Polymicrobial Nature of Chronic Diabetic Foot Ulcer Biofilm Infections Determined Using Bacterial Tag Encoded FLX Amplicon Pyrosequencing (bTEFAP)
2008

Understanding Bacteria in Diabetic Foot Ulcers

Sample size: 40 publication Evidence: moderate

Author Information

Author(s): Dowd Scot E., Wolcott Randall D., Sun Yan, McKeehan Trevor, Smith Ethan, Rhoads Daniel

Primary Institution: Research and Testing Laboratory, Lubbock, Texas, United States of America

Hypothesis

A single major pathogen such as Staphylococcus aureus would be associated with all such wounds.

Conclusion

The study found that no single genus of bacteria was present in all diabetic foot ulcers, highlighting the complexity of bacterial communities in these infections.

Supporting Evidence

  • The most prevalent bacterial genus associated with diabetic chronic wounds was Corynebacterium spp.
  • Obligate anaerobes were found to be ubiquitous in diabetic ulcers.
  • The study introduced the concept of functional equivalent pathogroups (FEP) to describe bacterial communities that work together to cause infections.

Takeaway

Diabetic foot ulcers have many different types of bacteria, and they work together in groups, which makes it hard to treat infections.

Methodology

The study used bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP) to evaluate the bacterial diversity in samples from 40 diabetic foot ulcers.

Potential Biases

There is a risk of bias in traditional culturing methods that favor easily cultured organisms over more difficult-to-culture bacteria.

Limitations

The study suggests that traditional culturing methods may be biased and may not accurately represent the bacterial diversity present in chronic wounds.

Participant Demographics

Participants were individuals with diabetic extremity ulcers from the Southwest Regional Wound Care Center in Lubbock, Texas.

Digital Object Identifier (DOI)

10.1371/journal.pone.0003326

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