Susceptibility in vitro of Nocardia species to antimicrobial agents

Isolated Nocardiosis, an Unrecognized Primary Immunodeficiency?

Nocardiosis is an infectious disease caused by the gram-positive bacterium Nocardia spp. Although it is commonly accepted that exposure to Nocardia is almost universal, only a small fraction of exposed individuals develop the disease, while the vast majority remain healthy. Nocardiosis has been described as an "opportunistic" disease of immunocompromised patients, suggesting that exposure to the pathogen is necessary, but a host predisposition is also required. Interestingly, increasing numbers of nocardiosis cases in individuals without any detected risk factors, i.e., without overt immunodeficiency, are being reported. Furthermore, a growing body of evidence have shown that selective susceptibility to a specific pathogen can be caused by a primary immunodeficiency (PID). This raises the question of whether an undiagnosed PID may cause nocardiosis affecting otherwise healthy individuals. This review summarizes the specific clinical and microbiological characteristics of patients with isolated nocardiosis published during the past 30 years. Furthermore, it gives an overview of the known human immune mechanisms to fend off Nocardia spp. obtained from the study of PIDs and patients under immunomodulatory therapies.

Tricholoma matsutake dominates diverse microbial communities in different forest soils

Fungal and actinobacterial communities were analyzed together with soil chemistry and enzyme activities in order to profile the microbial diversity associated with the economically important mushroom Tricholoma matsutake. Samples of mycelium-soil aggregation (shiro) were collected from three experimental sites where sporocarps naturally formed. PCR was used to confirm the presence and absence of matsutake in soil samples. PCR-denaturing gradient gel electrophoresis (DGGE) fingerprinting and direct sequencing were used to identify fungi and actinobacteria in the mineral and organic soil layers separately. Soil enzyme activities and hemicellulotic carbohydrates were analyzed in a productive experimental site. Soil chemistry was investigated in both organic and mineral soil layers at all three experimental sites. Matsutake dominated in the shiro but also coexisted with a high diversity of fungi and actinobacteria. Tomentollopsis sp. in the organic layer above the shiro and Piloderma sp. in the shiro correlated positively with the presence of T. matsutake in all experimental sites. A Thermomonosporaceae bacterium and Nocardia sp. correlated positively with the presence of T. matsutake, and Streptomyces sp. was a common cohabitant in the shiro, although these operational taxonomic units (OTUs) did not occur at all sites. Significantly higher enzyme activity levels were detected in shiro soil. These enzymes are involved in the mobilization of carbon from organic matter decomposition. Matsutake was not associated with a particular soil chemistry compared to that of nearby sites where the fungus does not occur. The presence of a significant hemicellulose pool and the enzymes to degrade it indicates the potential for obtaining carbon from the soil rather than tree roots.

Antimicrobial activity of cefotaxime tested against infrequently isolated pathogenic species (unusual pathogens)

The cefotaxime sodium spectrum of activity is very broad and includes many common species and a variety of less frequently isolated pathogens. We have reviewed the clinical microbiology literature (44 references) and the data base of the University of Iowa Hospitals and Clinics (Iowa City, IA) to collect data on the activity of cefotaxime against the less common species. Cefotaxime was consistently active against Actinobacillus actinomycetemcomitans, Capnocytophaga spp., Eikenella corrodens, Erysipelothrix rhusiopathiae, Pasteurella multocida, Plesiomonas shigelloides, and Fusobacterium nucleatum. The species Alcaligenes xylosoxidans, Flavobacterium spp., Stenotrophomonas (Xanthomonas) maltophilia, Bacillus cereus, Listeria monocytogenes, and Rhodococcus equi were uniformly cefotaxime resistant. For many other species there was considerable variation in reported minimum inhibitory concentrations. These data may be helpful in guiding therapy of unusual infections, particularly in the case of fastidious species, where the appropriate susceptibility testing methodology may not be immediately or routinely available.

Two cases of Nocardia asteroides sternotomy infection treated with ofloxacin and a review of other active antimicrobial agents

Two patients who developed post-operative sternotomy infections due to Nocardia asteroides were treated successfully with ofloxacin, in vitro susceptibility of the organisms being used as a guide to dosage. The place of this drug in the treatment of infection due to Nocardia asteroides merits further investigation.