1887

Abstract

spp. can cause several ocular infections, such as keratitis, endophthalmitis and scleral abscesses. Molecular identification of spp. by sequencing is the gold standard method at present for species identification, but closely related species can only be identified by multilocus sequence analysis (MLSA) of housekeeping genes.

The major objective was to profile species, antibiotic susceptibility patterns and clinical outcomes in endophthalmitis patients.

Between January 2009 and December 2018, endophthalmitis patients who were diagnosed with infection based on microscopic and culture characteristics were selected. Antibacterial susceptibility tests were performed and speciation was performed using MLSA and phylogenetic tree analysis of the 16 s rRNA gene and the , and genes.

A total of 43 culture-proven patients were identified during the study period. All isolates were 100 % sensitive to amikacin and 98 % resistant to ceftazidime. Fluoroquinolone sensitivity was observed in the range of 58 to 72 %. Year-wise analysis of antibiotic resistance patterns revealed there was a significant increase in resistance to fluoroquinolones. Twenty-two isolates were stored and six different species were identified. (=10) was found to be the most predominant, followed by (=4), (=3), (=2), (=2) and (=1).

is the major pathogen, and this is the first report to identify , and as causing endophthalmitis. Overall, visual outcomes were mostly poor even after aggressive management.

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2020-04-21
2020-06-04
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References

