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Journal of Clinical Microbiology, April 2003, p. 1705-1709, Vol. 41, No. 4
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.4.1705-1709.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Nocardia veterana, a New Emerging Pathogen

Sudha Pottumarthy,1 Ajit P. Limaye,1,2 Jennifer L. Prentice,1 Yolanda B. Houze,1 Susan R. Swanzy,1 and Brad T. Cookson1,3*

Departments of Laboratory Medicine,1 Infectious Diseases,2 Microbiology, University of Washington, Seattle, Washington3

Received 7 November 2002/ Returned for modification 9 December 2002/ Accepted 30 December 2002

Nocardia veterana is a newly described species named after the veteran's hospital where it was first isolated. This initial type strain was not thought to be clinically significant. We describe three cases of pulmonary disease attributable to N. veterana: two cases in patients presenting with multiple pulmonary nodules in a setting of immunocompromise and one case of exacerbation of chronic pulmonary disease. The isolates were susceptible to ampicillin, imipenem, gentamicin, amikacin, and trimethoprim-sulfamethoxazole and had reduced susceptibilities to ceftriaxone, cefotaxime, minocycline, and ciprofloxacin. The MICs of amoxicillin-clavulanate were higher than that of ampicillin alone, and the bacteria produced a ß-lactamase detectable only after induction with clavulanic acid. Phenotypically, the isolates could not be characterized beyond the Nocardia genus level. All three isolates were definitively identified as N. veterana by PCR and sequencing of the 16S rRNA gene. On the basis of their susceptibility and restriction enzyme analysis profiles, our findings indicate that they could potentially be misidentified as N. nova. These cases illustrate the pathogenic potential of this newly described species and emphasize the importance of accurate identification of Nocardia isolates to the species level by integrated use of phenotypic and genotypic methods.

* Corresponding author. Mailing address: University of Washington, 1959 NE Pacific Street, NW 120, Box 357110, Seattle, WA 98195. Phone: (206) 598-6131. Fax: (206) 598-6189. E-mail: cookson{at}u.washington.edu.

Journal of Clinical Microbiology, April 2003, p. 1705-1709, Vol. 41, No. 4
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.4.1705-1709.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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