Polymicrobial nature of chronic diabetic foot ulcer biofilm infections determined using bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP).
Polymicrobial nature of chronic diabetic foot ulcer biofilm infections determined using bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP).
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DOI：
10.1371/journal.pone.0003326
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发表时间：
2008-10-03
期刊：
影响因子：
3.7
通讯作者：
Rhoads D
中科院分区：
文献类型：
--
作者：
Dowd SE;Wolcott RD;Sun Y;McKeehan T;Smith E;Rhoads D
糖尿病肢体溃疡与慢性感染有关。这类溃疡感染常常导致截肢，因为人们对这类感染的生态学，以及如何控制或消除这种慢性感染知之甚少，甚至一无所知。慢性伤口愈合的一个主要障碍是生物膜表型感染。糖尿病足溃疡是糖尿病最常见、最致残且代价最高的并发症。在此，我们试图更好地了解慢性糖尿病肢体溃疡感染的多微生物特性。
我们使用一种新的细菌标签编码的FLX扩增子焦磷酸测序（bTEFAP）方法，评估了来自不同患者的40个慢性糖尿病足溃疡的细菌多样性。与糖尿病慢性伤口相关的最常见细菌属是棒状杆菌属。研究结果还表明，专性厌氧菌，包括拟杆菌属、消化链球菌属、芬戈尔德菌属、厌氧球菌属和 peptostreptococcus属，在糖尿病溃疡中普遍存在，构成了伤口生物膜群落的重要部分。细菌群落的其他主要组成部分包括常见培养的菌属，如链球菌属、沙雷氏菌属、葡萄球菌属和肠球菌属。
在本文中，我们强调了在样本中观察到的种群多样性模式，并引入了初步证据来支持功能等效病原体群（FEP）的概念。在此，我们将FEP介绍为基因型不同的细菌的集合体，它们共生形成一个致病群落。根据这一假设，这些群落的单个成员单独存在时可能不会致病，但当它们共同聚集或联合形成一个FEP时，协同效应提供了与众所周知的病原体（如金黄色葡萄球菌）等效的功能，使生物膜群落具备维持慢性生物膜感染所需的因素。为了证明FEP概念是否是一个可行的假设，进一步的研究肯定是必要的。这里的研究结果还表明，传统培养方法作为一种诊断工具可能存在极大的偏差，因为它们选择容易培养的生物体（如金黄色葡萄球菌），而不利于培养困难的细菌（如厌氧菌）。虽然PCR方法也存在偏差，但现在需要进一步的工作来比较传统培养结果与高分辨率分子诊断方法（如bTEFAP）。
Diabetic extremity ulcers are associated with chronic infections. Such ulcer infections are too often followed by amputation because there is little or no understanding of the ecology of such infections or how to control or eliminate this type of chronic infection. A primary impediment to the healing of chronic wounds is biofilm phenotype infections. Diabetic foot ulcers are the most common, disabling, and costly complications of diabetes. Here we seek to derive a better understanding of the polymicrobial nature of chronic diabetic extremity ulcer infections. Using a new bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP) approach we have evaluated the bacterial diversity of 40 chronic diabetic foot ulcers from different patients. The most prevalent bacterial genus associated with diabetic chronic wounds was Corynebacterium spp. Findings also show that obligate anaerobes including Bacteroides, Peptoniphilus, Fingoldia, Anaerococcus, and Peptostreptococcus spp. are ubiquitous in diabetic ulcers, comprising a significant portion of the wound biofilm communities. Other major components of the bacterial communities included commonly cultured genera such as Streptococcus, Serratia, Staphylococcus and Enterococcus spp. In this article, we highlight the patterns of population diversity observed in the samples and introduce preliminary evidence to support the concept of functional equivalent pathogroups (FEP). Here we introduce FEP as consortia of genotypically distinct bacteria that symbiotically produce a pathogenic community. According to this hypothesis, individual members of these communities when they occur alone may not cause disease but when they coaggregate or consort together into a FEP the synergistic effect provides the functional equivalence of well-known pathogens, such as Staphylococcus aureus, giving the biofilm community the factors necessary to maintain chronic biofilm infections. Further work is definitely warranted and needed in order to prove whether the FEPs concept is a viable hypothesis. The findings here also suggest that traditional culturing methods may be extremely biased as a diagnostic tool as they select for easily cultured organisms such as Staphylococcus aureus and against difficult to culture bacteria such as anaerobes. While PCR methods also have bias, further work is now needed in comparing traditional culture results to high-resolution molecular diagnostic methods such as bTEFAP.
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