title: A comparison of bacterial composition in diabetic ulcers and contralateral intact skin.
abstract: An extensive portion of the healthcare budget is allocated to chronic human infection. Chronic wounds in particular are a major contributor to this financial burden. Little is known about the types of bacteria which may contribute to the chronicity, biofilm and overall bioburden of the wound itself. In this study we compare the bacteriology of wounds and associated intact skin. Wound and paired intact skin swabs (from a contralateral location) were collected. The bacterial diversity was determined using bacterial Tag-encoded FLX amplicon pyrosequencing (bTEFAP). Diversity analysis showed intact skin to be significantly more diverse than wounds on both the species and genus levels (3% and 5% divergence). Furthermore, wounds show heightened levels of anaerobic bacteria, like Peptoniphilus, Finegoldia, and Anaerococcus, and other detrimental genera such as Corynebacterium and Staphylococcus. Although some of these and other bacterial genera were found to be common between intact skin and wounds, notable opportunistic wound pathogens were found at lower levels in intact skin. Principal Component Analysis demonstrated a clear separability of the two groups. The findings of the study not only greatly support the hypothesis of differing bacterial composition of intact skin and wounds, but also contribute additional insight into the ecology of skin and wound microflora. The increased diversity and lowered levels of opportunistic pathogens found in skin make the system highly distinguishable from wounds.
authors.affiliation: Medical Biofilm Research Institute, 4321 Marsha Sharp Freeway, Lubbock, TX 79407.
authors.forename: Viktoria
authors.initials: V
authors.lastname: Gontcharova
authors.forename: Eunseog
authors.initials: E
authors.lastname: Youn
authors.forename: Yan
authors.initials: Y
authors.lastname: Sun
authors.forename: Randall D
authors.initials: RD
authors.lastname: Wolcott
authors.forename: Scot E
authors.initials: SE
authors.lastname: Dowd
references.citation: J Bacteriol. 1972 Mar;109(3):953-65
references.pmid: 4551757
references.citation: Proc Natl Acad Sci U S A. 2008 Apr 1;105(13):5134-8
references.pmid: 18375765
references.citation: Diabetes Care. 2007 Jun;30(6):1473-9
references.pmid: 17363754
references.citation: Clin Microbiol Rev. 1997 Jan;10(1):125-59
references.pmid: 8993861
references.citation: Wound Repair Regen. 2008 Jan-Feb;16(1):37-44
references.pmid: 18086294
references.citation: Eur J Dermatol. 2008 Nov-Dec;18(6):705-7
references.pmid: 18955204
references.citation: Proc Natl Acad Sci U S A. 2006 Aug 8;103(32):12115-20
references.pmid: 16880384
references.citation: Diabetes Care. 1999 Aug;22(8):1354-60
references.pmid: 10480782
references.citation: Infect Immun. 1980 Jan;27(1):44-50
references.pmid: 6987176
references.citation: Annu Rev Microbiol. 1995;49:711-45
references.pmid: 8561477
references.citation: Biometrics. 2002 Sep;58(3):531-9
references.pmid: 12229987
references.citation: Appl Environ Microbiol. 2005 Mar;71(3):1501-6
references.pmid: 15746353
references.citation: PLoS One. 2008 Oct 03;3(10):e3326
references.pmid: 18833331
references.citation: J Wound Care. 2009 Feb;18(2):54-6
references.pmid: 19418781
references.citation: Diabet Med. 2000 Nov;17(11):814-5
references.pmid: 11131109
references.citation: Proc Natl Acad Sci U S A. 1999 Mar 30;96(7):4023-7
references.pmid: 10097156
references.citation: Int J Dermatol. 1999 Aug;38(8):573-8
references.pmid: 10487444
references.citation: Annu Rev Microbiol. 1988;42:441-64
references.pmid: 3144238
references.citation: BMC Bioinformatics. 2006 Aug 07;7:371
references.pmid: 16893466
references.citation: J Clin Microbiol. 2008 Oct;46(10):3355-60
references.pmid: 18716234
references.citation: Infect Immun. 1998 Oct;66(10):4729-32
references.pmid: 9746571
references.citation: Infection. 1988 Sep-Oct;16(5):305
references.pmid: 3215693
references.citation: Nat Immunol. 2005 Jan;6(1):12-3
references.pmid: 15611775
references.citation: J Bacteriol. 2005 Jul;187(13):4671-82
references.pmid: 15968079
references.citation: Int J Dermatol. 1998 Jun;37(6):426-8
references.pmid: 9646126
references.citation: BMC Microbiol. 2008 Jul 24;8:125
references.pmid: 18652685
references.citation: JAMA. 2008 Jun 11;299(22):2682-4
references.pmid: 18544729
references.citation: BMC Microbiol. 2008 Mar 06;8:43
references.pmid: 18325110
references.citation: Biotechnol Bioeng. 1998 Aug 5;59(3):302-9
references.pmid: 10099341
references.citation: J Biochem. 1997 May;121(5):902-13
references.pmid: 9192732
references.citation: MMWR Morb Mortal Wkly Rep. 2003 Nov 14;52(45):1098-102
references.pmid: 14614407
references.citation: Proc Natl Acad Sci U S A. 2007 Feb 20;104(8):2927-32
references.pmid: 17293459
references.citation: J Wound Care. 2009 Aug;18(8):317-23
references.pmid: 19862869
references.citation: Crit Rev Microbiol. 1987;14(3):171-93
references.pmid: 3556018
references.citation: J Wound Care. 2008 Aug;17(8):333-41
references.pmid: 18754194
references.citation: J Dermatol Sci. 2009 Apr;54(1):1-5
references.pmid: 19203862
references.citation: Microbiology (Reading). 1996 Mar;142 ( Pt 3):623-629
references.pmid: 8868437
references.citation: J Med Microbiol. 2005 Dec;54(Pt 12):1231-1238
references.pmid: 16278439
references.citation: Wound Repair Regen. 2008 Jan-Feb;16(1):52-7
references.pmid: 18211579
references.citation: Acta Derm Venereol. 1988;68(3):240-4
references.pmid: 2455418
references.citation: J Wound Care. 2008 Dec;17(12):513-6
references.pmid: 19052515
references.citation: Proc Natl Acad Sci U S A. 2006 Jan 3;103(1):117-22
references.pmid: 16368757
references.citation: J Antimicrob Chemother. 2005 Feb;55(2):143-9
references.pmid: 15649989
references.citation: J Wound Care. 1999 May;8(5):216-8
references.pmid: 10531934
references.citation: J Mol Biol. 1990 Oct 5;215(3):403-10
references.pmid: 2231712
references.citation: Acta Derm Venereol. 1995 Jan;75(1):24-30
references.pmid: 7747531
references.citation: J Wound Care. 2008 Apr;17(4):145-8, 150-2, 154-5
references.pmid: 18494432
references.citation: Wound Repair Regen. 2008 Jan-Feb;16(1):2-10
references.pmid: 18211573
references.citation: J Wound Care. 1996 Jun;5(6):277-80
references.pmid: 8850916