title: Sulfonamide resistance in isolates of Nocardia spp. from a US multicenter survey.
abstract: Recent reports of increasing in vitro sulfonamide resistance in Nocardia prompted us to investigate the findings. Despite the reports, there is a paucity of clinical reports of sulfonamide failure in treatment of nocardia disease. We reviewed 552 recent susceptibilities of clinical isolates of Nocardia from six major laboratories in the United States, and only 2% of the isolates were found to have resistant MICs of trimethoprim-sulfamethoxazole and/or sulfamethoxazole. We hypothesize that the discrepancies in the apparent sulfonamide resistance between our study and the previous findings may be associated with difficulty in the laboratory interpretation of in vitro MICs for trimethoprim-sulfamethoxazole and sulfamethoxazole and the lack of quality controls for Nocardia for these agents.
authors.affiliation: University of Texas Health Science Center at Tyler, Tyler, Texas, USA. barbara.elliott@uthct.edu
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Brown-Elliott
authors.forename: Jon
authors.initials: J
authors.lastname: Biehle
authors.forename: Patricia S
authors.initials: PS
authors.lastname: Conville
authors.forename: Samuel
authors.initials: S
authors.lastname: Cohen
authors.forename: Michael
authors.initials: M
authors.lastname: Saubolle
authors.forename: Den
authors.initials: D
authors.lastname: Sussland
authors.forename: Nancy
authors.initials: N
authors.lastname: Wengenack
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kriel
authors.forename: Linda
authors.initials: L
authors.lastname: Bridge
authors.forename: Steven
authors.initials: S
authors.lastname: McNulty
authors.forename: Ravikiran
authors.initials: R
authors.lastname: Vasireddy
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wallace
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods / Q000592:standards; D009615:Nocardia / Q000187:drug effects* / Q000302:isolation & purification*; D009617:Nocardia Infections / Q000382:microbiology*; D013420:Sulfamethoxazole / Q000494:pharmacology; D013449:Sulfonamides / Q000494:pharmacology*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D013449:Sulfonamides; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D013420:Sulfamethoxazole