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Microbiota of Diabetic Wounds Linked to Healing Outcomes

May 07, 2019

By Reuters Staff

NEW YORK (Reuters Health) - Different strains of bacteria in diabetic foot ulcers are associated with clinical outcomes and therapeutic efficacy, researchers report.

Microbial colonization, biofilm formation, and infection are thought to impair healing of diabetic foot ulcers and contribute to severe complications. But the significance of microbial load and diversity and the role of specific microorganisms in outcomes and complications remain unclear.

Dr. Elizabeth A. Grice of the Perelman School of Medicine at the University of Pennsylvania, in Philadelphia, and colleagues used shotgun metagenomics, the untargeted sequencing of bulk microbial genomes in a specimen, to identify strain-level diversity and profile the genomic content of ulcer microbiota and their association with outcomes in 100 patients with neuropathic, plantar diabetic foot ulcers.

Staphylococcus was the most abundant genus identified, followed by Corynebacterium, Pseudomonas and Streptococcus, the team reports in Cell Host and Microbe, online April 18.

Several strains of S. aureus were exclusively associated with unhealed wounds.

Nonhealing wounds also contained a microbiome associated with biofilm- and virulence-related genetic pathways.

Debridement was followed by reduced abundance of mixed anaerobic bacteria in healed wounds, but not in unhealed wounds.

"Our in-depth investigation of the diabetic foot ulcer microbiome, coupled with in vitro and in vivo functional modeling, enhances our understanding of microbial influences on tissue repair pathways, suggests diagnostic/prognostic and therapeutic targets, and has the potential to overcome challenges for improving patient outcomes," the researchers conclude.


Dr. Grice did not respond to a request for comments.


Cell Host Microbe 2019.

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