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Clinical Microbiology Reviews, April 2006, p. 259-282, Vol. 19, No. 2
0893-8512/06/$08.00+0     doi:10.1128/CMR.19.2.259-282.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Clinical and Laboratory Features of the Nocardia spp. Based on Current Molecular Taxonomy

Barbara A. Brown-Elliott,1 June M. Brown,2 Patricia S. Conville,3 and Richard J. Wallace Jr1*

University of Texas Health Center, Department of Microbiology, Tyler, Texas,1 Centers for Disease Control and Prevention, Division of Bacterial and Mycotic Diseases, Atlanta, Georgia,2 National Institutes of Health, Department of Laboratory Medicine, Bethesda, Maryland3

The recent explosion of newly described species of Nocardia results from the impact in the last decade of newer molecular technology, including PCR restriction enzyme analysis and 16S rRNA sequencing. These molecular techniques have revolutionized the identification of the nocardiae by providing rapid and accurate identification of recognized nocardiae and, at the same time, revealing new species and a number of yet-to-be-described species. There are currently more than 30 species of nocardiae of human clinical significance, with the majority of isolates being N. nova complex, N. abscessus, N. transvalensis complex, N. farcinica, N. asteroides type VI (N. cyriacigeorgica), and N. brasiliensis. These species cause a wide variety of diseases and have variable drug susceptibilities. Accurate identification often requires referral to a reference laboratory with molecular capabilities, as many newer species are genetically distinct from established species yet have few or no distinguishing phenotypic characteristics. Correct identification is important in deciding the clinical relevance of a species and in the clinical management and treatment of patients with nocardial disease. This review characterizes the currently known pathogenic species of Nocardia, including clinical disease, drug susceptibility, and methods of identification.

* Corresponding author. Mailing address: The University of Texas Health Center, Department of Microbiology, 11937 U.S. Highway 271, Tyler, TX 75708. Phone: (903) 877-7685. Fax: (903) 877-7652. E-mail: richard.wallace{at}uthct.edu.

Clinical Microbiology Reviews, April 2006, p. 259-282, Vol. 19, No. 2
0893-8512/06/$08.00+0     doi:10.1128/CMR.19.2.259-282.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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