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Nocardia sp. in cystic fibrosis patients in a Greek tertiary hospital

Abstract number: r2069

Papaefstathiou  E., Kanellopoulou  M., Skarmoutsou  N., Inglezos  I., Fakiri  E., Tsakris  A., Legakis  N., Papafrangas  E.

Objectives: 

1) To determine the incidence of Nocardia sp.in Cystic Fibrosis (CF) patients, 2) to identify them to the species level and 3) to investigate their susceptibility to common used antibiotics.

Methods: 

During an 8 years period, multiple sputum specimens of 68 (CF) adult patients were cultured in appropriate media. The identification was performed on the basis of adenine, casein, xanthine, hypoxanthine, tyrosine utilization, urea hydrolysis and antimicrobial susceptibility patterns. The susceptibility testing was obtained by disk diffusion and microdilution methods according to CLSI/NCCLS guidelines and by epsilometer test (E-test) (AB BIODISK, Solna, Sweden) according to the manufacture's recommendations. Bita-Lactamase production was detected by nitrocefin disks (Mast Diagnostics, UK).

Results: 

In a period of 8 years 7/68 (10.29%) CF patients had Nocardia sp. in their sputa, without any significant change in their clinical status, radiology findings and pulmonary function. The following species were isolated: N. asteroids (I, II, VI) (4/7), N. farcinica (1/7), N. otitidiscaviarum (1/7), N. transvalensis complex (1/7). The above isolates were found resistant to: ampicillin (100%), ciprofloxacin, clarithromycin, erythromycin (71.14% each), cefamandole (42.86%), imipenem, tobramycin, gentamicin (28.57% each), amikacin, amoxicillin-clavulanic acid, cefepime, ceftriaxone, (14.28% each). All isolates were sensitive to linezolid, trimethoprim-sulfamethoxazole (TMP-SMX), cefotaxime and doxycycline.

Conclusions: 

1) The incidence of Nocardia sp. in our Cystic Fibrosis (CF) patients is remarkable (10.29%). 2) The predominant isolated Nocardia sp. was: N. asteroides (I, II, VI). 3). All Nocardia sp have to be tested for their susceptibility profile, since routinely used antibiotics in CF patients such as Ciprofloxacin or Imipenem may be inactive.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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