title: Genetic diversity and antimicrobial susceptibility of Nocardia species among patients with nocardiosis.
abstract: The aim of this multicenter study was to determine the genetic diversity and antibiotic susceptibility of clinically isolated Nocardia species. One hundred twenty-seven patients with nocardiosis were randomly selected from 5 provinces of Iran. Molecular diagnosis of Nocardia species was performed using multilocus sequence analysis of gyrase B of the β subunit of DNA topoisomerase (gyrB), and 16S rRNA and subunit A of SecA preproteintranslocase (secA1). Antimicrobial susceptibility testing was performed following the Clinical and Laboratory Standards Institute recommendations. Thirty-five N. cyriacigeorgica, 30 N. asteroides, 26 N. farcinica, 12 N. otitidiscaviarum, and 10 N. abscessus cultures were studied. All isolates were susceptible to linezolid. All isolates of N. cyriacigeorgica, N. asteroides, N. abscessus, and N. otitidiscaviarum were susceptible to trimethoprim-sulfamethoxazole, while 8% of N. farcinica isolates were resistant to this drug. All N. otitidiscaviarum isolates were highly resistant to imipenem, but N. cyriacigeorgica, N. asteroides, N. farcinica, and N. abscessus were only moderate resistant. The susceptibility patterns vary with different species of Nocardia. Resistance to trimethoprim-sulfamethoxazole in Iran is low and this drug should be first line therapy, unless drug susceptibility testing shows resistance. Linezolid also covers Nocardia well and could be a second line agent.
authors.affiliation: Department of Epidemiology, Pasture Institute of Iran, Tehran, Iran.
authors.forename: Abodolrazagh
authors.initials: A
authors.lastname: Hashemi-Shahraki
authors.affiliation: Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Alborz, Iran.
authors.forename: Parvin
authors.initials: P
authors.lastname: Heidarieh
authors.affiliation: Biology and Microbiology Department, Islamic Azad University, Parand Branch, Tehran, Iran.
authors.forename: Saeed Zaker
authors.initials: SZ
authors.lastname: Bostanabad
authors.affiliation: Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Hashemzadeh
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohamad Mehdi
authors.initials: MM
authors.lastname: Feizabadi
authors.affiliation: Division of Pulmonary and Critical Care, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Dean
authors.initials: D
authors.lastname: Schraufnagel
authors.affiliation: Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mirsaeidi
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology*; D001483:Base Sequence; D003710:Demography; D005260:Female; D014644:Genetic Variation; D005843:Geography; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009615:Nocardia / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D009617:Nocardia Infections / Q000382:microbiology*; D010802:Phylogeny; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D013045:Species Specificity
chemical_list: D000890:Anti-Infective Agents; D012336:RNA, Ribosomal, 16S