Nocardia species distribution and antimicrobial susceptibility within Australia.

Autor: O'Brien A; Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Western Australia, Australia., Hart J; Department of Infectious Diseases, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia., Higgins A; PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia., Arthur I; PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia., Lee GH; PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia., Leung M; PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia., Kennedy K; ACT Health, Canberra Hospital, Canberra, Australian Capital Territory, Australia., Bradbury S; ACT Health, Canberra Hospital, Canberra, Australian Capital Territory, Australia., Foster S; Launceston General Hospital, Tasmanian Health Service (THS), Hobart, Tasmania, Australia., Warren S; Royal Hobart Hospital, Department of Microbiology and Infectious Diseases, Hobart, Tasmania, Australia., Korman TM; Monash Health, Monash Infectious Diseases, Melbourne, Victoria, Australia., Abbott IJ; Alfred Health, Melbourne, Victoria, Australia., Heney C; Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia., Bletchley C; Pathology Queensland, Brisbane, Queensland, Australia., Warner M; Infectious Diseases and Microbiology Department, Queen Elizabeth Hospital, Adelaide, South Australia, Australia., Wells N; South Australia Pathology, Adelaide, South Australia, Australia., Wilson D; South Australia Pathology, Adelaide, South Australia, Australia., Varadhan H; Hunter New England, NSW Health Pathology, Newcastle, New South Wales, Australia., Stevens R; South Eastern Sydney, NSW Health Pathology, Sydney, New South Wales, Australia.; School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia., Lahra M; NSW Health Pathology, Newcastle, New South Wales, Australia., Newton P; Illawarra-Shoalhaven, NSW Health Pathology, Wollongong, New South Wales, Australia., Maley M; South Western Sydney, NSW Health Pathology, Sydney, New South Wales, Australia.; Microbiology, Liverpool Hospital, Sydney, New South Wales, Australia., van Hal S; NSW Health Pathology, Newcastle, New South Wales, Australia.; Infectious Diseases and Microbiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia., Ingram PR; Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Western Australia, Australia.
Jazyk: angličtina
Zdroj: Internal medicine journal [Intern Med J] 2024 Apr; Vol. 54 (4), pp. 613-619. Date of Electronic Publication: 2023 Nov 06.
DOI: 10.1111/imj.16234
Abstrakt: Background: Nocardia is a ubiquitous saprophyte capable of causing human disease. Disease is primarily respiratory or cutaneous, usually acquired via inhalation or inoculation. Under the influence of environmental and host factors, Nocardia incidence and species distribution demonstrate geographical variation.
Aims: To examine for differences in Nocardia incidence within Western Australia (WA) and analyse species distribution in the context of prior published studies. To analyse antibiogram data from a nationwide passive antimicrobial resistance surveillance program.
Methods: Retrospective extraction of laboratory data for Western Australian Nocardia isolates over a 21-year period. Analysis of Nocardia antimicrobial susceptibility testing data submitted to the Australian Passive Antimicrobial Resistance Surveillance (APAS) program between 2005 and 2022.
Results: Nine hundred sixty WA isolates were identified, giving an annual incidence of 3.03 per 100 000 population with apparent latitudinal variation. The four most common species identified within WA and amongst APAS isolates were N. nova, N. cyriacigeorgica, N. brasiliensis and N. farcinica. APAS data demonstrated that all species exhibited high rates of susceptibility to linezolid (100%) and trimethoprim-sulfamethoxazole (98%). Amikacin (>90% susceptibility for all species except N. transvalensis) was the next most active parenteral agent, superior to both carbapenems and third-generation cephalosporins. Susceptibility to oral antimicrobials (other than linezolid) demonstrated significant interspecies variation.
Conclusions: We demonstrate geographical variation in the distribution of Nocardia incidence. Four species predominate in the Australian setting, and nationwide data confirm a high in vitro susceptibility to trimethoprim-sulphamethoxazole and linezolid, justifying their ongoing role as part of first-line empiric therapy.
(© 2023 Royal Australasian College of Physicians.)
Databáze: MEDLINE
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