Exploring the Microbiome of Diabetic Foot Ulcers: A Focus on Cases with a Clinical Worse Outcome
Por:
Soldevila-Boixader, L, Carrera-Salinas, A, Mur, I, Morata, L, Rivera, A, Bosch, J, Montero-Saez, A, Castillejo, JM, Benito, N, Martí, S, Murillo, O
Publicada:
18 jul 2025
Resumen:
Background/Objectives: We evaluated the diabetic foot ulcer (DFU) microbiome in clinical situations identified as risk factors for a worse outcome and explored the roles of the most abundant microorganisms. Methods: A prospective multicenter cohort of diabetic patients with DFU were followed up for 6 months. We obtained a DFU tissue biopsy for microbiome analysis at the baseline visit. Genomic DNA was extracted (QIAamp DNA Mini Kit, Qiagen, Hilden, Germany) and quantified (QuantiFluor dsDNA System, Promega, Madison, WI, USA), with analysis of bacterial communities focusing on relative abundances (RA) and on alpha and beta diversity. Results: Overall, 59 DFUs were analyzed. DFUs of long duration (>= 4 weeks) presented a higher RA of Gammaproteobacteria compared with ulcers of short duration (p = 0.02). Non-infected DFUs had a higher proportion of Actinobacteriota phyla than infected DFUs and, particularly, a higher RA of Corynebacterium genera (means +/- SD: 0.063 +/- 0.14 vs. 0.028 +/- 0.13, respectively; p = 0.03). Regarding the pathogenic role of Staphylococcus aureus, DFUs with low S. aureus bacterial loads (<10(6) CFU/mL) compared with those with high loads (>= 10(6) CFU/mL) showed a higher Corynebacterium RA (0.045 +/- 0.08 vs. 0.003 +/- 0.01, respectively; p = 0.01). Conclusions: In clinical situations associated with poor DFU outcomes, we observed a predominance of Gammaproteobacteria in the microbiome of long-duration ulcers and a higher RA of Corynebacterium in non-infected DFUs. An inverse relationship between the predominance of Corynebacterium and the S. aureus bacterial load in DFUs was also noted, which may suggest these commensals have a modulatory role. Further studies should explore the clinical utility of microbiome analysis for DFUs.
Filiaciones:
Soldevila-Boixader, L:
Univ Barcelona UB, Bellvitge Biomed Res Inst IDIBELL, Bellvitge Univ Hosp, Infect Dis Unit,Dept Infect Dis, Barcelona 08907, Spain
Hosp Moises Broggi, Infect Dis Unit, Internal Med, Sant Joan Despi 08970, Spain
Study Grp Osteoarticular Infect Spanish Soc Clin M, Madrid 28003, Spain
Carrera-Salinas, A:
Univ Barcelona UB, Bellvitge Univ Hosp, Bellvitge Biomed Res Inst IDIBELL, Dept Microbiol, Barcelona 08907, Spain
Mur, I:
Hosp Moises Broggi, Infect Dis Unit, Internal Med, Sant Joan Despi 08970, Spain
Study Grp Osteoarticular Infect Spanish Soc Clin M, Madrid 28003, Spain
Univ Autonoma Barcelona UAB, Hosp Santa Creu & St Pau Hosp, Inst Recerca St Pau IR ST PAU, Infect Dis Unit,Dept Med, Barcelona 08041, Spain
Morata, L:
Univ Barcelona UB, Clin Hosp Barcelona, August Pi & Sunyer Biomed Res Inst IDIBAPS, Dept Infect Dis, Barcelona 08036, Spain
Rivera, A:
Hosp Santa Creu & Sant Pau, Inst Recerca St Pau IR ST PAU, Dept Microbiol, Barcelona 08041, Spain
Bosch, J:
Clin Hosp, Dept Microbiol, ISGlobal, Barcelona 08036, Spain
Montero-Saez, A:
Univ Barcelona UB, Bellvitge Univ Hosp, Bellvitge Biomed Res Inst IDIBELL, Internal Med Dept, Barcelona 08907, Spain
Castillejo, JM:
Clin Hosp, Dept Nursery Orthoped Surg, Barcelona 08036, Spain
Benito, N:
Study Grp Osteoarticular Infect Spanish Soc Clin M, Madrid 28003, Spain
Univ Autonoma Barcelona UAB, Hosp Santa Creu & St Pau Hosp, Inst Recerca St Pau IR ST PAU, Infect Dis Unit,Dept Med, Barcelona 08041, Spain
Univ Queensland Ctr Clin Res UQCCR, Brisbane 4029, Australia
Natl Inst Hlth Carlos III ISCIII, Ctr Invest Biomed Red Enfermedades Infecciosas CIB, Madrid 28029, Spain
Martí, S:
Univ Barcelona UB, Bellvitge Univ Hosp, Bellvitge Biomed Res Inst IDIBELL, Dept Microbiol, Barcelona 08907, Spain
Natl Inst Hlth Carlos III ISCIII, Res Network Resp Dis CIBERES, Madrid 28029, Spain
Murillo, O:
Univ Barcelona UB, Bellvitge Biomed Res Inst IDIBELL, Bellvitge Univ Hosp, Infect Dis Unit,Dept Infect Dis, Barcelona 08907, Spain
Study Grp Osteoarticular Infect Spanish Soc Clin M, Madrid 28003, Spain
Natl Inst Hlth Carlos III ISCIII, Ctr Invest Biomed Red Enfermedades Infecciosas CIB, Madrid 28029, Spain
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