clin Infect Dis. 2016;63:338-45. DOI: https://doi.org/10.1093/cid/ciw241
Khan M, Adnan MM, Shahbaz N, Hamza M, Mujeeb SA. Nocardia mikamii a novel species causing disseminated nocardiosis: a literature review of disseminated nocardiosis. Int Sch Res Notices. 2014;16;869153. DOI: https://doi.org/10.1155/2014/869153
Conville PS, Brown-Elliott BA, Smith T, Zelazny AM. The complexities of Nocardia taxonomy and identification. J Clin Microbiol. 2017;56(1):e01419-17. DOI: https://doi.org/10.1128/JCM.01419-17
Lafont E, Conan PL, Rodriguez-Nava V, Lebeaux D. Invasive nocardiosis: disease presentation, diagnosis and treatment-old questions, new answers? Infect Drug Resist. 2020;13:4601-13. DOI: https://doi.org/10.2147/IDR.S249761
Nau R, Sorgel F, Eiffert H. Penetration of drugs through the blood cerebrospinal fluid/blood-brain barrier for treatment of central nervous system infections. Clin Microbiol Rev. 2010;23:858-83. DOI: https://doi.org/10.1128/CMR.00007-10
Rahdar HA, Azadi D, Shojaei H, Daei-Naser A. Molecular analysis and species diversity of Nocardia in the hospital environment in a developing country, a potential health hazard. J Med Microbiol. 2017;66:334-1. DOI: https://doi.org/10.1099/jmm.0.000436
Besteiro B, Coutinho D, Fragoso J, Figueiredo C, Nunes S, Azevedo C, et al. Nocardiosis: a single-center experience and literature review. Braz J Infect Dis. 2023;27(5):102806. DOI: https://doi.org/10.1016/j.bjid.2023.102806
Hamdi AM, Fida M, Deml SM, Abu Saleh OM, Wengenack NL. Retrospective analysis of antimicrobial susceptibility profiles of Nocardia species from a tertiary hospital and reference laboratory, 2011 to 2017. Antimicrob Agents Chemother. 2020;64:e01868-79. DOI: https://doi.org/10.1128/AAC.01868-19
Couble A, Rodríguez-Nava V, Pérouse de Montelos M, Boiron P, Laurent F. Direct detection of Nocardia spp. in clinical samples by a rapid molecular method. J Clin Microbiol. 2005;43:1921-4. DOI: https://doi.org/10.1128/JCM.43.4.1921-1924.2005
Valdezate S, Garrido N, Carrasco G, Medina-Pascual MJ, Villalon P, Navarro AM, et al. Epidemiology and susceptibility to antimicrobial agents of the main Nocardia species in Spain. J Antimicrob Chemother. 2017;72:754-61. DOI: https://doi.org/10.1093/jac/dkw489