Journal article
Strain- and Species-Level Variation in the Microbiome of Diabetic Wounds Is Associated with Clinical Outcomes and Therapeutic Efficacy
Cell host & microbe, Vol.25(5), pp.641-655.e5
05/08/2019
DOI: 10.1016/j.chom.2019.03.006
PMCID: PMC6526540
PMID: 31006638
Abstract
Chronic wounds are a major complication of diabetes associated with high morbidity and health care expenditures. To investigate the role of colonizing microbiota in diabetic wound healing, clinical outcomes, and response to interventions, we conducted a longitudinal, prospective study of patients with neuropathic diabetic foot ulcers (DFU). Metagenomic shotgun sequencing revealed that strain-level variation of Staphylococcus aureus and genetic signatures of biofilm formation were associated with poor outcomes. Cultured wound isolates of S. aureus elicited differential phenotypes in mouse models that corresponded with patient outcomes, while wound “bystanders” such as Corynebacterium striatum and Alcaligenes faecalis, typically considered commensals or contaminants, also significantly impacted wound severity and healing. Antibiotic resistance genes were widespread, and debridement, rather than antibiotic treatment, significantly shifted the DFU microbiota in patients with more favorable outcomes. These findings suggest that the DFU microbiota may be a marker for clinical outcomes and response to therapeutic interventions.
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•Wound microbiota was profiled longitudinally in patients with diabetic foot ulcers•Staphylococcus aureus strains were associated with poor outcomes•S. aureus and other wound isolates promoted differential wound healing responses•Debridement depleted anaerobic bacteria in wounds with favorable outcomes
Kalan et al. investigate the role of colonizing microbiota in wound healing, clinical outcomes, and response to therapy in patients with chronic diabetic wounds. Strains of the wound pathogen S. aureus were associated with poor outcomes, and sharp debridement therapy depleted anaerobic bacteria in wounds with favorable outcomes.
Details
- Title: Subtitle
- Strain- and Species-Level Variation in the Microbiome of Diabetic Wounds Is Associated with Clinical Outcomes and Therapeutic Efficacy
- Creators
- Lindsay R. Kalan - University of PennsylvaniaJacquelyn S. Meisel - University of Maryland, College ParkMichael A. Loesche - University of PennsylvaniaJoseph Horwinski - University of PennsylvaniaIoana Soaita - University of PennsylvaniaXiaoxuan Chen - University of PennsylvaniaAayushi Uberoi - University of PennsylvaniaSue E. Gardner - University of IowaElizabeth A. Grice - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Cell host & microbe, Vol.25(5), pp.641-655.e5
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.chom.2019.03.006
- PMID
- 31006638
- PMCID
- PMC6526540
- ISSN
- 1931-3128
- eISSN
- 1934-6069
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000056, name: National Institute of Nursing Research, award: R01-NR-009448, R01-NR-015639, P20 NR018081; DOI: 10.13039/100000069, name: National Institute of Arthritis, Musculoskeletal, and Skin Diseases, award: R01-AR-006663, R00-AR-060873; DOI: 10.13039/100000861, name: Burroughs Wellcome Fund; name: Penn Skin Biology and Disease Resource-Based Center, award: P30-AR-069589; name: Dermatology Research Training grant, award: T32-AR-007465
- Language
- English
- Date published
- 05/08/2019
- Academic Unit
- Nursing
- Record Identifier
- 9984368096102771
Metrics
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