Strain- and Species-Level Variation in the Microbiome of Diabetic Wounds Is
Associated with Clinical Outcomes and Therapeutic Efficacy.
Authors Kalan LR, Meisel JS, Loesche MA, Horwinski J, Soaita I, Chen X, Uberoi A,
Gardner SE, Grice EA
Submitted By Lindsay Kalan on 10/14/2019
Status Published
Journal Cell host & microbe
Year 2019
Date Published 5/1/2019
Volume : Pages 25 : 641 - 655.e5
PubMed Reference 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.