Jundishapur Journal of Microbiology
Volume:6 Issue: 1, Feb 2013

Spoilage of tea (Camellia sinensis) is often accompanied by contamination and formation of mycotoxins, which are toxic secondary metabolites produced by specific tea-borne fungi. The purposes of this study were to isolate Aspergillus flora in the air from tea gardens and factories in Gilan and Mazandaran provinces, in northern Iran, and to determine their protein patterns. Air samples were collected from 11 tea gardens and 13 tea factories between 2006 and 2008, and cultured in specific fungal media. Mycelial mats and spores of the Aspergillus species were disrupted in liquid nitrogen containing glass beads. The crude extracts were separated from other cell components by centrifugation and sterilized using a filter. The extracts obtained were analysed using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) to separate the fungal antigenic proteins. A total of 4 157 fungal colonies were observed in the tea gardens air and 3 950 colonies in the tea factories air. The most dominant and frequently occurring Aspergillus flora were; A. niveus (14.4%) and A. unguis (12.6%) in the gardens, and A. melleus (14.3%) and A. niger (12.3%) in the factories. The highest number of Aspergillus species collected from the tea gardens and factories were associated with the regions of Lahijan (23.9%) and Rasht (18.8%), respectively. The results from the SDS-PAGE method indicated that various Aspergillus species had 55 protein bands, which ranged from 5 to 120 kDa. Among these species, A. foetidus had the maximum number of protein bands (22 bands) ranging from 14.4 to 120 kDa, while A. unguis contained the minimum protein bands (5 bands) ranging from 30 to 120 kDa. The results revealed the presence of a variety of Aspergillus species in tea gardens and factories air, and the presence of a large number of Aspergillus species based upon the protein banding patterns obtained with SDS-PAGE analysis

Blastocystis is a common protozoan parasite in mammals, birds, amphibians, reptiles, fish, arthropods, and annelids. This parasite has some subtypes, which pathogenicity status of them still remained controversial. Some of Blastocystis subtypes are potentially pathogenic to human. This study has identified the B. hominis subtypes and their prevalence rates in Hamadan.Patients and During two months of summer 2011, a total number of 250 human fecal samples referred for parasitology examination to Beasat Hospital and a few clinical laboratories of Hamadan city were collected. The samples were examined by direct method and formalin-ether. 41 samples exhibited positive results for B. hominis thereby were cultured in Locke-egg medium. After the growth and in order to genotype identification, B. hominis isolates were amplified by PCR, using seven pairs of sequencestagged site primers. In this study, three subtypes of B. hominis consisted of one [SB83], two [SB340] and three [SB227] were identified. The most dominant genotype was SB83 with 56.1% frequency. The prevalence rate of genotype SB227 and SB340 were 22% and 7.3%, respectively. Coexistence of genotypes SB83 and SB227 was detected in 14.6% of positive cases. This is the first study in Hamadan on genotyping of B. hominis, which may trigger other epidemiologic and zoonotic studies on different subtypes and hence control clinical manifestations of infection

Rotaviruses are the most common cause of viral gastroenteritis in newborns and young children. The current study intended to investigate the presence of rotavirus antigen in fecal specimens of children with acute diarrhea, to determine its prevalence and to examine its distribution pattern by age, gender and season. This was a retrospective investigation of cases with rotavirus antigen-positive fecal specimens from children under 5 years referring to the emergency department with acute gastroenteritis between January 2008 and December 2010. Patient distribution patterns by season, month and age groups were recorded.Patients and Rotavirus antigen was detected in 412 out of 1500 fecal specimens; 279 of these cases (66%) were male. The presence of rotavirus antigen in fecal specimens was investigated using the immunochromatographic test (VIKIA® Rota-Adeno, bioMérieux ® sa, Marcy-l’Etoile/France), following the manufacturer’s recommendations. Rotavirus positivity was most common in the 24-36 months age group (n = 104, 25%) (P < 0.001). Positivity was most frequent in January, February and March. The high level determined in January was statistically significant (n = 69, 17%) (P < 0.001). Most of the cases were found in winter months (n = 179, 43%), and it was also statistically significant (P < 0.001). Rotavirus was most common in children with gastroenteritis aged between 24 and 36 months. The high numbers of cases were found in winter, with the highest peak in January. Rotavirus gastroenteritis appeared as a significant infection, particularly in winter months in children under 5 years. Vaccination could be helpful in protecting against the disease, since it imposes a significant burden on the health system

