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Nocardia species distribution and antimicrobial susceptibility within Australia.
- Source :
-
Internal medicine journal [Intern Med J] 2024 Apr; Vol. 54 (4), pp. 613-619. Date of Electronic Publication: 2023 Nov 06. - Publication Year :
- 2024
-
Abstract
- Background: Nocardia is a ubiquitous saprophyte capable of causing human disease. Disease is primarily respiratory or cutaneous, usually acquired via inhalation or inoculation. Under the influence of environmental and host factors, Nocardia incidence and species distribution demonstrate geographical variation.<br />Aims: To examine for differences in Nocardia incidence within Western Australia (WA) and analyse species distribution in the context of prior published studies. To analyse antibiogram data from a nationwide passive antimicrobial resistance surveillance program.<br />Methods: Retrospective extraction of laboratory data for Western Australian Nocardia isolates over a 21-year period. Analysis of Nocardia antimicrobial susceptibility testing data submitted to the Australian Passive Antimicrobial Resistance Surveillance (APAS) program between 2005 and 2022.<br />Results: Nine hundred sixty WA isolates were identified, giving an annual incidence of 3.03 per 100 000 population with apparent latitudinal variation. The four most common species identified within WA and amongst APAS isolates were N. nova, N. cyriacigeorgica, N. brasiliensis and N. farcinica. APAS data demonstrated that all species exhibited high rates of susceptibility to linezolid (100%) and trimethoprim-sulfamethoxazole (98%). Amikacin (>90% susceptibility for all species except N. transvalensis) was the next most active parenteral agent, superior to both carbapenems and third-generation cephalosporins. Susceptibility to oral antimicrobials (other than linezolid) demonstrated significant interspecies variation.<br />Conclusions: We demonstrate geographical variation in the distribution of Nocardia incidence. Four species predominate in the Australian setting, and nationwide data confirm a high in vitro susceptibility to trimethoprim-sulphamethoxazole and linezolid, justifying their ongoing role as part of first-line empiric therapy.<br /> (© 2023 Royal Australasian College of Physicians.)
- Subjects :
- Humans
Anti-Bacterial Agents pharmacology
Anti-Bacterial Agents therapeutic use
Linezolid
Retrospective Studies
Australia epidemiology
Trimethoprim, Sulfamethoxazole Drug Combination pharmacology
Microbial Sensitivity Tests
Nocardia
Nocardia Infections drug therapy
Nocardia Infections epidemiology
Anti-Infective Agents
Subjects
Details
- Language :
- English
- ISSN :
- 1445-5994
- Volume :
- 54
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Internal medicine journal
- Publication Type :
- Academic Journal
- Accession number :
- 37929813
- Full Text :
- https://doi.org/10.1111/imj.16234