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Abstract
Discussion Forum (0)
Abstract number: 2718

Session Type: ePosters

Session Title: ePosters

Authors(s): M. Irfana (1), U. Agrawal (1), V. Vaidya (1), M. Anil Sadani (2), S. Basu (2), A. Sunavala (3), A. Shetty (2)

Authors Affiliations(s): (1) Department of Infectious diseases, PD.Hinduja hospital and MRC., India, (2) Department of Microbiology, PD.Hinduja hospital and MRC., India, (3) Department of Infectious Diseases, PD.Hinduja hospital and MRC., India

Background:

Nocardia, a gram-positive, weakly acid-fast bacillus is an important cause of invasive infections in immunocompromised host. The susceptibility profile of this organism varies amongst species. There is paucity of literature on the susceptibility profile of this organism from India. The primary objective of this study is to understand the susceptibility profile and distribution of nocardia species in an Indian setting to guide empiric and eventually directed treatment.

 

Methods:

This single-center retrospective observation study was conducted between June 2014 and January 2021. The susceptibility patterns of 124 Nocardia isolates was recorded. Presumptive identification was performed according to colony morphology on solid medium, gram stain appearance, positive modified acid-fast staining. Susceptibility testing was performed by broth microdilution method using 2018 CLSI criteria. Species identification was available for 31 isolates, performed using Matrix assisted laser desorption ionization-Time of flight (MALDI-TOF).

 

 

 

Results:

Trimethoprim-Sulphamethoxazole (TMP-SMX), Amikacin and Linezolid were 100% sensitive for all the isolates. Susceptibility patterns of other antibiotics are illustrated in the chart below (Figure 1). 

Of the 31 isolates with speciation available, N.cyriacigeorgica was the most common (n=11), followed by N.farcinica (n=9)(Table 1).

Conclusions:

Important factors governing the susceptibility profile of Nocardia include the endemicity, the species, and previous antibiotic exposure. There is marked variation in the susceptibility of our isolates for imipenem, amoxy-clavulonate, cefoxitin and TMP-SMX when compared to the western world.  Hence, more evidence needs to be generated from other centers in the country to formulate an empiric regimen for the patients. Early institution of evidence-based empiric therapy is crucial for better clinical outcomes. The need for prolonged treatment as well as the toxicity of medications mandates more data for improved outcomes. 

Caveats: 

Species identification was performed only on request by the treating physician in 31 isolates. Hence, no conclusions could be drawn for species specific susceptibility.

 

 

Keyword(s): Nocardia susceptibility, Nocardia in india, susceptibility profile of Nocardia

Abstract number: 2718

Session Type: ePosters

Session Title: ePosters

Authors(s): M. Irfana (1), U. Agrawal (1), V. Vaidya (1), M. Anil Sadani (2), S. Basu (2), A. Sunavala (3), A. Shetty (2)

Authors Affiliations(s): (1) Department of Infectious diseases, PD.Hinduja hospital and MRC., India, (2) Department of Microbiology, PD.Hinduja hospital and MRC., India, (3) Department of Infectious Diseases, PD.Hinduja hospital and MRC., India

Background:

Nocardia, a gram-positive, weakly acid-fast bacillus is an important cause of invasive infections in immunocompromised host. The susceptibility profile of this organism varies amongst species. There is paucity of literature on the susceptibility profile of this organism from India. The primary objective of this study is to understand the susceptibility profile and distribution of nocardia species in an Indian setting to guide empiric and eventually directed treatment.

 

Methods:

This single-center retrospective observation study was conducted between June 2014 and January 2021. The susceptibility patterns of 124 Nocardia isolates was recorded. Presumptive identification was performed according to colony morphology on solid medium, gram stain appearance, positive modified acid-fast staining. Susceptibility testing was performed by broth microdilution method using 2018 CLSI criteria. Species identification was available for 31 isolates, performed using Matrix assisted laser desorption ionization-Time of flight (MALDI-TOF).

 

 

 

Results:

Trimethoprim-Sulphamethoxazole (TMP-SMX), Amikacin and Linezolid were 100% sensitive for all the isolates. Susceptibility patterns of other antibiotics are illustrated in the chart below (Figure 1). 

Of the 31 isolates with speciation available, N.cyriacigeorgica was the most common (n=11), followed by N.farcinica (n=9)(Table 1).

Conclusions:

Important factors governing the susceptibility profile of Nocardia include the endemicity, the species, and previous antibiotic exposure. There is marked variation in the susceptibility of our isolates for imipenem, amoxy-clavulonate, cefoxitin and TMP-SMX when compared to the western world.  Hence, more evidence needs to be generated from other centers in the country to formulate an empiric regimen for the patients. Early institution of evidence-based empiric therapy is crucial for better clinical outcomes. The need for prolonged treatment as well as the toxicity of medications mandates more data for improved outcomes. 

Caveats: 

Species identification was performed only on request by the treating physician in 31 isolates. Hence, no conclusions could be drawn for species specific susceptibility.