Cholera is a severe diarrheal illness caused by Vibrio cholerae, which produces a virulence factor named El Tor hemolysin encoded by the hlyA gene. This study meant to analyze the phenotypic characteristics and presence of hlyA gene in V. cholerae isolated from patients in Iran. The hlyA gene which codes for hemolysin, plays an essential role in manifestation of cholera, and could be used to diagnose pathogenic V. cholerae El Tor O1 strains. Patients and One hundred stool samples from the patients with cholera during 2002-2003 were collected from Tehran, Kashan, Kermanshah and Ahvaz cities, which were subject to diagnostic tests. Serotyping, and antibiotic susceptibility tests were applied and polymerase chain reaction (PCR) was also used to detect the hlyA gene. The group specific antisera identified the isolates as Ogawa, Inaba, Hikojima and NAG (Non-agglutinable) in 74%, 3%, 0% and 23% of the isolates, respectively. Antibiotic susceptibility test showed that all of the strains were sensitive to ciprofloxacin, gentamycin and doxycyclin but the isolates showed resistance to sulfamethoxazole/trimethoprim (74%), erythromycin (64%) and tetracycline (50%). V. cholerae El Tor isolates were 100% positive for hlyA gene, but hemolysis phenotype characteristics were found in 95% of the cases.The results indicated that Ogawa serotype was identified as the dominant serotype which revealed multiple antibiotic resistances to sulfamethoxazole/trimethoprim, oxytetracycline, erythromycin, tetracycline and chloramphenicol. The presence of hlyA gene in nonhemolytic strains of V. cholerae O1 biotype El Tor indicated that some factors prevent expression of the hemolysin gene

Candiduria is one of the most common symptoms of urinary tract infections caused by several species of Candida spp.. Several antifungals are available to treat such candidal infections. During the last decades, resistance to antifungal especially to non-albicans species has increased. The present study aimed to evaluate the susceptibility to antifungal drugs of Candida species isolated from candiduria in Ahvaz. Ninety three species of yeasts and yeast like organisms isolated from urine samples [Candida albicans (58), C. glabrata (25), C. tropicalis (4), C. krusei (1), unknown Candida species (4) and Geotrichum species (1)] were used for susceptibility tests. All species were re-identified based on standard mycological methods. Then a suspension of each isolate of overnight cultures was prepared in 1ml of sterile PBS and adjusted to 0.5 McFarland turbidity standards. In the present study several antifungal drugs (fluconazole, amphotericine B, ketoconazole, econazole, itraconazole) were used for susceptibility test using disk diffusion method.3 In the present study all tested isolates were sensitive/dose dependent to amphotericine B and nystatin, whereas only one isolate of C. glabrata was resistant to both antifungals. Resistance against fluconazole (48.4%) and ketoconazole (26.9%) were observed among tested isolates. Resistance against fluconazole was detected among all tested organisms, 34.4% of C. albicans, and 7.5% of C. glabrata. On the other hand, all isolates were sensitive to econazole (93.5% sensitive, 6.5% dose dependent). It was concluded that Candida species isolated from candiduria in hospitalized patients had excellent in vitro sensitivity against econazole. Other suitable antifungal drugs were amphotericine B and nystatin, itraconazole. Whereas, resistance against ketoconazole (26.9%) and especially fluconazole (48.4%) was significant

In recent decades, biological properties of biosurfactants, particularly glycolipids, including antimicrobial, antifungal, and anti-cellular effects have been projected in many research studies. The unique advantages of these compounds in terms of production and environment made them important as antimicrobial agents. This study aims to evaluate probable antibacterial and antifungal properties of MR01 and MASH1 biosurfactants against several specified microorganisms. In this article antibacterial activities of two rhamnolipid mixtures of MR01 and MASH1 were studied. MR01 and MASH1 are glycolipid-type biosurfactants that are being produced by two strains of Pseudomonas aeruginosa MR01 and MASH1, respectively. Antibacterial effects of two biosurfactants were assessed by disc diffusion test method and determination of minimum inhibitory concentration (MIC). They exhibit not only excellent surface activity but also remarkable inhibitory effect against Gram-positive bacteria. According to results, although none of two biosurfactants showed significant effects on Gram negative bacteria growth inhibition, both assessing methods confirmed the growth inhibition of Gram-positive bacteria by MR01 and MASH1 biosurfactants. According to results of this study, MR01 and MASH1 biosurfactants had antimicrobial efficacy against Gram positive bacterial groups. This effect is comparable to antibiotics and therefore the future use of these biosurfactants as broad spectrum antibiotics is highly promising. These features of biosurfactants (BS) should broaden its applications in new advanced technologies. Future studies will be performed on characterization and isolation of biologically active fraction of the rhamnolipid biosurfactant produced by P. aeruginosa strains. This bioactive compound may be evaluated as a potent antimicrobial agent to be applied against a panel of pathogenic micro-organisms including a few multidrug-resistant (MDR) clinical pathogenic isolates such as methicillin-resistant Staphylococcus aureus (MRSA) and other MDR pathogenic strains

