Pressure ulcers microbiota dynamics and wound evolution

Abstract

Bacterial species and their role in delaying the healing of pressure ulcers (PU) in spinal cord injury (SCI) patients have not been well described. This pilot study aimed to characterise the evolution of the cutaneous microbiota of PU in SCI cohort. Twenty-four patients with SCI from a French neurological rehabilitation centre were prospectively included. PU tissue biopsies were performed at baseline (D0) and 28 days (D28) and analysed using 16S rRNA gene-based sequencing analysis of the V3–V4 region. At D0, if the overall relative abundance of genus highlighted a large proportion of Staphylococcus, Anaerococcus and Finegoldia had a significantly higher relative abundance in wounds that stagnated or worsened in comparison with those improved at D28 (3.74% vs 0.05%; p = 0.015 and 11.02% versus 0.16%; p = 0.023, respectively). At D28, Proteus and Morganella genera were only present in stagnated or worsened wounds with respectively 0.02% (p = 0.003) and 0.01% (p = 0.02). Moreover, Proteus, Morganella, Anaerococcus and Peptoniphilus were associated within the same cluster, co-isolated from biopsies that had a poor evolution. This pathogroup could be a marker of wound degradation and Proteus could represent a promising target in PU management.

Bacterial Interactions in the Context of Chronic Wound Biofilm: A Review

“…Interestingly, a higher abundance of Peptoniphilus significantly correlated with impaired wound healing, with a similar trend, although not reaching significance for Finegoldia and Anaerococcus [ 35 ]. These results were corroborated by a recent study focusing on PUs, underlying the detrimental presence of Peptoniphilus but also Proteus , Morganella , and Anaerococcus as a worsening cluster [ 36 ].…”

“…Reducing individual diversity to the 11 selected species highlighted that Pseudomonas aeruginosa was positively correlated with increased healing time when its abundance increased, unlike Anaerococcus vaginalis , which was correlated with faster healing [ 34 ]. Conversely, the genus Anaerococcus was linked with a worsening evolution of the wounds in other studies in which it was associated with other bacteria in the same cluster [ 35 , 36 ]. Moreover, Corynebacterium sp.…”

Gut Microbiota as Early Predictor of Infectious Complications before Cardiac Surgery: A Prospective Pilot Study

“…Among them, Staphylococcus is the genus of facultative anaerobic bacteria which frequently colonizes the nares and skin in the healthy population, but in preoperative cardiac patients, carriage is associated with an elevated risk for post-operative surgical site infection and bacteremia [39,40]. Anaerococcus have the potential to metabolize peptones and amino acids and to produce short-chain fatty acids (SCFAs), such as butyric acid, but can be associated with skin and soft tissue infections and chronic wounds [41]. Ruminococcus and [Eubacterium] are usually the part of the resident microflora and also produce SCFAs; in some case, they may be players in the development of inflammation and bloodstream infection [42,43].…”

The Persistence of Staphylococcus aureus in Pressure Ulcers: A Colonising Role

“…Another explanation could be the influence of other bacteria present in the PU that could modulate the virulence of S. aureus . To explore this hypothesis, a specific microbiota analysis was performed following our first main study [ 21 ]. The cutaneous microbiota present in chronic wounds is particularly diverse, and bacteria are organised into pathogroups or functionally equivalent pathogroups, to form a bacterial community in the extracellular matrix [ 4 ].…”

“…Recently, we conducted a study (ESCAFLOR project) on the evolution of the wound microbiota over 28 days in SCI patients with pelvic PU [ 21 ]. Here, we evaluated the persistence and evolution of the virulence traits of S. aureus over time in these PU, and correlated this persistence with the clinical evolution and the polymicrobial environment of the chronic wound.…”