title: Quantitation and composition of cutaneous microbiota in diabetic and nondiabetic men.
abstract: BACKGROUND
  Diabetic foot infections are a leading cause of lower extremity amputations. Our study examines the microbiota of diabetic skin prior to ulcer development or infection.
  
  
  METHODS
  In a case-control study, outpatient males were recruited at a veterans hospital. Subjects were swabbed at 4 cutaneous sites, 1 on the forearm and 3 on the foot. Quantitative polymerase chain reaction (qPCR) with primers and probes specific for bacteria, Staphylococcus species, Staphylococcus aureus, and fungi were performed on all samples. High-throughput 16S ribosomal RNA (rRNA) sequencing was performed on samples from the forearm and the plantar aspect of the foot.
  
  
  RESULTS
  qPCR analysis of swab specimens from 30 diabetic subjects and 30 control subjects showed no differences in total numbers of bacteria or fungi at any sampled site. Increased log concentrations of Staphylococcus aureus, quantified by the number of nuc gene copies, were present in diabetic men on the plantar aspect of the foot. High-throughput 16S rRNA sequencing found that, on the foot, the microbiota in controls (n = 24) was dominated by Staphylococcus species, whereas the microbiota in diabetics (n = 23) was more diverse at the genus level. The forearm microbiota had similar diversity in diabetic and control groups.
  
  
  CONCLUSIONS
  The feet of diabetic men had decreased populations of Staphylococcus species, increased populations of S. aureus, and increased bacterial diversity, compared with the feet of controls. These ecologic changes may affect the risk for wound infections.
authors.affiliation: Department of Medicine, New York University School of Medicine, New York, NY 10010, USA. henry.redel@gmail.com
authors.forename: Henry
authors.initials: H
authors.lastname: Redel
authors.forename: Zhan
authors.initials: Z
authors.lastname: Gao
authors.forename: Huilin
authors.initials: H
authors.lastname: Li
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Alekseyenko
authors.forename: Yanjiao
authors.initials: Y
authors.lastname: Zhou
authors.forename: Guillermo I
authors.initials: GI
authors.lastname: Perez-Perez
authors.forename: George
authors.initials: G
authors.lastname: Weinstock
authors.forename: Erica
authors.initials: E
authors.lastname: Sodergren
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Blaser
mesh_terms: D000328:Adult; D000368:Aged; D003883:Arthrodermataceae / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D058491:Bacterial Load; D001426:Bacterial Proteins / Q000235:genetics; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000473:pathology*; D017719:Diabetic Foot / Q000382:microbiology* / Q000473:pathology; D005542:Forearm / Q000382:microbiology; D005798:Genes, Bacterial; D020459:Genes, rRNA; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008297:Male; D054892:Metagenome; D008836:Micrococcal Nuclease / Q000235:genetics; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012867:Skin / Q000382:microbiology* / Q000473:pathology; D013203:Staphylococcal Infections / Q000382:microbiology / Q000473:pathology; D013211:Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D055815:Young Adult
chemical_list: D001426:Bacterial Proteins; D012336:RNA, Ribosomal, 16S; C074002:nuc protein, staphylococcus; D008836:Micrococcal Nuclease