Chapter 13 : Aerobic Actinomycetes

Abstract:

The group of gram-positive bacillary organisms broadly known as “aerobic actinomycetes” consists of a vast array of taxonomically heterogeneous and divergent genera. This chapter deals only with those genera having the most impact on human health care, i.e., those that usually affect primarily patients with immunocompromising conditions. The combination of increasing conditions impairing host resistance to invasion by environmental pathogens and the rapidly progressing technological capability to identify isolates recovered from such patients has allowed a wide expansion of the species known to be capable of causing disease in humans (albeit under special circumstances). A better understanding of the epidemiology, clinical course, and antimicrobial susceptibilities of aerobic actinomycetes is essential. Molecular identification and typing techniques will also bring a better understanding of the interrelatedness of the various genera and species. Evidence-based evaluation is paramount to rapid diagnosis and early choice in therapeutic modalities, aimed to achieve better outcomes in patients. Clinical laboratories must become aware of the role now played by the aerobic actinomycetes in disease and must work with clinical care providers to determine when identification, susceptibility testing, and therapeutic or surgical interventions are necessary.