  1. Brown-Elliott BA, Brown JM, Conville PS, Wallace RJ. Clinical and laboratory features of the Nocardia spp. based on current molecular taxonomy. Clin Microbiol Rev 2006; 19:259–282 [CrossRef][PubMed]
    [Google Scholar]
  2. Saubolle MA. Aerobic Actinomycetes, 2nd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2002
    [Google Scholar]
  3. Minero MV, Marín M, Cercenado E, Rabadán PM, Bouza E et al. Nocardiosis at the turn of the century. Medicine 2009; 88:250–261 [CrossRef][PubMed]
    [Google Scholar]
  4. Ishibashi Y, Watanabe R, Hommura S, Koyama A, Ishikawa T et al. Endogenous Nocardia asteroides endophthalmitis in a patient with systemic lupus erythematosus. Br J Ophthalmol 1990; 74:433–436 [CrossRef][PubMed]
    [Google Scholar]
  5. Haripriya A, Lalitha P, Mathen M, Prajna NV, Kim R et al. Nocardia endophthalmitis after cataract surgery: clinicomicrobiological study. Am J Ophthalmol 2005; 139:837–846 [CrossRef][PubMed]
    [Google Scholar]
  6. Lalitha P. Nocardia keratitis. Curr Opin Ophthalmol 2009; 20:318–323 [CrossRef][PubMed]
    [Google Scholar]
  7. Dave VP, Pathengay A, Sharma S, Naveen N, Basu S et al. Diagnosis, clinical presentations, and outcomes of Nocardia endophthalmitis . Am J Ophthalmol 2019; 197:53–58 [CrossRef][PubMed]
    [Google Scholar]
  8. Chen LY, Kesen MR, Ghafourian A, Nguyen QD, Eberhart CG et al. Isolated endogenous Nocardia endophthalmitis after immunosuppression. J Ophthalmic Inflamm Infect 2012; 2:141–143 [CrossRef][PubMed]
    [Google Scholar]
  9. Kresloff MS, Castellarin AA, Zarbin MA. Endophthalmitis. Surv Ophthalmol 1998; 43:193–224 [CrossRef][PubMed]
    [Google Scholar]
  10. Lalitha P, Rajagopalan J, Prakash K, Ramasamy K, Prajna NV et al. Postcataract endophthalmitis in South India. Ophthalmology 2005; 112:1884–1889 [CrossRef]
    [Google Scholar]
  11. Tamura T, Matsuzawa T, Oji S, Ichikawa N, Hosoyama A et al. A genome sequence-based approach to taxonomy of the genus Nocardia. Antonie Van Leeuwenhoek 2012; 102:481–491 [CrossRef][PubMed]
    [Google Scholar]
  12. McTaggart LR, Richardson SE, Witkowska M, Zhang SX. Phylogeny and identification of Nocardia species on the basis of multilocus sequence analysis. J Clin Microbiol 2010; 48:4525–4533 [CrossRef][PubMed]
    [Google Scholar]
  13. Case RJ, Boucher Y, Dahllöf I, Holmström C, Doolittle WF et al. Use of 16S rRNA and rpoB genes as molecular markers for microbial ecology studies. Appl Environ Microbiol 2007; 73:278–288 [CrossRef][PubMed]
    [Google Scholar]
  14. Jannat-Khah D, Kroppenstedt RM, Klenk H-P, Spröer C, Schumann P et al. Nocardia mikamii sp. nov., isolated from human pulmonary infections in the USA. Int J Syst Evol Microbiol 2010; 60:2272–2276 [CrossRef][PubMed]
    [Google Scholar]
  15. Moser BD, Klenk H-P, Schumann P, Pötter G, Lasker BA et al. Nocardia niwae sp. nov., isolated from human pulmonary sources. Int J Syst Evol Microbiol 2011; 61:438–442 [CrossRef][PubMed]
    [Google Scholar]
  16. Rodríguez-Nava V, Couble A, Devulder G, Flandrois J-P, Boiron P et al. Use of PCR-restriction enzyme pattern analysis and sequencing database for hsp65 gene-based identification of Nocardia species. J Clin Microbiol 2006; 44:536–546 [CrossRef][PubMed]
    [Google Scholar]
  17. Kong F, Wang H, Zhang E, Sintchenko V, Xiao M et al. Seca1 gene sequence polymorphisms for species identification of Nocardia species and recognition of intraspecies genetic diversity. J Clin Microbiol 2010; 48:3928–3934 [CrossRef][PubMed]
    [Google Scholar]
  18. Takeda K, Kang Y, Yazawa K, Gonoi T, Mikami Y. Phylogenetic studies of Nocardia species based on gyrB gene analyses. J Med Microbiol 2010; 59:165–171 [CrossRef][PubMed]
    [Google Scholar]
  19. Venkat AG, Baynes K, Lowder CY, Srivastava SK, Sharma S. A case report of endogenous endophthalmitis in the setting of Nocardia kroppenstedtii infection. Ophthalmic Surg Lasers Imaging Retina 2019; 50:53–55 [CrossRef][PubMed]
