title: Nocardia cyriacigeorgica, an emerging pathogen in the United States.
abstract: Nocardia cyriacigeorgica is recognized as an emerging pathogen in many parts of the world. We present the first case description of invasive N. cyriacigeorgica pulmonary infection in the United States identified to the species level by 16S rRNA and hsp65 sequence analysis. A subsequent retrospective molecular screening of recent Nocardia clinical isolates at our New York City medical center yielded an additional six N. cyriacigeorgica isolates. Because routine laboratory algorithms for the phenotypic identification of Nocardia species are limited in practice, the true prevalence of N. cyriacigeorgica infections may be greater than currently appreciated. Indeed, we present evidence confirming that N. cyriacigeorgica is coincident with the unofficial species designation Nocardia asteroides complex antimicrobial susceptibility pattern type VI and distinct from the N. asteroides sensu stricto strain ATCC 19247(T). As nocardial species identity can predict antimicrobial susceptibility and guide clinical management, we offer simplified phenotypic and molecular protocols to assist the identification of N. cyriacigeorgica.
authors.affiliation: Department of Pathology, Clinical Microbiology Service, NewYork-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St., New York, NY 10032, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Schlaberg
authors.forename: Richard C
authors.initials: RC
authors.lastname: Huard
authors.forename: Phyllis
authors.initials: P
authors.lastname: Della-Latta
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D005260:Female; D005798:Genes, Bacterial / Q000235:genetics; D020459:Genes, rRNA; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D009519:New York City / Q000453:epidemiology; D009615:Nocardia / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000453:epidemiology* / Q000382:microbiology*; D009616:Nocardia asteroides / Q000187:drug effects; D010802:Phylogeny; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA; D012689:Sequence Homology, Nucleic Acid
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S