Identification of a novel drug-resistant community-acquired Nocardia spp. in a patient with bronchiectasis

ABSTRACT

A previously unknown Nocardia species was isolated from the lung tissue and bronchoalveolar lavage fluid (BALF) of a 58-year-old woman with bronchiectasis and recurrent pneumonia. This Nocardia (GZ2020^T), which grew readily in Columbia blood agar and could induce pneumonia in a mouse model, represents a novel Nocardia species, and its closest known relatives are Nocardia anaemiae NBRC 100462^T, Nocardia pseudovaccinii NBRC 100343^T and Nocardia vinacea NBRC 16497^T. However, unlike all previously known species, GZ2020^T is the first genus of Nocardia spp. that is not susceptible to multiple drugs but does show susceptibility to linezolid and moxifloxacin, and thus, GZ2020^T potentially represents a substantial health threat to patients with bronchiectasis and immunocompromised individuals. Although the original pathogen source and method of spreading remain uncertain, a mode of transmission from the environment to humans could exist. Vigilance with respect to its spread in the population and the transmission of antibiotic resistance genes in the environment should be maintained.

KEYWORDS:

• Nocardia
• antibiotic resistance
• novel species
• chronic lung diseases
• bronchiectasis

Acknowledgments

This work was funded by the ZHONGNANSHAN MEDICAL FOUNDATION OF GUANGDONG PROVINCE (ZNSA-2020003). We thank the staff members of the hospital for their effort in collecting the information used in this study; other staff members at the Clinical Microbiology Laboratory for the microbial cultivation; staff members at the Clinical Imaging Department for chest CT image processing; and staff members at the Clinicopathological Center for histopathological section detection. We also thank Jun Wang, Yi Zheng, and Boshi Yang from Hangzhou Matridx Biotechnology Co., Ltd. (Hangzhou, China), and Pengcheng Du and Le Yu from Beijing YuanShengKangTai (ProtoDNA) Genetech Co., Ltd. (Beijing, China) for the sequencing of GZ2020^T with mNGS and Nanopore technology. Furthermore, we would like to thank the AJE team for providing language editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Potential conflicts of interest

No potential conflict of interest is reported by the author(s).

Additional information

Funding

This work was supported by ZHONGNANSHAN MEDICAL FOUNDATION OF GUANGDONG PROVINCE: [Grant Number ZNSA-2020003].