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A multi-centre retrospective study of Nocardia speciation and antimicrobial susceptibility in Queensland, Australia

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Abstract

The study aims to characterise the species identification and antimicrobial susceptibility testing (AST) results of Nocardial isolates from adult patients across major public hospitals in Queensland, Australia, over a 15-year period. A multi-centre retrospective observational study of Nocardia sp. isolates was conducted from 7 major public hospitals in Queensland, Australia, over a 15-year period. Clinical samples from patients aged ≥ 18 years that isolated Nocardia sp. were included. Demographic and clinical data were collected, along with species identification and AST results. Overall, 484 Nocardia sp. were isolated. Most patients were male (297, 61%) with a mean (IQR) age of 60 (51–75) and a median (IQR) Charlson Comorbidity Index of 4 (2–6). Of these, 239 (49%) patients were immunosuppressed. Organisms were most frequently isolated from sputum (174, 36%), and superficial swabs (102, 21%). Patients presented with pulmonary infections (165, 35%) and superficial skin and soft tissue infections (87, 18%) most commonly. One hundred (21%) isolates were deemed pulmonary colonisation and were not treated. Of the speciated organisms, N. nova complex was the most common (93, 19%), followed by N. farcinica complex (79, 16%). Organisms were reliably susceptible to linezolid (240/245, 98%), amikacin (455/470, 97%), and trimethoprim/sulfamethoxazole (459/476, 96%), but less so to imipenem (243/472, 51%) and ceftriaxone (261/448, 58%). This is the largest Australian description of Nocardia sp. to date. Given antimicrobials are often commenced prior to AST results and sometimes even speciation, characterisation of local species and antibiogram data is important to guide empiric choices and local guidelines.

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Data availability

The datasets generated during and/or analysed during the current study are not publicly available due to patient confidentiality and privacy reasons, but may be available from the corresponding author on reasonable request.

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Acknowledgements

The authors acknowledge the QMRL and staff who conducted microbiological identification and susceptibility testing on these isolates.

Author information

Authors and Affiliations

  1. Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia

    B. Z. Sim, L. Aaron, K. May, A. H. Henderson & E. Bursle

  2. Cairns Hospital, 165 The Esplanade, Cairns, QLD, 4870, Australia

    B. Z. Sim, J. Ho, J. Hanson & S. Smith

  3. University of Queensland, St. Lucia, QLD, 4072, Australia

    B. Z. Sim & E. Bursle

  4. Queensland Mycobacterium Reference Laboratory, Herston Road, Herston, QLD, 4029, Australia

    C. Coulter

  5. The Prince Charles Hospital, 627 Rode Road, Chermside, QLD, 4032, Australia

    J. Parkes-Smith

  6. Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD, 4215, Australia

    T. Badrick

  7. Townsville University Hospital, 100 Angus Smith Drive, Douglas, QLD, 4814, Australia

    M. Armstrong & S. Hendry

  8. Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, QLD, 4029, Australia

    L. Sundac & L. Dang

  9. Kirby Institute, High Street, Kensington, NSW, 2052, Australia

    J. Hanson

  10. Sunshine Coast University Hospital, 6 Doherty Street, Birtinya, QLD, 4575, Australia

    K. Choong

Authors
  1. B. Z. Sim
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  2. L. Aaron
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  3. C. Coulter
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  4. J. Parkes-Smith
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  5. T. Badrick
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  6. K. May
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  7. M. Armstrong
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  8. S. Hendry
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  9. L. Sundac
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  10. L. Dang
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  11. J. Ho
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  12. J. Hanson
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  13. S. Smith
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  14. K. Choong
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  15. A. H. Henderson
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  16. E. Bursle
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Contributions

All authors contributed to the study conception, design, and data collection. Material preparation was performed by Evan Bursle and Andrew Henderson. Analysis was performed by Beatrice Sim, Luke Aaron, Evan Bursle, and Andrew Henderson. The first draft of the manuscript was written by Beatrice Sim, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to B. Z. Sim.

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Sim, B.Z., Aaron, L., Coulter, C. et al. A multi-centre retrospective study of Nocardia speciation and antimicrobial susceptibility in Queensland, Australia. Eur J Clin Microbiol Infect Dis 42, 339–345 (2023). https://doi.org/10.1007/s10096-022-04542-0

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  • DOI: https://doi.org/10.1007/s10096-022-04542-0

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