Salmonella is a common causative agent of food-borne illness in humans. Infection by this pathogen is usually due to ingestion of contaminated insufficiently cooked foods. Despite the fact that several studies of the prevalence and antimicrobial resistance of Salmonella have been conducted in Thailand, there is limited data available concerning the more rural areas of the country. This study aimed to investigate the prevalence and antimicrobial resistance profiles of Salmonella in meat and vegetable samples taken from Phatthalung Province, Thailand. Pork and chicken meat and fresh vegetable samples were randomly selected from retail markets in Phatthalung Province. Salmonella isolation and identification were performed on the same day of sample collection. Serovar typing was performed by slide agglutination according to The Kauffman and White scheme. Antimicrobial susceptibility testing was performed by disc diffusion method, and antimicrobial susceptibility patterns were analyzed by the WHONET 5 program. The prevalence of Salmonella in retail pork, chicken meat, and fresh vegetables were 82% (34/41), 67.5% (27/40), and 46% (37/80), respectively. The Salmonella isolated from pork, and vegetables were most resistant to tetracycline (77 and 33%) while the Salmonella isolated from chicken meat was most resistant to streptomycin (92%). Thirty-one samples (68%) isolated from pork and thirty-two samples (84%) isolated from chicken meat were of MDR strains. whereas only 7 samples (29%) isolated from vegetables exhibited resistance to two or more antimicrobial drugs. These results show that retail meat and vegetables can serve as a reservoir of multiple antimicrobial resistant Salmonella and can probably be a potential route of transmission of these pathogens into human population.

There is paucity of information in regards to prevalence of bacteria in urinary tract infection (UTI) in tribal population. This study was conducted to observe dominant organisms causing UTI in tribal community of Medinipur, West Bengal, India and evaluate their sensitivity to common antibiotics.Patients and A total number of 4,416 urine samples of clinically suspected UTI attending outpatient department and hospitalized tribal patients of West Medinipur zone were collected. Urine samples were inoculated on Blood agar, MacConkey’s agar, and cystine lactose electrolyte deficient (CLED) agar and incubated at 37oC for 24 hr and extended up to 48 hr in cases of negative growth. Antibiotic susceptibility testing against the most common causative bacteria was also performed. A total number of 1,190 samples revealed positive bacterial growth. Seven types of dominant organisms were isolated as causative agents like Escherichia coli (63.44%), Klebsiella sp. (14.62%), Pseudomonas aeruginosa (4.53%), Proteus sp. (4.62%), other Gram negative bacteria (5.79%), Staphylococcus aureus and coagulase negative Streptococci (5.21%), and other Enterococcus sp. (1.76%). E.coli was the most common pathogen of UTI in tribal population with female susceptibility predominantly more than male patients. Among16 antibiotics, amikacin (14.30%) and meropenem (12.0%) were shown to be the most sensitive to and Tobramycin (0.66%) the least effective on E.coli. Females are more susceptible to UTI than males and the most effective drug (sensitive against isolated E. coli) is Amikacin. Therefore, culture and antimicrobial drug sensitivity testing are essential procedures for proper management of UTI in tribal population

