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Diagn Microbiol Infect Dis. 2018 Dec 29. pii: S0732-8893(18)30805-8. doi: 10.1016/j.diagmicrobio.2018.12.007. [Epub ahead of print]

Clinical features, identification, antimicrobial resistance patterns of Nocardia species in China: 2009-2017.

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Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
Department of Laboratory Medicine, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, China.
Department of Clinical Laboratory, First Hospital Affiliated to Xiamen University, Xiamen, China.
Department of Laboratory Medicine, Liuyang city traditional Chinese medicine hospital, Liuyang City, Changsha, Hunan, China.
Department of Laboratory Medicine, Weifang People's Hospital, Weifang,Shandong, China.
Department of Laboratory Medicine, Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, China.
Medical Science Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
Department of Laboratory Medicine, Civil Aviation General Hospital, Beijing, China.
Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China. Electronic address:


Nocardia spp. is a pathogen responsible for a variety of clinical infections, ranging from skin and soft tissue infections, to the respiratory tract and central nervous system infections. Its epidemiological characteristics, including species distribution, clinical features, and antimicrobial susceptibility profiles, should be under surveillance for the prevention and treatment of nocardiosis. In the present study, over a 9-year period (from 2009 to 2017), 53 non-repetitive Nocardia isolates were collected from 8 tertiary general hospitals of 7 cities in China. These isolates were identified to species level by multilocus sequence analysis(MLSA). The clinical data were also reviewed. The susceptibilities to 10 commonly-used antibiotics for Nocardia were determined by E-test stripes, and the resistance rates, MIC50 and MIC90 to each antibiotic by different species were analyzed. Of 53 Nocardia isolates, N. farcinica was the most common species (24.5%, 13/53), followed by N. cyriacigeorgica (20.8%, 11/53), N. terpenica (15.1%, 8/53), N. abscessus (9.43%, 5/53), N. otitidiscaviarum (7.55%, 4/53), respectively. Furthermore, 31 Nocardia (58.5%) isolates were recovered from lower respiratory tract (sputum and BALF), 15 (28.3%) from superficial Infection, 3 (5.7%) from pleural effusion, 2 (3.8%) from CSF, and 1 from bone marrow and 1 from synovial fluid, respectively. The antibiotic resistance profiles varied between different Nocardia species. All Nocardia isolates were susceptible to linezolid, followed by imipenem and amikacin (both 92.5% susceptibility rate). N. terpenica, rarely documented elsewhere, showed a different antimicrobial susceptibility profile. In summary, herein, the clinical and antibiotic resistance features of Nocardia species reported would be helpful for understanding the diversity of Nocardia species circulating in China and for decision making in the context of empiric therapy.


Antibiotic susceptibility patterns; Epidemiological features; Nocardia farcinica; Nocardiosis; Species distribution; Trimethoprim-sulfamethoxazole resistance

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