AUTHOR=Jneid Joanne , Cassir Nadim , Schuldiner Sophie , Jourdan Nathalie , Sotto Albert , Lavigne Jean-Philippe , La Scola Bernard 

TITLE=Exploring the Microbiota of Diabetic Foot Infections With Culturomics

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 8 - 2018

YEAR=2018

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2018.00282

DOI=10.3389/fcimb.2018.00282

ISSN=2235-2988

ABSTRACT=The purpose of this prospective observational study was to evaluate the richness and diversity of bacteria in samples from diabetic foot infections using a culturomics approach. Bacterial culture findings from wound samples were analyzed together with clinical characteristics and treatment outcomes. We included 43 patients admitted to a French referral center with a moderate to severe diabetic foot infection. The 30,000 colonies identified yielded 53 different bacterial species. The global α-Shannon diversity was 3.34 and the bacterial richness per patient was 4 ± 2. Of all the identified bacterial species, 19 (35.8%) had never been previously cultured or identified by molecular methods from diabetic foot ulcers. Most of the samples were polymicrobial (N=38; 88.3%). Of all the isolated species, the most prevalent were Staphylococcus aureus (N=28; 52.8%), Enterococcus faecalis (N=24; 45.2%), Enterobacter cloacae (N=12; 22.6%), Staphylococcus lugdunensis (N=10; 18.7%), Staphylococcus epidermidis (N=6; 11.3%), Proteus mirabilis (N=6; 11.3%) and Finegoldia magna (N=5; 9.4%). The only factor associated with wound improvement after a one-month follow-up was the presence of E. faecalis (p=0.012) when compared with patients without wound improvement. This study confirms the complementary role of culturomics in the exploration of complex microbiota. Further studies on a larger scale are needed to fully understand the clinical importance of the microbiota of diabetic foot infections.