About
10 percent of U.S. citizens have been diagnosed with diabetes, and one quarter
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 diabetes commonly develop foot ulcers that may go unnoticed over time.
Current
treatments are insufficient, meaning patients can live with these wounds for
months or even years without healing. The mortality rate associated with
diabetic foot ulcers is equivalent to that of breast cancer and prostate cancer
combined -- higher than 70 percent when they lead to amputation.
Previous
studies have used lower resolution techniques to catalogue the microbes that
reside in chronic wounds. This study built on that research by using higher
resolution DNA sequencing to identify specific species and subspecies and how
they are related to patient outcomes. 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 researchers note the presence of the bacteria itself did not
predict whether or not a wound would heal. However, the high resolution DNA
sequencing showed certain strains of S. aureus were only in the wounds that did
not heal over the course of the study. Further testing revealed that the
"non-healing" strain was better equipped to cause tissue damage and
evade antibiotic treatments. Researchers further validated their findings in
mice.
They
also noted that another common microbe found in diabetic wounds, Alcaligenes
faecalis, was associated with quicker healing.
Posted by Dr. Tim Sandle, Pharmaceutical Microbiology
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