Department of Bacteriology, Nice Academic Hospital, Nice, France.
Université Côte D'Azur, CHU de Nice, Nice, France.
Ann Clin Microbiol Antimicrob. 2020 Aug 20;19(1):38. doi: 10.1186/s12941-020-00379-7.
Nocardia takedensis was first isolated in 2005, from soil in Japan. We report here two cases of lymphangitis in France (2012-2017) caused by N. takedensis both occurring after skin injury while gardening, which enabled its inoculation. The two patients were immunocompromised and successfully treated by an antimicrobial agent active on the isolated strain, trimethoprim-sulfamethoxazole and amoxicillin-clavulanic acid for patient one and patient two, respectively. Our study along with previous ones supports the idea of a newly recognized cutaneous opportunistic pathogen and reinforces the recommendation of using gloves during soil exposure for immunocompromised patients. Lastly, according to data found in the literature, we would recommend trimethoprim-sulfamethoxazole as an efficient empirical antibiotic therapy in case of cutaneous infection caused by N. takedensis.
日本土壤中于 2005 年首次分离到 takedensis 诺卡氏菌。我们在此报告两例法国淋巴管炎病例（2012-2017 年），均由接种 takedensis 诺卡氏菌引起，这两例均发生在园艺皮肤损伤后。这两名患者免疫功能低下，分别使用对分离株有效的抗菌药物（trimethoprim-sulfamethoxazole 和 amoxicillin-clavulanic acid）成功治疗。我们的研究以及以往的研究支持一种新认定的皮肤机会性病原体的观点，并加强了对免疫功能低下患者在接触土壤时使用手套的建议。最后，根据文献中的数据，我们建议在由 takedensis 诺卡氏菌引起的皮肤感染中使用 trimethoprim-sulfamethoxazole 作为有效的经验性抗生素治疗。
