Nocardiosis in Quebec, Canada, 1988-2008

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
J TremblayJ Pépin

Abstract

Nocardia is an uncommon pathogen, but immunosuppression, its main risk factor, is becoming more frequent. We aimed to evaluate changes in the annual incidence of nocardiosis and in the susceptibility profile of its aetiological agents. Demographic data were analysed for all isolates of Nocardia forwarded to the provincial public health laboratory of Quebec, Canada during the last two decades. Population incidence could be measured from 1997 onwards. Resistance patterns were analysed for those isolates selected for in vitro susceptibility testing. Throughout Quebec, 575 incident cases were identified between 1997 and 2008. The annual incidence of Nocardia infection/colonization increased from 0.33 (1997-1998) to 0.87 (2007-2008) per 100,000 inhabitants (p 0.001). In a small subset of patients for whom detailed clinical information was available, 59% of isolates corresponded to genuine infections. Nocardia farcinica predominated in specimens representing invasive infections (blood, brain, lung or pleural aspirates). Isolates were often non-susceptible to several antimicrobials, with the exception of amikacin and linezolid. Overall, 43% of 157 isolates were non-susceptible to trimethoprim-sulphamethoxazole. In conclusion, Nocardia...Continue Reading

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