Rhodococcus spp

Gram Stain

• Gram positive coccobacilli (can appear beaded) (aerobic)

Clinical Significance

These organisms are widely distributed in the environment.

They have been associated with granulomatous pneumonia, lymphadenitis, bacteremia, septicemia, central nervous system, medical device related, and skin/soft tissue infections, typically in immunocompromised patients (especially HIV and transplant recipients).

Usual Susceptibility Pattern

These organisms are usually susceptible to linezolid, macrolides, aminoglycosides, rifampin, and imipenem.

They have variable susceptibility to tetracyclines, quinolones, and clindamycin.

TMP/SMX is not clinically effective (although it may test susceptible).

Daptomycin has no activity against Rhodococcus spp.

Prolonged (2-6 months) combination therapy, including an antibiotic with intracellular activity (macrolide or rifampin), is recommended for serious infections.