Analysis of microbiota in normal skin and diabetic foot wound tissue from the same patients according to the clinical features

Diabetic foot ulcer (DFU) is one of complication in diabetic patients and it does not heal well by altered wound environment with various factors. Recently, several studies using molecular methods reported that microbes were more diverse than previous results based on culture assay. However, the comparison of skin microbiota in normal tissue and diabetic foot wound (DFW) tissue from the same patients according to clinical features are still limited. In this study, we analyzed the microbiota in normal skin and DFW tissue from the same subject, and compared the associated members of microbiota with clinical parameters using high-throughput sequencing. The diversity of skin microbiota was higher than that of DFW tissues, and the composition was different between them. Bacteroidetes, Prevotella, Peptoniphilus, Porphyromonas, and Dialister in DFW tissues were detected relatively higher in DFW tissue of severe groups than mild groups, whereas Firmicutes were lower in severe groups. The different microbiota in severe groups was predicted to be related to inflammation, damaging host cell membrane, and pathogenicity of microbiota through lipopolysaccharide biosynthesis, cellular antigens, and protein digestion metabolisms. The predicted DFW tissue microbiota functions according to systemic diabetic status such as ESRD and HbA1c were different to those presented by wound severity. Results in this study indicates that the microbiota in normal skin is related to the colonizing microbes in DFW tissue according to clinical features and the different colonized microbes can play important roles in DFW progress. This information can be applied to prevent or manage diabetic foot wound by modulating microbiota.