Nocardia species distribution and antimicrobial susceptibility within Australia

Aine O'Brien¹, Julie Hart², Ammie Higgins³, Ian Arthur³, Gar-Hing Lee³, Michael Leung³, Karina Kennedy⁴, Susan Bradbury⁴, Sarah Foster⁵, Sanchia Warren⁶, Tony M Korman⁷, Iain J Abbott⁸, Claire Heney⁹, Cheryl Bletchley¹⁰, Morgyn Warner¹¹, Nicholas Wells¹², Desley Wilson¹², Hemalatha Varadhan¹³, Robert Stevens^{14

15}, Monica Lahra¹⁶, Peter Newton¹⁷, Michael Maley^{18

19}, Sebastian van Hal^{16

20}, Paul R Ingram¹

Affiliations

¹ Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Western Australia, Australia.
² Department of Infectious Diseases, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia.
³ PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia.
⁴ ACT Health, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
⁵ Launceston General Hospital, Tasmanian Health Service (THS), Hobart, Tasmania, Australia.
⁶ Royal Hobart Hospital, Department of Microbiology and Infectious Diseases, Hobart, Tasmania, Australia.
⁷ Monash Health, Monash Infectious Diseases, Melbourne, Victoria, Australia.
⁸ Alfred Health, Melbourne, Victoria, Australia.
⁹ Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
¹⁰ Pathology Queensland, Brisbane, Queensland, Australia.
¹¹ Infectious Diseases and Microbiology Department, Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
¹² South Australia Pathology, Adelaide, South Australia, Australia.
¹³ Hunter New England, NSW Health Pathology, Newcastle, New South Wales, Australia.
¹⁴ South Eastern Sydney, NSW Health Pathology, Sydney, New South Wales, Australia.
¹⁵ School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
¹⁶ NSW Health Pathology, Newcastle, New South Wales, Australia.
¹⁷ Illawarra-Shoalhaven, NSW Health Pathology, Wollongong, New South Wales, Australia.
¹⁸ South Western Sydney, NSW Health Pathology, Sydney, New South Wales, Australia.
¹⁹ Microbiology, Liverpool Hospital, Sydney, New South Wales, Australia.
²⁰ Infectious Diseases and Microbiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

PMID: 37929813
DOI: 10.1111/imj.16234

Nocardia species distribution and antimicrobial susceptibility within Australia

Aine O'Brien et al. Intern Med J. 2024 Apr.

. 2024 Apr;54(4):613-619.

doi: 10.1111/imj.16234. Epub 2023 Nov 6.

Authors

Affiliations

¹ Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Western Australia, Australia.
² Department of Infectious Diseases, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia.
³ PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia.
⁴ ACT Health, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
⁵ Launceston General Hospital, Tasmanian Health Service (THS), Hobart, Tasmania, Australia.
⁶ Royal Hobart Hospital, Department of Microbiology and Infectious Diseases, Hobart, Tasmania, Australia.
⁷ Monash Health, Monash Infectious Diseases, Melbourne, Victoria, Australia.
⁸ Alfred Health, Melbourne, Victoria, Australia.
⁹ Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
¹⁰ Pathology Queensland, Brisbane, Queensland, Australia.
¹¹ Infectious Diseases and Microbiology Department, Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
¹² South Australia Pathology, Adelaide, South Australia, Australia.
¹³ Hunter New England, NSW Health Pathology, Newcastle, New South Wales, Australia.
¹⁴ South Eastern Sydney, NSW Health Pathology, Sydney, New South Wales, Australia.
¹⁵ School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
¹⁶ NSW Health Pathology, Newcastle, New South Wales, Australia.
¹⁷ Illawarra-Shoalhaven, NSW Health Pathology, Wollongong, New South Wales, Australia.
¹⁸ South Western Sydney, NSW Health Pathology, Sydney, New South Wales, Australia.
¹⁹ Microbiology, Liverpool Hospital, Sydney, New South Wales, Australia.
²⁰ Infectious Diseases and Microbiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

PMID: 37929813
DOI: 10.1111/imj.16234

Abstract

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.

Keywords: Australia; Nocardia; Western Australia; species distribution; susceptibility.

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References

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Nocardia species distribution and antimicrobial susceptibility within Australia

Affiliations

Nocardia species distribution and antimicrobial susceptibility within Australia

Authors

Affiliations

Abstract

References

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LinkOut - more resources

Full Text Sources