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To determine the risk factors, microbiological features, clinical features and other epidemiological characteristics of Nocardia asteroides, we evaluated 500 patients with suspected pulmonary and extra pulmonary tuberculosis seen over a period of 18 months. Samples were subjected to microscopy and culture using standard protocols. Out of 500 samples, 5 (1%) were found to be positive for Nocardia asteroids on the basis of growth characteristics and biochemical reactions. All the 5 (100%) cases were detected by McClung's Carbon free broth by paraffin baiting technique. Paraffin baiting technique had significantly higher efficacy (p<0.0001) as compared to Nutrient agar, Sabouraud's dextrose agar, Lowenstein-Jensen medium, paraffin agar and Gelatin agar. Antimicrobial susceptibility testing was done by disk diffusion method in blood agar and Mueller-Hinton agar plates, as recommended by the National Committee for Clinical Laboratory Standards. Amikacin and imipenem showed the 100% sensitivity. A diagnosis of nocardiosis may have direct benefits to the patient and physician by providing a clinical diagnosis and limiting extensive diagnostic evaluations. It may also reduce the use of empirical therapy, which could be ineffective and potentially harmful.

Evaluation of various techniques for the detection of Nocardia species in clinically evident cases of pulmonary and extrapulmonary tuberculosis