Bacteria Associated with Diabetic Wounds That Do not Heal

Whether a wound-such a diabetic foot ulcer-heals or progress to a worse outcome, including infection or even amputation, may depend on the microbiome within that wound. A new study from the Perelman School of Medicine and the University of Pennsylvania found specific strains of the common pathogen Staphylococcus aureus (S. aureus) are badociated with what do not heal. Such studies may also be of interest in the management of microbes of diabetics, which may be of benefit to physicians in the treatment of these diseases. Cell Host and Microbe published the findings today.

About 10 percent of Americans have been diagnosed with diabetes, and one of these patients will develop a wound that does not heal. In the worst case outcome, which occurs in up to 25 percent of these wound-developing patients, the wounds will require an amputation. Many patients who develop these ulcers may not notice the initial signs, since the high blood glucose of diabetes can lead to a lack of feeling and deformation of the feet. As a result, patients with uncomplicated overtime. Current treatments are insufficient, meaning patients can live with these wounds for months or even years without healing. The mortality rate badociated with diabetic foot cancer is greater than 70 percent when they lead to amputation.

"While they are not receiving the attention of other diseases, they are incredibly common, and our study of our understanding of microbes," said the study's senior author Elizabeth Grice, PhD, badociate professor of dermatology. The lead author, Lindsay Kalan, PhD, now an badistant professor of Medical Microbiology and Immunology at the University of Wisconsin School of Medicine and Public Health, began this work as a post-doctoral researcher in Grice's lab.

Previous studies have used lower resolution techniques to catalog the microbes that reside in chronic wounds. This study is based on the following hypothesis: Researchers collected samples from 46 patient ulcers every two weeks for six months, or until the wound healed or was amputated.

S. aureus, a common and difficult-to-treat pathogen, was found in the majority of wounds, but did not note the presence of the bacteria itself. However, the high resolution DNA sequencing shown in some strains of S. aureus was only in the range of the study. Further testing revealed that the "non-healing" strain is better than that. Researchers further validated their findings in mice.

They also noted that another common microbe found in diabetic wounds, Alcaligenes faecalis, was badociated with quicker healing.

"It is possible that they are actually benefiting the wound, and we can use it in this study to develop new treatment strategies for non-healing wounds," Grice said. "We hope this research will ultimately help identify patients at risk for bad outcomes and lead to treatment innovations that these patients desperately need."

Source: Perelman School of Medicine at the University of Pennsylvania