More than three million children in developing countries die from acute diarrhea annually. Rotaviruses and Adenoviruses are from the most important etiologic factors in acute gastroenteritis of children. The aim of this study was to determine the prevalence of rotavirus and adenovirus among children with acute diarrhoea admitted to Abuzar Hospital in Ahvaz (Southwest Iran).Patients and In a descriptive, cross-sectional study over 1 year (September 2009 to August 2010), children who were admitted to Abuzar Hospital in Ahvaz with a diagnosis of acute diarrhoea were studied. Stools were examined with ELISA kits for detection of adenoviruses and rotaviruses. Of 180 children in our study, 104 were boys (57.8%) and 76 were girls (42.2%), with a mean age of 12.86 months (1–60 months). Sixty-three (35%) had rotavirus infections (mean age, 11.57 months), and 6 (3.3%) had adenovirus infections (mean age, 8.17 months). We examined the seasonal distribution and found that 12 cases (19%) had occurred in spring, 11 (17.5%) in summer, 24 (38.1%) in autumn, and 16 (25.4%) in winter. There was no significant correlation between sex and viral agents causing acute diarrhoea (P = 0.96). This survey showed a high incidence of rotavirus infection (35%) in children with acute diarrhoea, especially in children under 2 years old. It seems that use of an appropriate vaccine could effectively prevent diarrhoea in this population

Phlebotomus papatasi and P. salehi are reported as vectors of cutaneous leishmaniasis in southeast of Iran. Seasonal activity of these species is different in zoogeographical zones and must be known well for better management of the disease. To determine the nocturnal activity of sand flies and their leptomonad infection rates. A cross-sectional study was carried out in Chabahar county, where sand flies were collected using sticky-paper traps at 2 - hours intervals from rodent burrows during May to October. Females of Phlebotomus spp. were dissected for leptomonad infection. A total of 9367 sand flies from four species of Phlebotomus and Sergentomyia genera were collected. The most sand flies were collected in the first third of the night (7:00- 11:00 PM), although there was seasonal variation in the nocturnal activity of different species. A total of 1132 female sand flies from two species of P. papatasi and P. salehi were dissected. Totally 2.1% of P. papatasi and 1.07% of P. salehi were found to have leptomonad infection in their midgut, pharynx or head. The infection was observed in September and October in P. salehi, but June, August, September and October for P. papatasi. Knowledge about nocturnal activity and biting rhythms of sand flies and therefore the risk of disease transmission is important for planning control programs for cutaneous leishmaniasis

Human T-lymphotropic virus type I (HTLV-I) is one of the health threatening problems in endemic areas and can be transmitted by different routes such as blood transfusion. In order to correct chronic anemia in thalassemia subjects, they may need to get blood units per month. Thus, they are at risk of infection with blood-borne viruses such as HTLV-I. In the present study, we investigated the prevalence of HTLV-I infection among high risk patients with thalassemia in north of Iran, Mazandaran.Patients and A total number of 288 thalassemia patients including 151 females (52.4%) and 137 males (47.6%) with mean age of 21.45 ± 6.6 years were tested for HTLV-I Ig G and Ig M antibodies against gag proteins by enzyme linked immuniosorbent assay (ELISA). Polymerase chain reaction (PCR) test was applied to confirm HTLV-I infection in DNA samples of antibody positive subjects. In the primary screening by ELISA, 20 out of 288 (6.9%) patients were positive for HTLV-I antibody. The PCR results confirmed that four out of 20 samples (1.4%) were HTLV-I positive. The seroprevalence of HTLV-I infection in patients with thalassemia in Mazandaran province compared to other parts of Iran was not too high; however, HTLV-I screening should be performed prior to blood transfusions to decline the risk of virus transmission in these patients

Chlorhexidine gluconate (CHX) is the most common antimicrobial agent used against oral pathogens, however information on its ability to inhibit and disrupt anaerobic single and multispecies biofilms is relatively unknown. The purpose of this study was to test the efficacy of CHX for its biofilm inhibition and disruption properties using crystal violet assay. Biofilm assays were carried out on single and multispecies of four oral pathogens: Streptococcus mutans, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. Streptococcus mutans, Fusobacterium nucleatum and multi-species biofilm formation were inhibited in more than 90% of cases at concentrations of 3-12 mg/L. CHX exhibited strong disruptive activity (> 65%) on one-day old biofilms of A. actinomycetemcomitans and P. gingivalis. In conclusion, CHX was a high effective biofilm inhibitor on S. mutans, F. nucleatum and multispecies biofilms but had a minimal effect on P. gingivalis and A. actinomycetemcomitans. Conversely, CHX showed disruptive properties on late colonizers in single species biofilms but not on early colonizers and multispecies biofilms

