Molecular Typing of Nocardia Species

Identification of clinically significant Nocardia species is essential for the definitive diagnosis, predict antimicrobial susceptibility, epidemiological purposes, and for an effective treatment. Conventional identification of Nocardia species in routine medical laboratories which is based on phenotypic (cellular morphology, colonial characteristics), biochemical and enzymatic profiles, and chemotaxonomic characteristics is often laborious, and time-consuming. The procedure requires expertise, and newer species can be difficult to differentiate with accuracy from other related species. Alternative methods of identification, such as high performance liquid chromatography (HPLC) and molecular biology techniques allow a better characterization of species. The taxonomy of the genus Nocardia has been dramatically been revised during the last decade and more than 30 valid human clinical significance species of Nocardia have been reported. The use of molecular approaches, including 16S rRNA gene sequencing, restriction fragment length polymorphism (RFLP) or PCR restriction endonuclease analysis has been the focus of recent investigations to distinguish the isolates of Nocardia from other actinomycetes genera. The methods have revolutionized the characterization of the Nocardiae by providing rapid, sensitive, and accurate identification procedures. The present review describes the currently known medically important pathogenic species of Nocardia.