Clinical and microbiological characteristics of infections caused by various Nocardia species in Taiwan: a multicenter study from 1998 to 2010

  • W. L. Liu
  • C. C. Lai
  • W. C. Ko
  • Y. H. Chen
  • H. J. Tang
  • Y. L. Huang
  • Y. T. Huang
  • P. R. Hsueh
Article

DOI: 10.1007/s10096-011-1227-9

Cite this article as:
Liu, W.L., Lai, C.C., Ko, W.C. et al. Eur J Clin Microbiol Infect Dis (2011) 30: 1341. doi:10.1007/s10096-011-1227-9

Abstract

This multicenter study in Taiwan investigated the clinical presentations of various Nocardia species infections based on 16S rRNA sequence analysis. Patients with nocardiosis in four large medical centers from 1998 to 2010 were included. A total of 100 preserved nonduplicate isolates causing human infection were identified as Nocardia species. Sequencing analysis of 16S rRNA confirmed that 35 of 36 N. asteroides isolates identified by conventional tests were non-asteroides Nocardia species, and that two of 50 N. brasiliensis isolates had also been initially misidentified. N. brasiliensis (50%) was the most common pathogen, followed by N. cyriacigeorgica (18%). In addition, several rare pathogens were identified, including N. asiatica, N. rhamnosiphila, N. abscessus, N. transvalensis, N. elegans, and N. carnea. Primary cutaneous infection was the most common presentation, noted in 55 (55%) patients, while pulmonary infection presented in 26 (26%) patients. The crude mortality rate was 6.7% (6/89), and was lowest for primary cutaneous infection (2.2%) and highest for disseminated disease and pulmonary infection (16.7%). In conclusion, N. brasiliensis and N. cyriacigeorgica were the most common pathogens causing nocardiosis in Taiwan. Molecular methods for identifying Nocardia to the species level are mandatory for better understanding the epidemiology and clinical characteristics of patients with nocardiosis.

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • W. L. Liu
    • 1
  • C. C. Lai
    • 1
  • W. C. Ko
    • 2
  • Y. H. Chen
    • 3
  • H. J. Tang
    • 4
  • Y. L. Huang
    • 5
  • Y. T. Huang
    • 6
  • P. R. Hsueh
    • 6
  1. 1.Department of Intensive Care MedicineChi Mei Medical CenterLiouying, TainanTaiwan
  2. 2.Department of Internal MedicineNational Cheng Kung University Medical College and HospitalTainanTaiwan
  3. 3.Department of Internal Medicine, Kaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiungTaiwan
  4. 4.Department of Internal MedicineChi Mei Medical CenterTainanTaiwan
  5. 5.Department of PediatricsCathay General HospitalTaipeiTaiwan
  6. 6.Departments of Laboratory Medicine and Internal Medicine, National Taiwan University HospitalNational Taiwan University College of MedicineTaipeiTaiwan

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