Recurrent skin infection with Rhodococcus in an immunosuppressed patient.

A renal transplant patient taking prednisone and azathioprine has had repeated episodes of skin infection with the soil saphrophyte Rhodococcus. Human disease with this organism has not been proved before. Although the lesions have always responded to antibiotics, frequent recurrence makes the long-term outlook uncertain.

Numerical classification of some named strains of Nocardia asteroides and related isolates from soil.

One hundred and forty-nine strains of nocardiae, freshly isolated from soil samples obtained from a number of countries with either tropical or temperate climates, and from rubber pipe seals, were compared with appropriate marker cultures in a numerical phenetic study using 156 unit characters. Marker strains were chosen to represent the Nocardia asteroides complex, other Nocardia species and related taxa in an effort both to classify the new soil isolates and, possibly, clarify the structure of the heterogeneous N. asteroides complex. The data were examined using the simple matching (SSM) and pattern (DP) coefficients, and clustering was achieved using both single and average linkage algorithms. Cluster composition was not markedly affected by either of the coefficients or clustering methods. The estimated test error of 7.1% was rather high and could account for a few apparently anomalous results. The 16 defined clusters, containing 185 of the 197 strains studied, were divided into seven major and nine minor clusters, four of which were further subdivided into two subclusters. Marker strains allowed four clusters to be designated as N. asteroides, seven as Nocardia species and one each as Nocardia carnea, Nocardia farcinica, Nocardia autotrophica, Mycobacterium farcinogenes and Rhodococcus species. Twelve strains formed single member clusters including the type strains of Nocardia aerocolonigenes, Nocardia amarae, Nocardia fukuyae, Nocardia orientalis and Nocardia otitidis-caviarum. The majority of the soil and rubber isolates were recovered in the major clusters labelled N. asteroides, N. carnea and Nocardia species and clusters of soil isolates without marker strains seem to represent new centres of variation. The study highlights the need for additional reproducible tests to help both define and determine the status of defined clusters within the N. asteroides complex which would considerably benefit both the ecological and epidemiological study of these organisms.