Department of Infectious diseases, Wollongong Hospital, Wollongong NSW 2500.
Microbiology, NSW Health Pathology, Wollongong Hospital, Wollongong NSW, 2500.
Commun Dis Intell (2018). 2022 Feb 16;46. doi: 10.33321/cdi.2022.46.7.
Nocardia species are a diverse group of gram-positive bacteria that are encountered as pathogens in clinical practice. They are ubiquitous environmental organisms classically causing opportunistic infections in immunocompromised individuals. This case series describes the epidemiological, microbiological and clinical features of 26 culture-proven cases of nocardiosis presenting to the public healthcare service in a regional area of New South Wales over a ten year period. These cases involved ten distinct species of Nocardia and appeared to demonstrate increasing incidence over time. The majority of Nocardia isolates (88%) were grown on conventional bacteriological media and speciation was primarily via 16S rRNA sequencing and/or matrix assisted laser desorption ionisation-time of flight mass spectrometry. Similar to other Australian Nocardia studies, the isolates seen in this case series were universally susceptible to trimethoprim-sulfamethoxazole. This was reflected in treatment data, with all but one patient receiving this agent as part of their antibiotic regimen. While similar case series have been reported from other Australian states, there are no published clinical studies of nocardiosis in New South Wales. Given the nature of Nocardia species as an environmental saprophyte, this study examined the association between incidence of nocardiosis and regional geographic or climatic variation but was unable to demonstrate a statistically significant correlation.
诺卡氏菌属是一组多样化的革兰氏阳性细菌，在临床实践中被视为病原体。它们是无处不在的环境生物体，经典地在免疫功能低下的个体中引起机会性感染。本病例系列描述了在新南威尔士州一个地区的公共医疗服务中，十年来 26 例经培养证实的诺卡氏菌病的流行病学、微生物学和临床特征。这些病例涉及十种不同的诺卡氏菌属，似乎随着时间的推移发病率有所增加。大多数诺卡氏菌分离株（88%）在常规细菌培养基上生长，种系主要通过 16S rRNA 测序和/或基质辅助激光解吸电离飞行时间质谱进行鉴定。与其他澳大利亚诺卡氏菌研究相似，本病例系列中所见的分离株对甲氧苄啶-磺胺甲恶唑普遍敏感。这反映在治疗数据中，除了一名患者外，所有患者都接受了该药物作为其抗生素方案的一部分。虽然其他澳大利亚州也有类似的病例系列报告，但新南威尔士州没有关于诺卡氏菌病的临床研究。鉴于诺卡氏菌属作为一种环境腐生物的性质，本研究检查了诺卡氏菌病的发病率与区域地理或气候变化之间的关系，但未能证明存在统计学上的显著相关性。
