Role of anaerobes in polymicrobial communities and biofilms complicating diabetic foot ulcers
Role of anaerobes in polymicrobial communities and biofilms complicating diabetic foot ulcers
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DOI：
10.1111/iwj.12926
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发表时间：
2018-10-01
影响因子：
3.1
通讯作者：
Schultz, Gregory
中科院分区：
文献类型：
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作者：
Percival, Steven L.;Malone, Matthew;Schultz, Gregory
糖尿病足溃疡（DFU）形式的糖尿病患者足部感染组织为临床医生提供了复杂的病理学管理。这部分归因于该疾病的多因素性质，其可能包括：改变足部结构，导致足底压力和摩擦力过大、外周动脉疾病和保护性感觉丧失。此外，对于上述共病变量，应理解的是，延迟的伤口愈合状态可能由于存在于伤口组织中的微生物而持续。慢性DFU的微生物学经常被报告为多微生物。越来越感兴趣的是厌氧微生物在DFU病理学中的存在和潜在作用，以及它们如何有助于感染过程或延迟愈合。厌氧菌在DFU中的存在被大大低估了，这主要是由于常规培养方法在从样品中鉴定厌氧菌方面的局限性。分子和显微镜技术的进步扩大了我们对伤口微生物组的看法，除了观察原位微生物的生长和行为（生物膜或生物膜）。这篇综述文章将反映厌氧菌在DFU和感染中的作用和意义的证据。本次审查的重点将是探索分子基因组学和显微镜技术的最新进展，以更好地评估厌氧菌在慢性DFU和生物膜为基础的伤口护理中的作用。
Infected tissues in the feet of people with diabetes in the form of a diabetic foot ulcer (DFU) present a complex pathology for clinicians to manage. This is partly attributed to the multi-factorial nature of the disease, which may include; altered foot architecture leading to excessive plantar pressures and frictional forces peripheral arterial disease and loss of protective sensation. In addition, to the above co-morbid variables, it is understood that a delayed wound healing state may be perpetuated by the presence of microorganisms residing in the wound tissue. The microbiology of chronic DFUs has often been reported as being polymicrobial. Of growing interest is the presence and potential role of anaerobic microorganisms in the pathology of DFUs and how they may contribute to the infective process or delayed healing. The presence of anaerobes in DFUs has been greatly underestimated, largely due to the limitations of conventional culture methods in identifying them from samples. Advancements in molecular and microscopy techniques have extended our view of the wound microbiome in addition to observing the growth and behaviour (planktonic or biofilm) of microorganisms in situ. This review paper will reflect on the evidence for the role and significance of anaerobes in DFUs and infection. A focus of this review will be to explore recent advancements in molecular genomics and microscopy techniques in order to better assess the roles of anaerobic bacteria in chronic DFUs and in biofilm-based wound care.