Pressure ulcers microbiota dynamics and wound evolution

Scientific Reports, 2021 · DOI: https://doi.org/10.1038/s41598-021-98073-x · Published: September 22, 2021

Simple Explanation

This study investigates the types of bacteria found in pressure ulcers of patients with spinal cord injuries and how these bacteria change over time and affect wound healing. The study found that certain bacteria, particularly strict anaerobic types like Anaerococcus and Finegoldia, were more common in wounds that did not heal well. The research suggests that monitoring the bacteria in pressure ulcers could help predict and improve wound healing, potentially leading to personalized treatments.

Study Duration

28 days

Participants

24 patients with spinal cord injury and pressure ulcers

Evidence Level

Not specified

Key Findings

1
Wounds with a 'Stagnated/Worsened' evolution had a significantly higher relative abundance of Anaerococcus and Finegoldia at baseline (D0).
2
Proteus and Morganella genera were exclusively present at D28 in wounds with a 'Stagnated/Worsened' evolution, suggesting a potential role in hindering wound healing.
3
A pathogroup consisting of Proteus, Morganella, Anaerococcus, and Peptoniphilus was frequently co-isolated from biopsies with poor wound evolution, indicating a potential synergistic effect.

Research Summary

This study aimed to characterize the evolution of the cutaneous microbiota of pressure ulcers (PU) in a spinal cord injury (SCI) cohort, analyzing tissue biopsies at baseline and 28 days using 16S rRNA gene-based sequencing. The research identified specific bacterial genera, such as Anaerococcus and Finegoldia, that were associated with worsened wound evolution at baseline, and the presence of Proteus and Morganella in non-improving wounds at day 28. The study highlights the potential for using molecular tests to personalize the diagnosis and treatment of chronic wounds, particularly by targeting specific bacterial interactions and preventing the formation of functionally equivalent pathogroups (FEPs).

Practical Implications

Personalized Wound Management

Molecular tests can provide clinicians with personalized diagnoses to tailor treatments based on the specific bacterial composition of the wound.

Targeted Debridement Strategies

The presence of specific strict anaerobic bacteria associated with poor wound evolution could trigger more aggressive and repeated debridement.

Antibiotic Stewardship

The study suggests that antibiotic therapy without clear signs of infection may not be beneficial for restoring balance within wound microbiota, promoting more judicious antibiotic use.

Study Limitations

1
Limited sample size (n=24)
2
Significant number of samples excluded due to low sequencing quality
3
The study only considered p-values due to the small sample size and large number of bacterial tests

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury