title: The cutaneous microbiome in outpatients presenting with acute skin abscesses.
abstract: BACKGROUND
  Previous studies have demonstrated an association between antibiotic use and the development of skin abscesses. We tested the hypothesis that alterations in the composition of the cutaneous microbiota may predispose individuals to skin abscesses.
  
  
  METHODS
  We studied 25 patients with skin abscesses and 25 age-matched controls, who each completed a questionnaire. Skin swab samples were obtained for DNA analysis from 4 sites around the abscess site (hereafter, "peri-abscess specimens") and from similar sites on the patient's contralateral side and on healthy control subjects. DNA was extracted and analyzed by quantitative polymerase chain reaction (qPCR) and high-throughput sequencing. The purulent abscess drainage was sent for culture.
  
  
  RESULTS
  Fifteen patients with abscess were infected with Staphylococcus aureus. Use of nuc qPCR to quantitate S. aureus revealed a significantly greater frequency of positive results for peri-abscess and contralateral skin samples, compared with control skin specimens. Analysis of community structure showed greater heterogeneity in the control samples than in the peri-abscess and contralateral samples. Metagenomic analysis detected significantly more predicted genes related to metabolic activity in the peri-abscess specimens than in the control samples.
  
  
  CONCLUSIONS
  The peri-abscess microbiome was similar to the contralateral microbiome, but both microbiomes differed from that for control patients. Host characteristics affecting microbial populations might be important determinants of abscess risk.
authors.affiliation: Division of Infectious Disease, Department of Internal Medicine.
authors.forename: James M
authors.initials: JM
authors.lastname: Horton
authors.affiliation: Departments of Medicine and Microbiology, Human Microbiome Program, New York University Langone Medical Center.
authors.forename: Zhan
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: D Matthew
authors.initials: DM
authors.lastname: Sullivan
authors.affiliation: Division of Infectious Disease, Department of Internal Medicine.
authors.forename: Bo
authors.initials: B
authors.lastname: Shopsin
authors.affiliation: Departments of Medicine and Microbiology, Human Microbiome Program, New York University Langone Medical Center.
authors.forename: Guillermo I
authors.initials: GI
authors.lastname: Perez-Perez
authors.affiliation: Departments of Medicine and Microbiology, Human Microbiome Program, New York University Langone Medical Center Medical Service, New York Harbor Veterans Affairs Medical Center, New York.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Blaser
mesh_terms: D000038:Abscess / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D005260:Female; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008297:Male; D064307:Microbiota; D010045:Outpatients; D060888:Real-Time Polymerase Chain Reaction; D012867:Skin / Q000382:microbiology*; D017192:Skin Diseases, Bacterial / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: MRSA; abscess; skin infection; skin microbiome