Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy.
The recent explosion of newly described species of Nocardia results from the impact in the last decade of newer molecular technology, including PCR restriction enzyme analysis and 16S rRNA sequencing. These molecular techniques have revolutionized the identification of the nocardiae by providing rapid and accurate identification of recognized nocardiae and, at the same time, revealing new species and a number of yet-to-be-described species. There are currently more than 30 species of nocardiae of human clinical significance, with the majority of isolates being N. nova complex, N. abscessus, N. transvalensis complex, N. farcinica, N. asteroides type VI (N. cyriacigeorgica), and N. brasiliensis. These species cause a wide variety of diseases and have variable drug susceptibilities. Accurate identification often requires referral to a reference laboratory with molecular capabilities, as many newer species are genetically distinct from established species yet have few or no distinguishing phenotypic characteristics. Correct identification is important in deciding the clinical relevance of a species and in the clinical management and treatment of patients with nocardial disease. This review characterizes the currently known pathogenic species of Nocardia, including clinical disease, drug susceptibility, and methods of identification.
Brown-Elliott
Barbara A
BA
Department of Microbiology, The University of Texas Health Center, 11937 U.S. Highway 271, Tyler, 75708, USA.
Brown
June M
JM
Conville
Patricia S
PS
Wallace
Richard J
RJ
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001431:Bacteriological Techniques; D003470:Culture Media; D004269:DNA, Bacterial / Q000235:genetics; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D009615:Nocardia / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000175:diagnosis* / Q000188:drug therapy; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D012329:RNA, Bacterial / Q000235:genetics; D012336:RNA, Ribosomal, 16S; D012871:Skin Diseases / Q000175:diagnosis / Q000382:microbiology; D013045:Species Specificity
D000900:Anti-Bacterial Agents; D003470:Culture Media; D004269:DNA, Bacterial; D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S