Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, United States of America.
Department of Statistics, University of Nebraska-Lincoln, Lincoln, Nebraska, United States of America.
PLoS One. 2020 Jan 24;15(1):e0227006. doi: 10.1371/journal.pone.0227006. eCollection 2020.
Diabetic foot ulcers (DFUs) lead to nearly 100,000 lower limb amputations annually in the United States. DFUs are colonized by complex microbial communities, and infection is one of the most common reasons for diabetes-related hospitalizations and amputations. In this study, we examined how DFU microbiomes respond to initial sharp debridement and offloading and how the initial composition associates with 4 week healing outcomes. We employed 16S rRNA next generation sequencing to perform microbial profiling on 50 samples collected from 10 patients with vascularized neuropathic DFUs. Debrided wound samples were obtained at initial visit and after one week from two DFU locations, wound bed and wound edge. Samples of the foot skin outside of the wounds were also collected for comparison. We showed that DFU wound beds are colonized by a greater number of distinct bacterial phylotypes compared to the wound edge or skin outside the wound. However, no significant microbiome diversity changes occurred at the wound sites after one week of standard care. Finally, increased initial abundance of Gram-positive anaerobic cocci (GPAC), especially Peptoniphilus (p < 0.05; n = 5 subjects), was associated with impaired healing; thus, GPAC's abundance could be a predictor of the wound-healing outcome.
糖尿病足溃疡（DFU）导致美国每年近 100,000 例下肢截肢。DFU 被复杂的微生物群落定植，感染是导致糖尿病相关住院和截肢的最常见原因之一。在这项研究中，我们研究了 DFU 微生物组如何对初始锐清创和减压做出反应，以及初始组成如何与 4 周愈合结果相关。我们采用 16S rRNA 下一代测序技术对来自 10 例血管性神经病变 DFU 患者的 50 个样本进行微生物特征分析。在初始就诊时以及从两个 DFU 部位（伤口床和伤口边缘）获得清创后的伤口样本。还采集了伤口外的足部皮肤样本进行比较。结果表明，DFU 伤口床定植的细菌型明显多于伤口边缘或伤口外的皮肤。然而，在标准治疗一周后，伤口部位的微生物组多样性没有明显变化。最后，初始革兰阳性厌氧球菌（GPAC），尤其是消化链球菌属（Peptoniphilus）（p<0.05；n=5 例）的丰度增加与愈合不良有关；因此，GPAC 的丰度可能是伤口愈合结果的预测指标。
