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=8

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=<p>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 (<italic>N</italic> = 38; 88.3%). Of all the isolated species, the most prevalent were <italic>Staphylococcus aureus</italic> (<italic>N</italic> = 28; 52.8%), <italic>Enterococcus faecalis</italic> (<italic>N</italic> = 24; 45.2%), <italic>Enterobacter cloacae</italic> (<italic>N</italic> = 12; 22.6%), <italic>Staphylococcus lugdunensis</italic> (<italic>N</italic> = 10; 18.7%), <italic>Staphylococcus epidermidis</italic> (<italic>N</italic> = 6; 11.3%), <italic>Proteus mirabilis</italic> (<italic>N</italic> = 6; 11.3%), and <italic>Finegoldia magna</italic> (<italic>N</italic> = 5; 9.4%). The only factor associated with wound improvement after a 1-month follow-up was the presence of <italic>E. faecalis</italic> (<italic>p</italic> = 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.</p>