Association between baseline abundance of Peptoniphilus, a Gram-positive anaerobic coccus, and wound healing outcomes of DFUs

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

糖尿病足溃疡（Diabetic Foot Ulcers, DFUs）在美国每年导致近10万例下肢截肢病例。糖尿病足溃疡被复杂的微生物群落定植，而感染是糖尿病相关住院与截肢的最常见诱因之一。本研究探讨了糖尿病足溃疡微生物组对初始锐性清创与创面减压疗法的响应，以及溃疡初始微生物组构成与4周愈合结局的关联。本研究采用16S rRNA高通量测序技术，对10例血管神经性糖尿病足溃疡患者的50份样本开展微生物组分析；分别于初诊时及治疗1周后，从糖尿病足溃疡的两个部位——创面床与创面边缘——采集清创后的创面样本，同时采集创面外足部皮肤样本作为对照。研究结果显示，与创面边缘或创面外足部皮肤相比，糖尿病足溃疡创面床定植的不同细菌系统型数量更多。但经标准治疗1周后，创面部位的微生物组多样性未出现显著变化。最后，革兰氏阳性厌氧球菌（Gram-positive Anaerobic Cocci, GPAC）的初始丰度升高，尤其是消化链球菌属（Peptoniphilus）（p