Chan Alfred A, Flores Evelyn A, Navarrete Marian, Phan Tran Donna, Lee Delphine J, Miller Loren G
Division of Dermatology, Department of Medicine, Lundquist Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, California, USA.
Division of Infectious Diseases, Department of Medicine, Lundquist Research Institute at Harbor-University of California, Los Angeles Medical Center, Torrance, California, USA.
Open Forum Infect Dis. 2022 Mar 22;9(5):ofac141. doi: 10.1093/ofid/ofac141. eCollection 2022 May.
Skin and soft tissue infections (SSTIs) are very common bacterial infections. There are few data on the microbiome of persons with and without SSTIs and the effects of systemic antibiotic therapy.
We sampled the skin microbiome from 10 outpatients with acute suppurative SSTI before and after systemic antibiotic therapy and enrolled 10 matched controls. Samples were collected at 6 skin body sites (occipital scalp, axilla, interdigital hand web spaces, gluteal crease, inguinal creases, and popliteal fossa), 2 mucosal sites (throat, anterior nares), and the site of skin infection (for case subjects) at baseline and a week later after abscess incision, drainage, and oral antibiotics.
Among 10 SSTI cases, mean age was 41.5 years and 3 had diabetes mellitus. The gluteal crease at baseline had higher α-diversity in controls vs cases ( = .039); β-diversity analysis showed significant differences in overall bacterial community composition ( = .046). However, at other body sites there were no significant differences by either α- or β-diversity. Systemic antibiotic use did not affect body site diversity indices except at the SSTI site (α-diversity increased, = .001).
We surprisingly found no significant differences in microbiome comparing noninfected skin sites before and after systemic SSTI antibiotic therapy nor significant differences at noninfected skin sites between SSTI cases and uninfected controls. We also found minimal significant differences between microbiome diversity and bacterial signatures at noninfected skin sites between patients with acute skin infection and uninfected controls. Our findings challenge the dogma that systemic antibiotics impact the skin microbiome.
皮肤和软组织感染（SSTIs）是非常常见的细菌感染。关于患有和未患有SSTIs的人群的微生物群以及全身抗生素治疗的影响的数据很少。
我们对10例急性化脓性SSTI门诊患者在全身抗生素治疗前后的皮肤微生物群进行了采样，并纳入了10例匹配的对照。在基线时以及脓肿切开、引流和口服抗生素一周后，在6个皮肤身体部位（枕部头皮、腋窝、指间手部网状间隙、臀沟、腹股沟皱襞和腘窝）、2个黏膜部位（咽喉、前鼻孔）以及皮肤感染部位（病例受试者）采集样本。
在10例SSTI病例中，平均年龄为41.5岁，3例患有糖尿病。基线时，对照组臀沟的α多样性高于病例组（P = 0.039）；β多样性分析显示总体细菌群落组成存在显著差异（P = 0.046）。然而，在其他身体部位，α或β多样性均无显著差异。全身使用抗生素除了在SSTI部位外，未影响身体部位的多样性指数（α多样性增加，P = 0.001）。
我们惊人地发现，在全身性SSTI抗生素治疗前后，未感染皮肤部位的微生物群没有显著差异，SSTI病例与未感染对照之间的未感染皮肤部位也没有显著差异。我们还发现，急性皮肤感染患者与未感染对照之间，未感染皮肤部位的微生物群多样性和细菌特征之间的显著差异极小。我们的研究结果挑战了全身抗生素会影响皮肤微生物群的教条。
