Table 2. Correlation between antimicrobial susceptibility profiles and Nocardia species designation.
| Drug pattern typea | Nocardia sp. | No. of strains | Antimicrobial susceptibility profileb | |
|---|---|---|---|---|
| Nonsusceptible (% intermediate or resistant) | Susceptible (%) | |||
| Iac | N. asiatica | 2 | Ciprofloxacin, moxifloxacin, clarithromycin, amoxicillin-clavulanic acid, clindamycin, tigecycline, vancomycin, kanamycin, levofloxacin, azithromycin, ofloxacin, rifampicin, isoniazid, streptomycin, and ethambutol | Ceftriaxone, cefepime (50), tobramycin, amikacin, doxycycline, linezolid, imipenem, SXT, minocyclin, sulfamethoxazole, ampicillin, gentamicin, clofazimine, cefoxitin, meropenem, and cefmetazole |
| IIa | N. brevicatena, N. paucivorans | 2 | Kanamycin MICs low (<1 μg/ml), clarithromycin clindamycin, vancomycin, ethambutol, rifampicin, isoniazid, and azithromycin | Ampicillin, amoxicillin-clavulanic acid, ceftriaxone, linezolid, amikacin, imipenem, ciprofloxacin, Minocyclin, moxifloxacin, SXT, tobramycin, cefepime, cefotaxime, doxycycline, tigecycline, kanamycin, levofloxacin, clofazimine, ofloxacin, streptomycin, and meropenem |
| IIIa | N. nova complexd | 16 | Amoxicillin-clavulanic acid (68), tobramycin, doxycycline, ciprofloxacin (94), moxifloxacin (94), tigecycline, vancomycin, levofloxacin, ofloxacin, rifampicin, isoniazid, ethambutol, and cefoxitin | Ceftriaxone (94), cefepime (88), imipenem, amikacin, clarithromycin (94), linezolid, SXT, cefotaxime, ampicillin (94), azithromycin (88), and meropenem |
| IVa | N. transvalensis complexe | 4 | Imipenem (50), tobramycin, amikacin, doxycycline, clarithromycin (75), ampicillin, gentamicin, clindamycin, vancomycin, kanamycin, azithromycin, rifampicin, isoniazid, streptomycin, cefoxitin, and cefmetazole | Ceftriaxone, ciprofloxacin, moxifloxacin, linezolid, SXT (50), cefotaxime, levofloxacin, clofazimine, ofloxacin, and meropenem |
| Va | N. farcinica | 23 | Ceftriaxone (72), cefepime (80), tobramycin (96), doxycycline (68), ampicillin, clarithromycin, sulfamethoxazole (91), ampicillin, gentamicin (96), clindamycin, tigecycline (91), kanamycin, azithromycin, rifampicin, isoniazid, streptomycin, ethambutol, and cefoxitin (96) | Amoxicillin-clavulanic acid (84), amikacin, moxifloxacin (88), linezolid, imipenem (88), SXT, and meropenem; variable susceptibility toward ciprofloxacin (60) |
| VIa | N. asteroides | 3 | Ampicillin, amoxicillin–clavulanic acid, clarithromycin, ciprofloxacin, cefepime, ampicillin, clindamycin, vancomycin, azithromycin, rifampicin, isoniazid, and ethambutol | Ceftriaxone, amikacin, linezolid, imipenem, minocyclin, moxifloxacin, SXT cefotaxime, gentamicin, and meropenem |
| VIac | N. cyriacigeorgica | 3 | Amoxicillin–clavulanic acid (77), ciprofloxacin, moxifloxacin, clarithromycin, doxycycline (77), ampicillin (77), minocycline, moxifloxacin, clindamycin, vancomycin, kanamycin, levofloxacin, clofazimine, azithromycin, ofloxacin, rifampicin, isoniazid, ethambutol, and cefoxitin | Ceftriaxone, imipenem, tobramycin, amikacin, linezolid, SXT, tobramycin, cefepime, cefotaxime, gentamicin, streptomycin, and meropenem |
