INSERM, U1138, LRMA, Equipe 12 du Centre de Recherche des Cordeliers, Paris, France; Université Pierre et Marie Curie, UMRS 1138, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, UMRS 1138, Paris, France; Assistance Publique-Hôpitaux de Paris, Service de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, AP-HP, Hôpital Necker Enfants Malades, Centre d'Infectiologie Necker-Pasteur and Institut Imagine, Paris, France.
Research group on Bacterial Opportunistic Pathogens and Environment UMR5557 Écologie Microbienne, French Observatory of Nocardiosis, Institute of Infectious Agents, Hospices Civils de Lyon, Université de Lyon 1, CNRS, VetAgro Sup, Lyon, France.
Clin Microbiol Infect. 2019 Apr;25(4):489-495. doi: 10.1016/j.cmi.2018.06.013. Epub 2018 Jun 20.
Nocardia, a Gram-positive bacterium, is responsible for rare and severe infections. Accurate microbiological data are essential to guide antibiotic treatment. Our primary objective was to describe species identification and results of antimicrobial susceptibility testing (AST) for Nocardia isolates analysed over a 6-year period. Secondary objectives were to study temporal trends in species distribution and AST results.
We retrospectively analysed results from Nocardia isolates sent between January 2010 and December 2015 to a French laboratory dedicated to Nocardia (Observatoire Français des Nocardioses). Species identification was obtained by amplification and sequencing of a 600-bp fragment of the 16S rRNA gene (for all isolates) and of hsp65 (when required). AST was performed using disk diffusion.
We included 793 Nocardia isolates, mostly from the lungs (53.8%). The most frequent species were Nocardia farcinica (20.2%), Nocardia abscessus complex (19.9%) and Nocardia nova complex (19.5%). The proportion of N. farcinica increased significantly over time from 13% in 2010 to 27.6% in 2014. Linezolid, amikacin, trimethoprim-sulfamethoxazole, minocycline and imipenem were the most frequently identified active antibiotics with, respectively, 0% (0/734), 2.9% (21/730), 5.4% (40/734), 9.4% (69/734) and 19.5% (143/732) of isolates not susceptible. Nocardia farcinica was frequently not susceptible to cefotaxime (118/148, 79.7% of the isolates), but only about 5% of Nocardia cyriacigeorgica and N. abscessus complex isolates were not susceptible to cefotaxime.
In this first epidemiological study of Nocardia isolated from human samples in France, N. farcinica was the species most frequently identified and its prevalence increased over time.
奴卡菌为革兰阳性菌，可导致罕见且严重的感染。准确的微生物数据对于指导抗生素治疗至关重要。我们的主要目标是描述在 6 年期间分析的奴卡菌分离株的种属鉴定和抗菌药物敏感性试验（AST）结果。次要目标是研究种属分布和 AST 结果的时间趋势。
我们回顾性分析了 2010 年 1 月至 2015 年 12 月间送往法国奴卡菌监测实验室（Observatoire Français des Nocardioses）的奴卡菌分离株的结果。通过扩增和测序 16S rRNA 基因 600bp 片段（所有分离株）和 hsp65（需要时）来进行种属鉴定。AST 使用纸片扩散法进行。
我们纳入了 793 株奴卡菌分离株，主要来自肺部（53.8%）。最常见的种属为星状奴卡菌（20.2%）、脓肿奴卡菌复合体（19.9%）和新星奴卡菌复合体（19.5%）。2010 年至 2014 年，星状奴卡菌的比例从 13%显著增加至 27.6%。利奈唑胺、阿米卡星、复方磺胺甲噁唑、米诺环素和亚胺培南是最常鉴定的有效抗生素，分别有 0%（0/734）、2.9%（21/730）、5.4%（40/734）、9.4%（69/734）和 19.5%（143/732）的分离株不敏感。星状奴卡菌对头孢噻肟的不敏感率频繁（118/148，148 株中 79.7%），但仅有约 5%的棘状奴卡菌和脓肿奴卡菌复合体分离株对头孢噻肟不敏感。
在这项法国首次针对人类样本分离的奴卡菌的流行病学研究中，星状奴卡菌是最常鉴定的种属，且其流行率随时间推移而增加。