 

 

Keyword(s): Nocardia susceptibility, Nocardia in india, susceptibility profile of Nocardia

Susceptibility profile of Nocardia species: A single-centre retrospective study of 124 patients: an Indian experience
Dr. Irfana Mohammed
Dr. Irfana Mohammed
ESCMID eAcademy. Mohammed I. 07/09/2021; 328905; 2718;
user
Dr. Irfana Mohammed
Abstract
Discussion Forum (0)
Abstract number: 2718

Session Type: ePosters

Session Title: ePosters

Authors(s): M. Irfana (1), U. Agrawal (1), V. Vaidya (1), M. Anil Sadani (2), S. Basu (2), A. Sunavala (3), A. Shetty (2)

Authors Affiliations(s): (1) Department of Infectious diseases, PD.Hinduja hospital and MRC., India, (2) Department of Microbiology, PD.Hinduja hospital and MRC., India, (3) Department of Infectious Diseases, PD.Hinduja hospital and MRC., India

Background:

Nocardia, a gram-positive, weakly acid-fast bacillus is an important cause of invasive infections in immunocompromised host. The susceptibility profile of this organism varies amongst species. There is paucity of literature on the susceptibility profile of this organism from India. The primary objective of this study is to understand the susceptibility profile and distribution of nocardia species in an Indian setting to guide empiric and eventually directed treatment.

 

Methods:

This single-center retrospective observation study was conducted between June 2014 and January 2021. The susceptibility patterns of 124 Nocardia isolates was recorded. Presumptive identification was performed according to colony morphology on solid medium, gram stain appearance, positive modified acid-fast staining. Susceptibility testing was performed by broth microdilution method using 2018 CLSI criteria. Species identification was available for 31 isolates, performed using Matrix assisted laser desorption ionization-Time of flight (MALDI-TOF).

 

 

 

Results:

Trimethoprim-Sulphamethoxazole (TMP-SMX), Amikacin and Linezolid were 100% sensitive for all the isolates. Susceptibility patterns of other antibiotics are illustrated in the chart below (Figure 1). 

Of the 31 isolates with speciation available, N.cyriacigeorgica was the most common (n=11), followed by N.farcinica (n=9)(Table 1).

Conclusions:

Important factors governing the susceptibility profile of Nocardia include the endemicity, the species, and previous antibiotic exposure. There is marked variation in the susceptibility of our isolates for imipenem, amoxy-clavulonate, cefoxitin and TMP-SMX when compared to the western world.  Hence, more evidence needs to be generated from other centers in the country to formulate an empiric regimen for the patients. Early institution of evidence-based empiric therapy is crucial for better clinical outcomes. The need for prolonged treatment as well as the toxicity of medications mandates more data for improved outcomes. 

Caveats: 

Species identification was performed only on request by the treating physician in 31 isolates. Hence, no conclusions could be drawn for species specific susceptibility.

 

 

Keyword(s): Nocardia susceptibility, Nocardia in india, susceptibility profile of Nocardia

Abstract number: 2718

Session Type: ePosters

Session Title: ePosters

Authors(s): M. Irfana (1), U. Agrawal (1), V. Vaidya (1), M. Anil Sadani (2), S. Basu (2), A. Sunavala (3), A. Shetty (2)

Authors Affiliations(s): (1) Department of Infectious diseases, PD.Hinduja hospital and MRC., India, (2) Department of Microbiology, PD.Hinduja hospital and MRC., India, (3) Department of Infectious Diseases, PD.Hinduja hospital and MRC., India

Background:

Nocardia, a gram-positive, weakly acid-fast bacillus is an important cause of invasive infections in immunocompromised host. The susceptibility profile of this organism varies amongst species. There is paucity of literature on the susceptibility profile of this organism from India. The primary objective of this study is to understand the susceptibility profile and distribution of nocardia species in an Indian setting to guide empiric and eventually directed treatment.

 

Methods:

This single-center retrospective observation study was conducted between June 2014 and January 2021. The susceptibility patterns of 124 Nocardia isolates was recorded. Presumptive identification was performed according to colony morphology on solid medium, gram stain appearance, positive modified acid-fast staining. Susceptibility testing was performed by broth microdilution method using 2018 CLSI criteria. Species identification was available for 31 isolates, performed using Matrix assisted laser desorption ionization-Time of flight (MALDI-TOF).

 

 

 

Results:

Trimethoprim-Sulphamethoxazole (TMP-SMX), Amikacin and Linezolid were 100% sensitive for all the isolates. Susceptibility patterns of other antibiotics are illustrated in the chart below (Figure 1). 

Of the 31 isolates with speciation available, N.cyriacigeorgica was the most common (n=11), followed by N.farcinica (n=9)(Table 1).

Conclusions:

Important factors governing the susceptibility profile of Nocardia include the endemicity, the species, and previous antibiotic exposure. There is marked variation in the susceptibility of our isolates for imipenem, amoxy-clavulonate, cefoxitin and TMP-SMX when compared to the western world.  Hence, more evidence needs to be generated from other centers in the country to formulate an empiric regimen for the patients. Early institution of evidence-based empiric therapy is crucial for better clinical outcomes. The need for prolonged treatment as well as the toxicity of medications mandates more data for improved outcomes. 

Caveats: 

Species identification was performed only on request by the treating physician in 31 isolates. Hence, no conclusions could be drawn for species specific susceptibility.

 

 

Keyword(s): Nocardia susceptibility, Nocardia in india, susceptibility profile of Nocardia

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