Epidemiology of Nocardiosis -A six years study from Northern India

Abstract

Objective: To isolate and speciate Nocardia species from clinical samples and to study their antimicrobial susceptibility pattern to different antimicrobials. Various risk factors associated with nocardiosis were also studied. Methods: 32 clinical specimens with clinical history of pneumonia, abscesses, or disseminated infections were collected over a period of 6 years (2009-2014) from Inpatient and Outpatient departments and processed for Nocardia cultures and sensitivity. Results: Twelve cases of nocardiosis were reported out of 32 clinically suspected cases. The mean age of presentation in our study was 57.9 years. Pneumonia was the most common clinical presentation followed by primary cutaneous disease and one case of disseminated disease. 8/ 10 patients with nocardiosis were immunocompromised with history of organ transplantation, use of immunosuppressive agents or steroids. Based on biochemical reactions 5 of the isolates were identified as N. asteroides, 3 N. brasiliensis, 2 N. farcinica and 1 each were N. transvalensis, & N. nova. All were sensitive to linezolid followed by cotrimoxazole (91.6%) Conclusions: With increasing number of immunocompromised patients and an increased incidence of nocardiosis, diagnosis of Nocardia infections should always be kept in mind as it can present with nonspecific symptoms and can mimic confused with other diseases. Linezolid, Cotrimoxazole, imipenem and minocycline were found to be very effective, in vitro, against most Nocardia species. J Microbiol Infect Dis 2016;6(2): 60-64