    [Google Scholar]
  20. Rodríguez-Lozano J, Armiñanzas Castillo C, Ruiz de Alegría Puig C, Ventosa Ayarza JA, Fariñas MC et al. Post-traumatic endophthalmitis caused by Nocardia nova . JMM Case Rep 2019; 6:e005175 [CrossRef][PubMed]
    [Google Scholar]
  21. Cody WL, Wilson JW, Hendrixson DR, McIver KS, Hagman KE et al. Skim milk enhances the preservation of thawed -80 degrees C bacterial stocks. J Microbiol Methods 2008; 75:135–138 [CrossRef][PubMed]
    [Google Scholar]
  22. Clinical and Laboratory Standards Institute Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes; Approved Standard, 2nd ed. CLSI document M24-A2 Wayne, PA: Clinical and Laboratory Standards Institute; 2011
    [Google Scholar]
  23. Jaeger EE, Carroll NM, Choudhury S, Dunlop AA, Towler HM et al. Rapid detection and identification of Candida, Aspergillus, and Fusarium species in ocular samples using nested PCR. J Clin Microbiol 2000; 38:2902–2908 [CrossRef][PubMed]
    [Google Scholar]
  24. Kumar S, Stecher G, Li M, Knyaz C, Tamura K. MEGA X: molecular evolutionary genetics analysis across computing platforms. Mol Biol Evol 2018; 35:1547–1549 [CrossRef][PubMed]
    [Google Scholar]
  25. Saitou N, Nei M. The neighbor-joining method: a new method for reconstructing phylogenetic trees. Mol Biol Evol 1987; 4:406–425 [CrossRef][PubMed]
    [Google Scholar]
  26. Kimura M. A simple method for estimating evolutionary rates of base substitutions through comparative studies of nucleotide sequences. J Mol Evol 1980; 16:111–120 [CrossRef][PubMed]
    [Google Scholar]
  27. Ng EWM, Zimmer-Galler IE, Green WR. Endogenous Nocardia asteroides endophthalmitis. Arch Ophthalmol 2002; 120:210–213[PubMed]
    [Google Scholar]
  28. Hashemi-Shahraki A, Heidarieh P, Bostanabad SZ, Hashemzadeh M, Feizabadi MM et al. Genetic diversity and antimicrobial susceptibility of Nocardia species among patients with nocardiosis. Sci Rep 2015; 5:17862 [CrossRef][PubMed]
    [Google Scholar]
  29. Tsui I, Uslan DZ, Hubschman J-P, Deng SX. Nocardia farcinica infection of a Baerveldt implant and endophthalmitis in a patient with a Boston type I keratoprosthesis. J Glaucoma 2010; 19:339–340 [CrossRef][PubMed]
    [Google Scholar]
  30. Kawakami H, Sawada A, Mochizuki K, Takahashi K, Muto T et al. Endogenous Nocardia farcinica endophthalmitis. Jpn J Ophthalmol 2010; 54:164–166 [CrossRef][PubMed]
    [Google Scholar]
  31. Tsukamura M. Nocardiae that recently caused lung infection in Japan--Nocardia asteroides and Nocardia farcinica . Microbiol Immunol 1982; 26:341–345 [CrossRef][PubMed]
    [Google Scholar]
  32. Wallace RJ, Tsukamura M, Brown BA, Brown J, Steingrube VA et al. Cefotaxime-resistant Nocardia asteroides strains are isolates of the controversial species Nocardia farcinica . J Clin Microbiol 1990; 28:2726–2732 [CrossRef][PubMed]
    [Google Scholar]
  33. Sridhar MS, Sharma S, Garg P, Rao GN. Treatment and outcome of Nocardia keratitis . Cornea 2001; 20:458–462 [CrossRef][PubMed]
    [Google Scholar]
  34. Eggink CA, Wesseling P, Boiron P, Meis JF. Severe keratitis due to Nocardia farcinica . J Clin Microbiol 1997; 35:999–1001 [CrossRef][PubMed]
    [Google Scholar]
  35. Lalitha P, Tiwari M, Prajna NV, Gilpin C, Prakash K et al. Nocardia keratitis: species, drug sensitivities, and clinical correlation. Cornea 2007; 26:255–259 [CrossRef][PubMed]
    [Google Scholar]
  36. Gowrinath K, Baig WW, Prabhu AR, Chawla K, Bairy I. Pulmonary nocardiosis due to Nocardia farcinica in a renal transplant recipient. Indian J Chest Dis Allied Sci 2009; 51:237–239[PubMed]
    [Google Scholar]
  37. Hitti W, Wolff M. Two cases of multidrug-resistant Nocardia farcinica infection in immunosuppressed patients and implications for empiric therapy. Eur J Clin Microbiol Infect Dis 2005; 24:142–144 [CrossRef][PubMed]
