Introduction. Nocardia spp. can cause several ocular infections, such as keratitis, endophthalmitis and scleral abscesses. Molecular identification of Nocardia spp. by 16S rDNA sequencing is the gold standard method at present for species identification, but closely related species can only be identified by multilocus sequence analysis (MLSA) of housekeeping genes.Aim. The major objective was to profile Nocardia species, antibiotic susceptibility patterns and clinical outcomes in endophthalmitis patients.Methodology. Between January 2009 and December 2018, endophthalmitis patients who were diagnosed with Nocardia infection based on microscopic and culture characteristics were selected. Antibacterial susceptibility tests were performed and Nocardia speciation was performed using MLSA and phylogenetic tree analysis of the 16 s rRNA gene and the gyrB, hsp65 and secA1 genes.Results. A total of 43 culture-proven patients were identified during the study period. All isolates were 100 % sensitive to amikacin and 98 % resistant to ceftazidime. Fluoroquinolone sensitivity was observed in the range of 58 to 72 %. Year-wise analysis of antibiotic resistance patterns revealed there was a significant increase in resistance to fluoroquinolones. Twenty-two isolates were stored and six different species were identified. Nocardia farcinica (n=10) was found to be the most predominant, followed by Nocardia cyriacigeorgica (n=4), Nocardia otitidiscaviarum (n=3), Nocardia amikacinitolerans (n=2), Nocardia puris (n=2) and Nocardia higoensis (n=1).Conclusions. N. farcinica is the major pathogen, and this is the first report to identify N. otitidiscaviarum, N. amikacinitolerans and N. higoensis as causing endophthalmitis. Overall, visual outcomes were mostly poor even after aggressive management.

中文翻译：

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使用多基因座序列分析（MLSA）的分子鉴定诺卡氏菌引起的眼内炎：10年的前景。

介绍。诺卡氏菌 会引起多种眼部感染，例如角膜炎，眼内炎和巩膜脓肿。诺卡氏菌的分子鉴定。通过16S rDNA测序是目前鉴定物种的金标准方法，但是只有通过管家基因的多基因座序列分析（MLSA）才能鉴定密切相关的物种。主要目的是描述眼内炎患者的诺卡氏菌种类，抗生素敏感性模式和临床结局。在2009年1月至2018年12月之间，根据显微镜和培养特征选择了被诊断出患有诺卡氏菌感染的眼内炎患者。进行了药敏试验，并使用MLSA进行了诺卡氏菌形成，并对16 s rRNA基因和gyrB进行了系统树分析，hsp65和secA1基因。结果。在研究期间，共鉴定出43名经过文化验证的患者。所有分离株对阿米卡星敏感100％，对头孢他啶耐药98％。观察到的氟喹诺酮敏感性为58％至72％。对抗生素耐药性模式的逐年分析表明，对氟喹诺酮类药物的耐药性显着增加。存储了22种分离株，并鉴定了6种不同的物种。诺卡氏菌（n = 10）被发现是最主要的，其次为cynocigeorgica诺卡氏菌（n = 4），奥卡替卡坦诺卡氏菌（n = 3），阿米卡汀醇（Nocardia amikacinitolerans）（n = 2），嘌呤诺卡氏菌（n = 2）和Nocardia。 higoensis（n = 1）。结论。farcinica N. farcinica是主要的病原体，这是鉴定N. otitidiscaviarum，N。amikacinitolerans和N.的第一份报告。肥大犬可引起眼内炎。总体而言，即使采取积极的治疗措施，视觉效果仍较差。