title: The Microbiological Landscape of Anaerobic Infections in Hidradenitis Suppurativa: A Prospective Metagenomic Study.
abstract: BACKGROUND
  Hidradenitis suppurativa (HS) is a frequent and severe disease of the skin, characterized by recurrent or chronic skinfold suppurative lesions with a high impact on quality of life. Although considered inflammatory, antimicrobial treatments can improve or lead to clinical remission of HS, suggesting triggering microbial factors. Indeed, mixed anaerobic microbiota are associated with a majority of HS lesions. Our aim in this study was to characterize the landscape of anaerobic infections in HS using high-throughput sequencing.
  
  
  METHODS
  We sampled and cultured 149 lesions and 175 unaffected control skinfold areas from 65 adult HS patients. The microbiome of 80 anaerobic lesions was compared to that of 88 control samples by 454 high-throughput sequencing after construction of 16S ribosomal RNA gene libraries.
  
  
  RESULTS
  Bacterial cultures detected anaerobes in 83% of lesions vs 53% of control samples, combined with milleri group streptococci and actinomycetes in 33% and 26% of cases, respectively. High-throughput sequencing identified 43 taxa associated with HS lesions. Two gram-negative anaerobic rod taxa, Prevotella and Porphyromonas, predominated, contrasting with a reduced abundance of aerobic commensals. These rare taxa of normal skinfold microbiota were associated with lesions independently of gender, duration and familial history of HS, body mass index, and location. Two main additional taxa, Fusobacterium and Parvimonas, correlated with the clinical severity of HS.
  
  
  CONCLUSIONS
  In this study we reveal the high prevalence and particular landscape of mixed anaerobic infection in HS, paving the way for rationale targeted antimicrobial treatments.
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité.|Department of Clinical Microbiology, Necker-Enfants malades Hospital, Assistance Publique - Hôpitaux de Paris.|INSERM U11151, Team 11.|Centre d'Infectiologie Necker-Pasteur.
authors.forename: Hélène
authors.initials: H
authors.lastname: Guet-Revillet
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité.|Department of Biostatistics, Necker-Enfants malades Hospital, Assistance Publique - Hôpitaux de Paris.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jais
authors.affiliation: ICAReB platform of the Center for Translational Science, Institut Pasteur.
authors.forename: Marie-Noelle
authors.initials: MN
authors.lastname: Ungeheuer
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité.|Centre d'Infectiologie Necker-Pasteur.|Department of Tropical Medicine and Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique - Hôpitaux de Paris.
authors.forename: Hélène
authors.initials: H
authors.lastname: Coignard-Biehler
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité.|INSERM U1163, Imagine Institute, Department of Genetics.
authors.forename: Sabine
authors.initials: S
authors.lastname: Duchatelet
authors.affiliation: Centre d'Infectiologie Necker-Pasteur.|Department of Dermatology, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris.
authors.forename: Maïa
authors.initials: M
authors.lastname: Delage
authors.affiliation: Centre d'Infectiologie Necker-Pasteur.|Department of Tropical Medicine and Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique - Hôpitaux de Paris.|Medical Center, Institut Pasteur.
authors.forename: Thi
authors.initials: T
authors.lastname: Lam
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité.|INSERM U1163, Imagine Institute, Department of Genetics.
authors.forename: Alain
authors.initials: A
authors.lastname: Hovnanian
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité.|Centre d'Infectiologie Necker-Pasteur.|Department of Tropical Medicine and Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique - Hôpitaux de Paris.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité.|Department of Clinical Microbiology, Necker-Enfants malades Hospital, Assistance Publique - Hôpitaux de Paris.|INSERM U11151, Team 11.|Centre d'Infectiologie Necker-Pasteur.
authors.forename: Xavier
authors.initials: X
authors.lastname: Nassif
authors.affiliation: Centre d'Infectiologie Necker-Pasteur.|Department of Tropical Medicine and Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique - Hôpitaux de Paris.|Medical Center, Institut Pasteur.
authors.forename: Aude
authors.initials: A
authors.lastname: Nassif
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité.|Department of Clinical Microbiology, Necker-Enfants malades Hospital, Assistance Publique - Hôpitaux de Paris.|INSERM U11151, Team 11.|Centre d'Infectiologie Necker-Pasteur.
authors.forename: Olivier
authors.initials: O
authors.lastname: Join-Lambert
mesh_terms: D000328:Adult; D001421:Bacteria, Anaerobic / Q000235:genetics* / Q000302:isolation & purification / Q000502:physiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000235:genetics* / Q000302:isolation & purification; D017497:Hidradenitis Suppurativa / Q000382:microbiology* / Q000503:physiopathology; D059014:High-Throughput Nucleotide Sequencing / Q000379:methods; D006801:Humans; D008297:Male; D056186:Metagenomics; D064307:Microbiota; D018720:Prevotella / Q000302:isolation & purification; D011446:Prospective Studies; D011788:Quality of Life; D012867:Skin / Q000382:microbiology / Q000473:pathology; D018461:Soft Tissue Infections / Q000382:microbiology
keywords: Fusobacterium; Porphyromonas; Prevotella; hidradenitis suppurativa; soft tissue and skin infections