Summary: Microbial infections have been associated with approximately 50% of impaired healing of chronic wounds, but there are many gaps in understanding this relationship. Technologies to dissect wound microbiomes, or microbial populations, have just become available; these new tools analyze microbiome composition directly, replacing unreliable culturing methods. Diabetic foot ulcers (DFUs) are common chronic wounds, affecting 15-25% of diabetes patients and can lead to amputation. Researchers conducted a longitudinal study of DFUs in a cohort of diabetes patients and identified characteristics of dynamic microbial populations for wounds that healed quickly and for wounds that persisted.

The study yielded four different microbial “community types” (CTs) with different percentages of microbial classes, such as predominantly staphylococcus, predominantly staph aureus, or highly diverse populations of more than 20 different microbes. The microbial populations of wounds that healed quickly were “unstable”: over time, they changed from one CT to another CT more frequently. In wounds that took longer to heal, there were fewer transitions from one CT to another CT over the observation period. The researchers concluded that effective clinical control of chronic wounds disrupts bacterial colonization of the wound. These findings about microbiome dynamics may also be applicable to chronic wounds in a broad array of health conditions.

Citation: Temporal Stability in Chronic Wound Microbiota Is Associated with Poor Healing. Loesche M, Gardner SE, Kalan L, Horwinski J, Zheng Q, Hodkinson BP, Tyldsley AS, Franciscus CL, Hillis SL, Mehta S, Margolis DJ, Grice EA. J Invest Dermatol. 2017 Jan;137(1):237-244. PMID: 27566400