{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:26:43Z","timestamp":1790774803761,"version":"4.1.0"},"reference-count":28,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,8,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n \n \n The role of specific\n Nocardia<\/jats:italic>\n species in human infections continues to expand as advanced methods enable species\/species complex identification. We conducted a multiyear population-based (2010\u20132022) characterization of invasive\n Nocardia<\/jats:italic>\n spp. Isolates were analyzed using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. A total of 94 cases and 117 unique 16S rRNA gene sequences were evaluated from pulmonary (53%), skin and soft tissues (SSTIs) (29%), central nervous system (CNS) (7%), bloodstream (6%), and other sites of infection. Infections were mainly caused by three species complexes:\n N. farcinica<\/jats:italic>\n (\n n<\/jats:italic>\n = 20, 21.3%),\n N. cyriacigeorgica<\/jats:italic>\n (\n n<\/jats:italic>\n = 16, 17%), and\n N. nova<\/jats:italic>\n (\n n<\/jats:italic>\n = 15, 16%). Phylogenetic analysis correlated with the clinical site of infection. Most\n N. cyriciageorgica<\/jats:italic>\n (92%) complex isolates caused SSTIs or pulmonary infections, and most\n N. farcinica<\/jats:italic>\n complex (67%) and\n N. nova<\/jats:italic>\n complex (69%) isolates caused pulmonary and CNS infections, respectively. Several other unique\n Nocardia<\/jats:italic>\n spp. rarely caused invasive infections (\u22645 cases): (i) pulmonary (\n N. abscessus<\/jats:italic>\n complex,\n N. amamiensis<\/jats:italic>\n ,\n N. asteroides<\/jats:italic>\n ,\n N. otitidiscaviarum<\/jats:italic>\n complex,\n N. sputorum<\/jats:italic>\n ,\n N. transvalensis<\/jats:italic>\n complex,\n Nocardiopsis<\/jats:italic>\n spp.,\n Pseudonocardia<\/jats:italic>\n spp.); (ii) SSTIs (\n N. otitidiscaviarum<\/jats:italic>\n complex); and (iii) CNS (\n N. flavorosea<\/jats:italic>\n and\n N. paucivorans<\/jats:italic>\n complex).\n Nocardia<\/jats:italic>\n species were highly susceptible to amikacin, trimethoprim-sulfamethoxazole, moxifloxacin, and linezolid. Imipenem resistance occurred in the\n N. farcinica<\/jats:italic>\n complex and\n N. nova<\/jats:italic>\n complex, while ceftriaxone resistance only occurred in the former. Antibiotic profiles varied for rare\n Nocardia<\/jats:italic>\n spp. Species-level\n Nocardia<\/jats:italic>\n identification using MALDI-TOF MS and 16S rRNA gene sequencing improves understanding of these organisms\u2019 unique roles in causing invasive disease.\n <\/jats:p>\n \n IMPORTANCE<\/jats:title>\n \n Nocardia<\/jats:italic>\n spp. are a rare cause of invasive infections, particularly in immunocompromised patients. The role of specific\n Nocardia<\/jats:italic>\n species in human infections continues to expand as advanced methods enable species\/species complex identification. We conducted a multiyear population-based (2010\u20132022) characterization of invasive\n Nocardia<\/jats:italic>\n spp. Isolates were analyzed using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. A total of 94 cases included pulmonary infections (53%), skin and soft tissue infections (29%), central nervous system infections (7%), bloodstream infections (6%), and septic arthritis and intra-abdominal infections (5%). One hundred seventeen unique 16S rRNA gene sequences from clinical isolates were analyzed. Phylogenetic analysis correlated with the clinical site of infection.\n Nocardia<\/jats:italic>\n species were highly susceptible to amikacin, trimethoprim-sulfamethoxazole, moxifloxacin, and linezolid. Imipenem resistance only occurred in\n N. farcinica<\/jats:italic>\n complex and\n N. nova<\/jats:italic>\n complex strains, and ceftriaxone resistance only occurred in the former. Species-level\n Nocardia<\/jats:italic>\n identification using MALDI-TOF MS and 16S sequencing improves understanding of these organisms\u2019 unique roles in invasive disease.\n <\/jats:p>\n <\/jats:sec>\n <\/jats:sec>","DOI":"10.1128\/spectrum.00914-25","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T08:00:49Z","timestamp":1751875249000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":5,"title":["Population-based microbiological characterization of\n Nocardia<\/i>\n strains causing invasive infections during a multiyear period in a large Canadian healthcare region"],"prefix":"10.1128","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8306-8099","authenticated-orcid":true,"given":"Deirdre","family":"Church","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yjb2x39","id-type":"ROR","asserted-by":"publisher"}],"name":"Section of Infectious Diseases, Department of Medicine, Cummings School of Medicine, University of Calgary","place":["Alberta, Canada"]},{"id":[{"id":"https:\/\/ror.org\/03yjb2x39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pathology and Laboratory Medicine, Cummings School of Medicine, University of Calgary","place":["Alberta, Canada"]},{"name":"Division of Microbiology, Alberta Precision Laboratories, Alberta Health Services","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisele","family":"Peirano","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yjb2x39","id-type":"ROR","asserted-by":"publisher"}],"name":"Section of Infectious Diseases, Department of Medicine, Cummings School of Medicine, University of Calgary","place":["Alberta, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Ugarte-Torres","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yjb2x39","id-type":"ROR","asserted-by":"publisher"}],"name":"Section of Infectious Diseases, Department of Medicine, Cummings School of Medicine, University of Calgary","place":["Alberta, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Naugler","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yjb2x39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pathology and Laboratory Medicine, Cummings School of Medicine, University of Calgary","place":["Alberta, Canada"]},{"name":"Division of Microbiology, Alberta Precision Laboratories, Alberta Health Services","place":["Calgary, Canada"]},{"id":[{"id":"https:\/\/ror.org\/03yjb2x39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Community Health Sciences, Cummings School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00027-21"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.19.2.259-282.2006"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201611-907OC"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000525509"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00430-014-0360-3"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jam.15778"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/5184386"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2024.3834"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2022.11.002"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001581"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1476-4"},{"key":"e_1_3_5_13_2","volume-title":"Susceptibility testing of Mycobacteria, Nocardia spp., and other aerobic actinomycetes","author":"Clinical and Laboratory Standards Institute (CLSI)","year":"2018","unstructured":"Clinical and Laboratory Standards Institute (CLSI). 2018. 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