title: Cutaneous manifestations of Nocardia brasiliensis infection in Taiwan during 2002-2012-clinical studies and molecular typing of pathogen by gyrB and 16S gene sequencing.
abstract: To observe the clinicopathologic and resistance profiles of the Nocardia brasiliensis causing cutaneous nocardiosis in Taiwan, 12 N. brasiliensis isolates were prospectively collected from patients with cutaneous nocardiosis in a hospital during 2002-2012. Clinicopathologic data were obtained, and isolates were identified by biochemical methods and 16S rRNA sequencing. Susceptibilities to 14 antimicrobial compounds were tested. Isolates were further genotyped by sequencing of 16S rRNA, secA1, hsp65, and gyrB genes. The nodulopustular pyoderma associated with sporotrichoid spreading was the most common skin presentations caused by N. brasiliensis. All of the isolates were susceptible to amikacin, gentamicin, tobramycin, piperacillin/tazobactam, and trimethoprim/sulfamethoxazole and resistant to kanamycin, erythromycin, and oxacillin, while susceptibilities to imipenem, vancomycin, penicillin-G, tetracycline, clindamycin, and ciprofloxacin varied among the 12 isolates. GyrB genotyping delineated the 12 isolates into 2 major groups, which was coincident with different single nucleotide substitutions at position 160 (G versus T) of 16S rRNA, different levels of imipenem minimum inhibition concentration (4-32 versus 0.25-0.75 mg/L), and prevalence of lymphadenitis (66.7 versus 16.7%). We have noted that tiny pustular lesions can be the first sign of cutaneous nocardiosis, which we believe has not been previously emphasized. No resistance to trimethoprim and sulfamethoxazole was found; therefore, sulphonamide drugs remain effective for treatment of cutaneous nocardiosis in Taiwan.
authors.affiliation: Mycotic Diseases Laboratory, Research and Diagnostic Center, Centers for Disease Control, Taipei, Taiwan.
authors.forename: Kuo-Wei
authors.initials: KW
authors.lastname: Chen
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Lu
authors.forename: Ting-Chi
authors.initials: TC
authors.lastname: Huang
authors.forename: Chin-Fang
authors.initials: CF
authors.lastname: Lu
authors.forename: Yea-Ling
authors.initials: YL
authors.lastname: Liau
authors.forename: Jeng-Fong
authors.initials: JF
authors.lastname: Lin
authors.forename: Shu-Ying
authors.initials: SY
authors.lastname: Li
mesh_terms: D000251:Adenosine Triphosphatases / Q000235:genetics; D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D027081:DNA Gyrase / Q000235:genetics; D005260:Female; D006360:Heat-Shock Proteins / Q000235:genetics; D006801:Humans; D008297:Male; D026901:Membrane Transport Proteins / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D008969:Molecular Sequence Data; D058889:Molecular Typing; D009615:Nocardia / Q000145:classification* / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D009617:Nocardia Infections / Q000382:microbiology* / Q000473:pathology*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D000069816:SEC Translocation Channels; D000081416:SecA Proteins; D017422:Sequence Analysis, DNA; D017192:Skin Diseases, Bacterial / Q000382:microbiology* / Q000473:pathology*; D013624:Taiwan; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D006360:Heat-Shock Proteins; D026901:Membrane Transport Proteins; D012336:RNA, Ribosomal, 16S; D000069816:SEC Translocation Channels; D000251:Adenosine Triphosphatases; D027081:DNA Gyrase; D000081416:SecA Proteins
keywords: 16S rRNA; Cutaneous nocardiosis; Drug resistance; Molecular typing; Nocardia brasiliensis; gyrB; hsp65; secA1