title: Multi-Body-Site Microbiome and Culture Profiling of Military Trainees Suffering from Skin and Soft Tissue Infections at Fort Benning, Georgia.
abstract: Skin and soft tissue infections (SSTIs) are common in the general population, with increased prevalence among military trainees. Previous research has revealed numerous nasal microbial signatures that correlate with SSTI development andStaphylococcus aureuscolonization. Thus, we hypothesized that the ecology of the inguinal, oropharynx, and perianal regions may also be altered in response to SSTI and/orS. aureuscolonization. We collected body site samples from 46 military trainees with purulent abscess (SSTI group) as well as from 66 asymptomatic controls (non-SSTI group). We also collected abscess cavity samples to assess the microbial composition of these infections. Samples were analyzed by culture, and the microbial communities were characterized by high-throughput sequencing. We found that the nasal, inguinal, and perianal regions were similar in microbial composition and significantly differed from the oropharynx. We also observed differences inAnaerococcusandStreptococcusabundance between the SSTI and non-SSTI groups for the nasal and oropharyngeal regions, respectively. Furthermore, we detected community membership differences between the SSTI and non-SSTI groups for the nasal and inguinal sites. Compared to that of the other regions, the microbial compositions of the nares ofS. aureuscarriers and noncarriers were dramatically different; we noted an inverse correlation between the presence ofCorynebacteriumand the presence ofStaphylococcusin the nares. This correlation was also observed for the inguinal region. Culture analysis revealed elevated methicillin-resistantS. aureus(MRSA) colonization levels for the SSTI group in the nasal and inguinal body sites. Together, these data suggest significant microbial variability in patients with SSTI as well as betweenS. aureuscarriers and noncarriers.IMPORTANCEWhile it is evident that nasal colonization withS. aureusincreases the likelihood of SSTI, there is a significant lack of information regarding the contribution of extranasal colonization to the overall risk of a subsequent SSTI. Furthermore, the impact ofS. aureuscolonization on bacterial community composition outside the nasal microbiota is unclear. Thus, this report represents the first investigation that utilized both culture and high-throughput sequencing techniques to analyze microbial dysbiosis at multiple body sites of healthy and diseased/colonized individuals. The results described here may be useful in the design of future methodologies to treat and prevent SSTIs.
authors.affiliation: Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Jatinder
authors.initials: J
authors.lastname: Singh
authors.affiliation: Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Johnson
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA.
authors.forename: Carey D
authors.initials: CD
authors.lastname: Schlett
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA.
authors.forename: Emad M
authors.initials: EM
authors.lastname: Elassal
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA.
authors.forename: Katrina B
authors.initials: KB
authors.lastname: Crawford
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA.
authors.forename: Deepika
authors.initials: D
authors.lastname: Mor
authors.affiliation: Martin Army Community Hospital, Fort Benning, Georgia, USA.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Lanier
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA; Martin Army Community Hospital, Fort Benning, Georgia, USA.
authors.forename: Natasha N
authors.initials: NN
authors.lastname: Law
authors.affiliation: Department of Microbiome Science, Max Planck Institute for Developmental Biology, Tübingen, Germany.
authors.forename: William A
authors.initials: WA
authors.lastname: Walters
authors.affiliation: Infectious Diseases Directorate, Wound Infections Department, Naval Medical Research Center, Silver Spring, Maryland, USA.
authors.forename: Nimfa
authors.initials: N
authors.lastname: Teneza-Mora
authors.affiliation: Walter Reed Army Institute of Research, Silver Spring, Maryland, USA; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Bennett
authors.affiliation: Infectious Diseases Directorate, Wound Infections Department, Naval Medical Research Center, Silver Spring, Maryland, USA.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Hall
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA.
authors.forename: Eugene V
authors.initials: EV
authors.lastname: Millar
authors.affiliation: The University of Toledo Medical Center, Toledo, Ohio, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Ellis
authors.affiliation: Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: D Scott
authors.initials: DS
authors.lastname: Merrell
keywords: MRSA; SSTI; Staphylococcus aureus; USA300; microbiome