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Journal of Clinical Microbiology
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Journal Article

New Nocardia taxon among isolates of Nocardia brasiliensis associated with invasive disease.

R J Wallace Jr, B A Brown, Z Blacklock, R Ulrich, K Jost, J M Brown, M M McNeil, G Onyi, V A Steingrube, J Gibson
R J Wallace Jr
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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B A Brown
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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Z Blacklock
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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R Ulrich
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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K Jost
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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J M Brown
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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M M McNeil
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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G Onyi
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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V A Steingrube
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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J Gibson
Department of Microbiology, University of Texas Health Center, Tyler 75710, USA.
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ABSTRACT

Nocardia brasiliensis, the second most frequently isolated aerobic actinomycete in the clinical laboratory, is usually associated with localized cutaneous infections. However, 22% of 238 N. brasiliensis isolates from the United States and 12% of 66 isolates from Queensland, Australia, which had been collected over a 17-year period, were associated with extracutaneous and/or disseminated diseases. Of the 62 invasive isolates, 37 (60%) were susceptible to ciprofloxacin and/or were susceptible to clarithromycin and resistant to minocycline, compared with only 6 (3%) of 242 localized cutaneous isolates. The 43 isolates with this susceptibility pattern appeared to define a new taxon. They were similar to Nocardia asteroides complex isolates clinically in proportions from persons with pulmonary (70%), central nervous system (23%), and/or disseminated diseases (37%) in the setting of corticosteroids (74%) or AIDS (14%). This putative new taxon differed from N. brasiliensis in the hydrolysis of adenine (92 versus 4%), beta-lactamase patterns on isoelectric focusing, and the presence of two early mycolic acid-ester peaks by high-performance liquid chromatography. Restriction analysis of a 439-bp fragment of the 65-kDa heat shock protein gene revealed that N. brasiliensis and the new taxon had different restriction patterns with 8 of the 11 enzymes tested. Screening of invasive isolates of N. brasiliensis for susceptibility to ciprofloxacin will identify most isolates of the new taxon, which likely represents a new Nocardia species.

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New Nocardia taxon among isolates of Nocardia brasiliensis associated with invasive disease.
R J Wallace Jr, B A Brown, Z Blacklock, R Ulrich, K Jost, J M Brown, M M McNeil, G Onyi, V A Steingrube, J Gibson
Journal of Clinical Microbiology Jun 1995, 33 (6) 1528-1533; DOI:

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New Nocardia taxon among isolates of Nocardia brasiliensis associated with invasive disease.
R J Wallace Jr, B A Brown, Z Blacklock, R Ulrich, K Jost, J M Brown, M M McNeil, G Onyi, V A Steingrube, J Gibson
Journal of Clinical Microbiology Jun 1995, 33 (6) 1528-1533; DOI:
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