South Western Sydney Limb Preservation and Wound Research, South Western Sydney LHD, Sydney, Australia.
Infectious Diseases and Microbiology, School of Medicine, Western Sydney University, Sydney, Australia.
NPJ Biofilms Microbiomes. 2021 Mar 22;7(1):29. doi: 10.1038/s41522-021-00202-x.
Diabetic foot infections (DFIs) are a major cause of hospitalization and can lead to lower extremity amputation. In this pilot study, we used a multiomics approach to explore the host-microbe complex within DFIs. We observed minimal differences in the overall microbial composition between PEDIS infection severities, however Staphylococcus aureus and Streptococcus genera were abundant and highly active in most mild to moderate DFIs. Further, we identified the significant enrichment of several virulence factors associated with infection pathogenicity belonging to both Staphylococcus aureus and Streptococcus. In severe DFIs, patients demonstrated a greater microbial diversity and differential gene expression demonstrated the enrichment of multispecies virulence genes suggestive of a complex polymicrobial infection. The host response in patients with severe DFIs was also significantly different as compared to mild to moderate DFIs. This was attributed to the enrichment of host genes associated with inflammation, acute phase response, cell stress and broad immune-related responses, while those associated with wound healing and myogenesis were significantly depleted.
糖尿病足感染(DFIs)是住院的主要原因,并可能导致下肢截肢。在这项初步研究中,我们采用多组学方法探索 DFIs 中的宿主-微生物复合物。我们观察到 PEDIS 感染严重程度之间的整体微生物组成差异极小,然而金黄色葡萄球菌和链球菌属在大多数轻度至中度 DFIs 中丰富且高度活跃。此外,我们鉴定出与感染致病性相关的几种毒力因子的显著富集,这些因子既存在于金黄色葡萄球菌中,也存在于链球菌属中。在严重的 DFIs 中,患者表现出更大的微生物多样性,差异基因表达显示出多种微生物毒力基因的富集,提示存在复杂的多微生物感染。与轻度至中度 DFIs 相比,严重 DFIs 患者的宿主反应也明显不同。这归因于与炎症、急性期反应、细胞应激和广泛的免疫相关反应相关的宿主基因的富集,而与伤口愈合和肌生成相关的基因则明显减少。