    [Google Scholar]
  38. Elsayed S, Kealey A, Coffin CS, Read R, Megran D et al. Nocardia cyriacigeorgica septicemia. J Clin Microbiol 2006; 44:280–282 [CrossRef][PubMed]
    [Google Scholar]
  39. Roth A, Andrees S, Kroppenstedt RM, Harmsen D, Mauch H. Phylogeny of the genus Nocardia based on reassessed 16S rRNA gene sequences reveals underspeciation and division of strains classified as Nocardia asteroides into three established species and two unnamed taxons. J Clin Microbiol 2003; 41:851–856 [CrossRef][PubMed]
    [Google Scholar]
  40. Patel JB, Wallace RJ, Brown-Elliott BA, Taylor T, Imperatrice C et al. Sequence-based identification of aerobic actinomycetes. J Clin Microbiol 2004; 42:2530–2540 [CrossRef][PubMed]
    [Google Scholar]
  41. Rivera K, Maldonado J, Dones A, Betancourt M, Fernández R et al. Nocardia cyriacigeorgica threatening an immunocompetent host; a rare case of paramediastinal abscess. Oxf Med Case Reports 2017; 2017:239–241 [CrossRef]
    [Google Scholar]
  42. Ezeoke I, Klenk H-P, Pötter G, Schumann P, Moser BD et al. Nocardia amikacinitolerans sp. nov., an amikacin-resistant human pathogen. Int J Syst Evol Microbiol 2013; 63:1056–1061 [CrossRef][PubMed]
    [Google Scholar]
  43. Schlaberg R, Fisher MA, Hanson KE. Susceptibility profiles of Nocardia isolates based on current taxonomy. Antimicrob Agents Chemother 2014; 58:795–800 [CrossRef][PubMed]
    [Google Scholar]
  44. Kageyama A, Yazawa K, Mukai A, Kinoshita M, Takata N et al. Nocardia shimofusensis sp. nov., isolated from soil, and Nocardia higoensis sp. nov., isolated from a patient with lung nocardiosis in Japan. Int J Syst Evol Microbiol 2004; 54:1927–1931 [CrossRef][PubMed]
    [Google Scholar]
  45. Watson ME, Estabrook MM, Burnham C-AD. Catheter-Associated Nocardia higoensis bacteremia in a child with acute Lymphocytic Leukemia. J Clin Microbiol 2011; 49:469–471 [CrossRef][PubMed]
    [Google Scholar]
  46. DeCroos FC, Garg P, Reddy AK, Sharma A, Krishnaiah S et al. Optimizing diagnosis and management of Nocardia keratitis, scleritis, and endophthalmitis: 11-year microbial and clinical overview. Ophthalmology 2011; 118:1193–1200 [CrossRef][PubMed]
    [Google Scholar]
  47. Haripriya A, Chang DF, Ravindran RD. Endophthalmitis Reduction with Intracameral Moxifloxacin Prophylaxis: Analysis of 600 000 Surgeries. Ophthalmology 2017; 124:768–775 [CrossRef][PubMed]
    [Google Scholar]
  48. Haripriya A, Chang DF, Namburar S, Smita A, Ravindran RD. Efficacy of Intracameral Moxifloxacin Endophthalmitis Prophylaxis at Aravind Eye Hospital. Ophthalmology 2016; 123:302–308 [CrossRef][PubMed]
    [Google Scholar]
  49. Barry P, Seal DV, Gettinby G, Lees F, Peterson M et al. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: preliminary report of principal results from a European multicenter study. J Cataract Refract Surg 2006; 32:407–410 [CrossRef][PubMed]
    [Google Scholar]
  50. Edward P, Benbow DTS. Sulfonamide therapy in actinomycosis, | two cases caused by aerobic partially acid-fast Actinomyces | American review of tuberculosis; 1994395–407
  51. Moylett EH, Pacheco SE, Brown-Elliott BA, Perry TR, Buescher ES et al. Clinical experience with linezolid for the treatment of Nocardia infection. Clin Infect Dis 2003; 36:313–318 [CrossRef][PubMed]
    [Google Scholar]
  52. Brown-Elliott BA, Ward SC, Crist CJ, Mann LB, Wilson RW et al. In vitro activities of linezolid against multiple Nocardia species. Antimicrob Agents Chemother 2001; 45:1295–1297 [CrossRef][PubMed]
    [Google Scholar]
  53. Hykin PG, Tobal K, McIntyre G, Matheson MM, Towler HM et al. The diagnosis of delayed post-operative endophthalmitis by polymerase chain reaction of bacterial DNA in vitreous samples. J Med Microbiol 1994; 40:408–415 [CrossRef][PubMed]
    [Google Scholar]
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