Microbial predictors of healing and short-term effect of debridement on the microbiome of chronic wounds
Microbial predictors of healing and short-term effect of debridement on the microbiome of chronic wounds
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DOI：
10.1038/s41522-020-0130-5
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发表时间：
2020-05-01
影响因子：
9.2
通讯作者：
Chen, Irene A.
中科院分区：
文献类型：
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作者：
Verbanic, Samuel;Shen, Yuning;Chen, Irene A.
慢性伤口是一个巨大且不断增长的疾病负担。感染和生物膜形成是伤口愈合的两个主要障碍，表明这些伤口的微生物组具有重要作用。清创术是治疗慢性伤口的一种常用而有效的方法。我们分析了20例门诊慢性伤口患者在清创前和清创后即刻以及健康皮肤的创面细菌含量。鉴于在不同伤口之间观察到的较大变化，我们引入了贝叶斯统计方法，该方法对患者间的变化进行建模，并确定了在伤口与健康皮肤中显著富集的几个属。我们发现原始伤口表面的微生物组与单次锐性清创暴露的微生物组之间没有差异，表明这种清创不会直接改变伤口微生物组。然而，我们发现需氧菌，特别是兼性厌氧菌与6个月内不愈合的伤口显著相关。兼性厌氧肠杆菌属与缺乏愈合显著相关。结果表明，在慢性伤口微生物组中，大量的兼性厌氧菌是一个负面的预后因素，这可能是由于这些群落对不同代谢环境的鲁棒性增加。
Chronic wounds represent a large and growing disease burden. Infection and biofilm formation are two of the leading impediments of wound healing, suggesting an important role for the microbiome of these wounds. Debridement is a common and effective treatment for chronic wounds. We analyzed the bacterial content of the wound surface from 20 outpatients with chronic wounds before and immediately after debridement, as well as healthy skin. Given the large variation observed among different wounds, we introduce a Bayesian statistical method that models patient-to-patient variability and identify several genera that were significantly enriched in wounds vs. healthy skin. We found no difference between the microbiome of the original wound surface and that exposed by a single episode of sharp debridement, suggesting that this debridement did not directly alter the wound microbiome. However, we found that aerobes and especially facultative anaerobes were significantly associated with wounds that did not heal within 6 months. The facultative anaerobic genus Enterobacter was significantly associated with lack of healing. The results suggest that an abundance of facultative anaerobes is a negative prognostic factor in the chronic wound microbiome, possibly due to the increased robustness of such communities to different metabolic environments.