Condas Larissa Anuska Zeni, Ribeiro Márcio Garcia, Muro Marisol Domingues, de Vargas Agueda Palmira Castagna, Matsuzawa Tetsuhiro, Yazawa Katsukiyo, Siqueira Amanda Keller, Salerno Tatiana, Lara Gustavo Henrique Batista, Risseti Rafaela Mastrangelo, Ferreira Karen Spadari, Gonoi Tohru
Department Veterinary Hygiene and Public Health, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Sao Paulo, Brazil.
Clinical Hospital, Universidade Federal do Parana, Curitiba, PR, Brazil.
Rev Inst Med Trop Sao Paulo. 2015 May-Jun;57(3):251-6. doi: 10.1590/S0036-46652015000300012.
Nocardia is a ubiquitous microorganism related to pyogranulomatous infection, which is difficult to treat in humans and animals. The occurrence of the disease is on the rise in many countries due to an increase in immunosuppressive diseases and treatments. This report of cases from Brazil presents the genotypic characterization and the antimicrobial susceptibility pattern using the disk-diffusion method and inhibitory minimal concentration with E-test® strips. In summary, this report focuses on infections in young adult men, of which three cases were cutaneous, two pulmonary, one neurological and one systemic. The pulmonary, neurological and systemic cases were attributed to immunosuppressive diseases or treatments. Sequencing analysis of the 16S rRNA segments (1491 bp) identified four isolates of Nocardia farcinica, two isolates of Nocardia nova and one isolate of Nocardia asiatica. N. farcinica was involved in two cutaneous, one systemic and other pulmonary cases; N. nova was involved in one neurological and one pulmonary case; and Nocardia asiatica in one cutaneous case. The disk-diffusion antimicrobial susceptibility test showed that the most effective antimicrobials were amikacin (100%), amoxicillin/clavulanate (100%), cephalexin (100%) and ceftiofur (100%), while isolates had presented most resistance to gentamicin (43%), sulfamethoxazole/trimethoprim (43%) and ampicillin (29%). However, on the inhibitory minimal concentration test (MIC test), only one of the four isolates of Nocardia farcinica was resistant to sulfamethoxazole/trimethoprim.
诺卡菌是一种与脓性肉芽肿感染相关的普遍存在的微生物,在人类和动物中难以治疗。由于免疫抑制性疾病和治疗方法的增加,该疾病在许多国家的发病率正在上升。这份来自巴西的病例报告呈现了使用纸片扩散法和E-test®试纸条的最低抑菌浓度的基因型特征和抗菌药敏模式。总之,本报告聚焦于年轻成年男性的感染,其中3例为皮肤感染,2例为肺部感染,1例为神经感染,1例为全身感染。肺部、神经和全身感染病例归因于免疫抑制性疾病或治疗。对16S rRNA片段(1491 bp)的测序分析鉴定出4株鼻疽诺卡菌、2株新星诺卡菌和1株亚洲诺卡菌。鼻疽诺卡菌涉及2例皮肤感染、1例全身感染和1例肺部感染;新星诺卡菌涉及1例神经感染和1例肺部感染;亚洲诺卡菌涉及1例皮肤感染。纸片扩散抗菌药敏试验表明,最有效的抗菌药物是阿米卡星(100%)、阿莫西林/克拉维酸(100%)、头孢氨苄(100%)和头孢噻呋(100%),而分离株对庆大霉素(43%)、磺胺甲恶唑/甲氧苄啶(43%)和氨苄西林(29%)表现出最高的耐药性。然而,在最低抑菌浓度试验(MIC试验)中,4株鼻疽诺卡菌分离株中只有1株对磺胺甲恶唑/甲氧苄啶耐药。