Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
Department of Medical Microbiology and Immunology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
Ann N Y Acad Sci. 2019 Jan;1435(1):79-92. doi: 10.1111/nyas.13926. Epub 2018 Jul 13.
Wound healing is a highly coordinated and complex process, and there can be devastating consequences if it is interrupted. It is believed that, in combination with host factors, microorganisms in a wound bed can not only impair wound healing but can lead to stalled, chronic wounds. It is hypothesized that the wound microbiota persists in chronic wounds as a biofilm, recalcitrant to antibiotic and mechanical intervention. Cultivation-based methods are the gold standard for identification of pathogens residing in wounds. However, these methods are biased against fastidious organisms, and do not capture the full extent of microbial diversity in chronic wounds. Thus, the link between specific microbes and impaired healing remains tenuous. This is partially because local infection and, more specifically, the formation of a biofilm, is difficult to diagnose. This has led to research efforts aimed at understanding if biofilm formation delays healing and leads to persistent and chronic infection. Circumventing challenges associated with culture-based estimations, advances in high-throughput sequencing analysis has revealed that chronic wounds are host to complex, diverse microbiomes comprising multiple species of bacteria and fungi. Here, we discuss how the use of genomic methodologies to study wound microbiomes has advanced the current understanding of infection and biofilm formation in chronic wounds.
伤口愈合是一个高度协调和复杂的过程，如果受到干扰，可能会产生毁灭性的后果。人们认为，在宿主因素的共同作用下，伤口床中的微生物不仅会损害伤口愈合，还会导致伤口停滞、慢性化。据推测，伤口微生物组以生物膜的形式存在于慢性伤口中，对抗生素和机械干预具有抵抗力。基于培养的方法是鉴定存在于伤口中的病原体的金标准。然而，这些方法对苛刻的生物体有偏见，并且不能捕捉慢性伤口中微生物多样性的全部范围。因此，特定微生物与愈合受损之间的联系仍然很脆弱。部分原因是局部感染，更具体地说是生物膜的形成，难以诊断。这导致了旨在了解生物膜形成是否会延迟愈合并导致持续和慢性感染的研究工作。为了规避基于培养的估计相关的挑战，高通量测序分析的进展揭示了慢性伤口中存在着复杂多样的微生物组，包含多种细菌和真菌。在这里，我们讨论了使用基因组方法研究伤口微生物组如何提高了对慢性伤口感染和生物膜形成的现有认识。
