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Received Feb 9, 2018; Accepted Mar 31, 2018
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1. Introduction
Nocardia is a genus belonging to the aerobic actinomycetes group of bacteria which are Gram-positive bacilli and showing branching filamentous forms [1]. They are saprophytic ubiquitous bacteria which can be found in several environments such as fresh water and saltwater, soil, dust, decaying vegetation, and decaying fecal deposits from animals [1]. Nevertheless, these environmental bacteria can be opportunistic pathogens and lead to human infectious diseases called “nocardiosis” [2]. Nocardiosis can be discriminated into two groups: invasive infection, mainly caused by N. asteroides, presenting commonly as pneumonia in patients who are immunocompromised, have underlying chronic lung disease, and are with a possible dissemination to other organs [3], and cutaneous infection via a cut or abraded skin, which can be manifest clinically as (i) abscess and cellulitis, (ii) lymphangitis, (iii) skin infection secondary to dissemination, and (iv) actinomycetoma. This latter group is the most amazing infection due to their severity characterized by the presence of tumefaction, subcutaneous nodules, destructive granulomata, fistulas, and pus [2, 4].
N. brasiliensis is the species isolated from the majority (approximately 80%) of cases of cutaneous nocardiosis, especially in actinomycetoma [2]. This species is more commonly isolated in areas with tropical or subtropical climates such as South America, Asia, and Africa. Due to false diagnosis, rural lifestyles, and poor access to care in these countries, N. brasiliensis nocardiosis constitutes a real public health problem that can lead, in the absence of treatment, to amputations and death in young populations. On the basis of epidemiological surveys conducted in France, the number of cases of nocardiosis between 2000 and 2007 according to the French Nocardiosis Observatory (OFN) was 607 with N. farcinica and N. nova being the most frequent species [5]. However, no data currently exists on the phylogenetic relationships between the indigenous N. brasiliensis strains of tropical origin and native strains isolated in France. Routine genus/species identification of Nocardia was based on macroscopic, microscopic, and biochemical characteristics. The methods described by Boiron et al. [6] were used to determine the decomposition of adenine, casein,...
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