| VIIc | N. otitidiscaviarum | 5 | Ceftriaxone, ampicillin (80), amoxicillin-clavulanic acid, and imipenem (often resistant to all β-lactam antibiotics), ciprofloxacin (80), clarithromycin, sulfamethoxazole, cefepime, cefotaxime, clindamycin, vancomycin, azithromycin, ofloxacin, rifampicin, isoniazid, streptomycin, ethambutol, cefoxitin, and cefmetazole | kanamycin, amikacin, doxycycline (80), moxifloxacin, linezolid, SXT, and kanamycin |
| VIIIc | N. brasiliensis | 4 | Cefepime, imipenem, doxycycline, ciprofloxacin (75), clarithromycin, ampicillin, clindamycin, vancomycin, kanamycin, levofloxacin, azithromycin, ofloxacin, rifampicin, isoniazid, streptomycin, ethambutol, and cefoxitin | Amoxicillin-clavulanic acid, tobramycin, amikacin, linezolid, SXT, moxifloxacin, gentamicin, and clofazimine |
| Ixa | N. pseudobrasiliensis | 1 | Kanamycin, ampicillin, minocycline, doxycycline, cefepime, amikacin, amoxicillin-clavulanic acid, ceftriaxone, sulfamethoxazole, cefotaxime, clindamycin, tigecycline, vancomycin, kanamycin, clofazimine, isoniazid, and ethambutol | Ciprofloxacin, clarithromycin, tobramycin, linezolid, imipenem SXT, moxifloxacin, levofloxacin azithromycin, ofloxacin, rifampicin, streptomycin, cefoxitin, meropenem, and cefmetazole |
| Xf | N. mexicana, N. pneumoniae | 2 | Amoxicillin-clavulanic acid, doxycycline, clindamycin, tigecycline, vancomycin levofloxacin, azithromycin ofloxacin, rifampicin, isoniazid, ethambutol and cefoxitin | Ceftriaxone, cefepime, imipenem, amikacin, linezolid, SXT, minocyclin, cefepime, cefotaxime, clofazimine, and meropenem |
| XIf | N. amikacinitolerans, N. beijingensis | 5 | Ciprofloxacin, clarithromycin, clindamycin, levofloxacin, azithromycin ofloxacin, isoniazid, streptomycin, and ethambutol | Amoxicillin-clavulanic acid Ceftriaxone, cefepime, imipenem linezolid, SXT, cefotaxime, ampicillin, and meropenem |
| XIIf | N. carnea, N. novocastrense, N. jinanensis, N. blacklockiae, N. caishijiensis | 7 | Clindamycin (88), vancomycin, azithromycin, rifampicin (88), and isoniazid | Amoxicillin-clavulanic acid, ciprofloxacin (86), ceftriaxone, cefepime, imipenem (86), tobramycin, amikacin (86), doxycycline (71), clarithromycin (71), linezolid, SXT, moxifloxacin, cefotaxime, clofazimine, and meropenem |
aDescribed by Wallace et al.17 and/or Brown-Elliott et al.1. bIf no value is indicated, the susceptible or nonsusceptible percentage is 100%. Amikacin, amoxicillin-clavulanic acid, ceftriaxone ciprofloxacin, clarithromycin, imipenem, linezolid, minocycline, moxifloxacin, trimethoprim-sulfamethoxazole, tobramycin, cefepime, cefotaxime, and doxycycline are drugs recommended by the CLSI20. Sulfamethoxazole, kanamycin, levofloxacin, clofazimine, azithromycin, ofloxacin, rifampicin, isoniazid, streptomycin, ethambutol, cefoxitin, meropenem, and cefmetazole are drugs tested for the first time or have rarely been used against Nocardia strains. cConsistent with the drug pattern type described by McTaggart et al.7 and assigned a number in this study. dThe N. nova complex contains strains of N. nova, N. africana, N. kruczakiae, N. veterana, and N. aobensis. eThe N. transvalensis complex contains strains of N. transvalensis and N. wallacei. fNew drug pattern type described in this study.