Nosocomial infections including infections of surgical wounds, urinary tract and lower respiratory tract infections are a major public health problem in hospitals worldwide. Bacterial infections in the lower respiratory tract especially due to Gram negative bacilli, has remained a major complication of tracheal intubation in patients requiring ventilator equipments. The aim of present study was to determine the presence or absence of bacterial infections in tracheal tubes and determination of their antimicrobial susceptibility patterns. In this study, specimens were collected from tracheal tubes of patients with endotracheal aspiration. The specimens were microbiologically investigated and the isolated bacteria were identified by using standard cultural and biochemical tests. The antibiotic susceptibility testing was then performed on the isolates by disc diffusion method according to CLSI guideline. In total, 278 specimens had positive culture with 508 isolates. Based on the bacteriology results, Enterobacter spp. with 209 cases (41.14%) were the most prevalent genera isolated from positive cultures. The number and frequency of other isolated bacteria were as follow: Pseudomonas aeruginosa 78 (15.35%), E. coli 71 (13.97.2%), coagulase negative staphylococci 75 (14.76%), Staphylococcus aureus 71 (13.97%), and proteus spp. 4 (0.79%). Antimicrobial susceptibility testing revealed that the most resistant Gram negative isolate was P. aeruginosa with highest resistance against cefixime (70.8%), and coagulase negative staphylococci were the most resistant Gram positive isolates with highest resistance against oxacillin (84.2%). In conclusion, this survey indicates the emergence of antibiotic resistant infections in the studied hospital. So, there is a need to improve the effectiveness of integrated infection control programs to control and manage nosocomial infections caused by highly resistant organisms

The rate of mother-to-infant hepatitis C virus (HCV) transmission is relatively low, however, this mode of infection is the most important route for childhood HCV involvement. The chances of transmission are increased by the level of maternal HCV viraemia and maternal human immunodeficiency virus (HIV) co infection. The objective of the present study was to determine the presence of HCV infection in orphan newborns of infected mothers.Patients and A total of 29, two to seven month old, orphan infants were included in the study. The tests performed consisted of the detection of; anti-HCV and anti- HIV antibodies, HCV RNA in the plasma and peripheral blood mononuclear cells by realtime polymerase chain reaction (PCR), and finally the detection of HCV core antigens (HCV core Ag). Anti-HCV antibodies were detectable in all of the infants. However HCV RNA was undetectable in both plasma and peripheral blood mononuclear cells (PBMCs) and there were also no anti-HIV 1/2 antibodies present in the infants. Few studies have addressed the issue of mother-to-infant transmission of HCV among orphan newborns. According to the present study, carried out with orphan babies, the use of a HCV core Ag assay and evaluation of HCV RNA in PBMCs together with HCV RNA real-time PCR on the plasma, could benefit the prediction or exclusion of HCV transmission from mother to child

Soil is the first habitat for pathogenic fungi and one of the important fungal reservoirs. The soil-borne fungi are major cause for different degrees of allergy or serious diseases in human beings. This current study aimed to determine the identities and diversity of the fungi associated with allergy, subcutaneous and even systemic fungal infections in an extensive region of Qazvin district Iran during 2008. In this study, 150 soil samples were randomly collected from 25 locations of the city. The soil suspensions were prepared by sterile saline and then antibiotics of streptomycin and penicillin were added and a portion of supernatant was cultured on sabouraud’s dextrose agar culture medium containing chloramphenicol with and without cycloheximide and incubated at 35°C for 2-3 weeks. The fungal isolates were examined macroscopically and microscopically. Plates were tested to be positive for saprophytic fungi. Out of a total of 1563 fungi isolates, 14 genera were diagnosed. Cladosporium species representing (29.69%) of isolates, followed by species of Aspergillus (22.52%), Penicillium (19.90%), Rhizopus (8.38%), Alternaria (6.59%), Mucor (3.77%), Chrysosporium (1.98%), Acremonium (1.60%), Fusarium (1.34%), Mycelia Sterilia (0.90%), Ulocladium (0.83%), Drechslera (0.58%) and Scopulariopsis (0.45%). The wide range of fungi, especially fungi associated with allergy, found in the soil of Qazvin indicated that this area was apt to propagate other medically important fungi and although none of the dimorphic ones were documented, there is always the possibility to find these diseases in the country and it is essential that physicians be aware of diseases produced by these fungi, especially in predisposed people

Staphylococcus aureus is a common cause of infections among humans and animals and it is known as a community-acquired and nosocomial pathogen. Most of the isolates contain lysogenic phages which are responsible for production of various virulence factors such as enterotoxins, staphylokinase, β-lysin, lipase, exfoliative toxin A and Pantone-vlaentine leukociden (PVL). All staphylococcus isolates are classified in 6 groups according to their sensitivity to 27 known lysogenic phages. This study was performed to detect the presence of bacteriophage types and determine antibiotic resistance pattern of methicillin resistant S. aureus (MRSA) isolates obtained from a tertiary care hospital in Tehran, Iran from 2008 to 2010. A total of 968 S. aureus isolates were collected from a tertiary care hospital in Tehran, Iran and identified at the species level by PCR and biochemical tests. Susceptibility to 17 antibiotics was determined. Then oxacillin and vancomycin minimum inhibitory concentration (MIC) of the resistant isolates were determined. Multiplex-PCR was used to detect 6 classes of prophages. Out of the 968 isolates 247 isolates were resistant to methicillin. Highest antibiotic resistance was seen to penicillin (100%), erythromycin (89.8%), kanamycin (89.4%), ciprofloxacin (88.6%) and tobramycin (87.4) respectively. None of the MRSA isolates showed resistance to vancomycin, synercid and linezolid. MIC results indicated that 46.1 and 4.4% of isolates with high (MIC ≥ 128 μg/ml) and low level (MIC ≥ 4 μg/ml) showed resistance to oxacillin, respectively. Four different phage types and eight patterns of prophages were detected. All MRSA isolates contained at least one prophage. Totally, 2.8, 69.2 and 27.9% contained 5, 4 and 3 different prophage types, respectively. High prevalence of different classes of prophages indicating the potential to carry a broad spectrum of virulence factors and high oxacillin resistance were found in the MRSA isolates. Detection of SGF phage in 100% of the isolates indicates the ability of these isolates to produce virulence factors.

Urinary Tract Infection (UTI) is one of the most common bacterial diseases worldwidethat can be presented asymptomatic or symptomatic, characterized by a wide range of symptoms from mild irritative voiding to bacteremia, sepsis, or even death. In latter decades, widespread utilization of antibiotics has resulted in increased incidence of antibiotic resistance among urinary tract pathogens all over the world. The aim of this study was to determine patterns of antibiotic resistance bacteria isolated from urinary tract infections in the city of Karaj, Iran. This descriptive study was conducted in the city of Karaj from November 2009 to August 2010. Bacterial isolates were identified by standard biochemical tests. Antibacterial susceptibility test was performed by Kirby-Bauer method against some common antibiotics for Gram negative and Gram positive bacteria and the data were analyzed by SPSS software, version 12.0.1. In this study, 230 (8.06%)out of 2852 patients showed positive urine cultures of which there were 204 (88.69%) females and 26 (11.3%) males. 180 (83.17%) cases of isolated bacteria were Gram negative bacilli while 50 (21.73%) cases were Gram positive cocci. E. coli isolates, as the most frequent Gram negative bacteria, showed high resistance to cephalothin (88.16%) and high susceptibility to nitrofurantoin (90.78%). Also Staphylococcus saprophyticus isolates, as the most frequent Gram positive bacteria, exhibited high resistance to ampicillin, tetracycline, and erythromycin (92.31%) and high susceptibility to nitrofurantoin and vancomycin (92.3%). considering the results of this study, E.coli isolates were the predominant pathogens in UTI. Our data demonstrated that antibiotics with the highest activity included ciprofloxacin and nitrofurantoin and those with the least activity included ampicillin and sulfamethoxazole-trimethoprim. Our findings reinforce the need for ongoing investigations to show the trends of antibiotic resistance which can help antibiotic prescription in the clinics

A few case reports of coinfections with Nocardia and Mycobacterium tuberculosis (TB) have previously been published in the literature. We report on a case of concomitant pulmonary nocardio sis and tuberculosis, in a recently diagnosed 55-year-old woman, with rheumatoid arthritis, who had been taking a short course of a low dose corticosteroid. The patient was treated with a combination of amikacin and imipenem, as well as a standard anti-TB regimen. Physiologic doses of corticosteroids might be a predisposing factor for opportunistic infections, such as nocardiosis or tuberculosis.