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Distinct polymicrobial populations in a chronic foot ulcer with implications for diagnostics and anti-infective therapy
BACKGROUND: Polymicrobial infections caused by combinations of different bacteria are being detected with an increasing frequency. The evidence of such complex infections is being revealed through the use of novel molecular and culture-independent methods. Considerable progress has been made in the...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974921/ https://www.ncbi.nlm.nih.gov/pubmed/24679105 http://dx.doi.org/10.1186/1756-0500-7-196 |
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author | Imirzalioglu, Can Sethi, Shneh Schneider, Christian Hain, Torsten Chakraborty, Trinad Mayser, Peter Domann, Eugen |
author_facet | Imirzalioglu, Can Sethi, Shneh Schneider, Christian Hain, Torsten Chakraborty, Trinad Mayser, Peter Domann, Eugen |
author_sort | Imirzalioglu, Can |
collection | PubMed |
description | BACKGROUND: Polymicrobial infections caused by combinations of different bacteria are being detected with an increasing frequency. The evidence of such complex infections is being revealed through the use of novel molecular and culture-independent methods. Considerable progress has been made in the last decade regarding the diagnostic application of such molecular techniques. In particular, 16S rDNA-based sequencing and even metagenomic analyses have been successfully used to study the microbial diversity in ecosystems and human microbiota. Here, we utilized denaturing high-performance liquid chromatography (DHPLC) as a diagnostic tool for identifying different bacterial species in complex clinical samples of a patient with a chronic foot ulcer. CASE PRESENTATION: A 45-year-old female suffered from a chronic 5x5cm large plantar ulcer located in the posterior calcaneal area with subcutaneous tissue infection and osteomyelitis. The chronic ulcer developed over a period of 8 years. Culture and DHPLC revealed a distinct and location-dependent polymicrobial infection of the ulcer. The analysis of a superficial biopsy revealed a mixture of Staphylococcus aureus, Proteus vulgaris, and Fusobacterium nucleatum, whereas the tissue-deep biopsy harbored a mixture of four different bacterial species, namely Gemella morbillorum, Porphyromonas asaccharolytica, Bacteroides fragilis, and Arcanobacterium haemolyticum. CONCLUSIONS: This clinical case highlights the difficulties in assessing polymicrobial infections where a mixture of fastidious, rapid and slow growing bacteria as well as anaerobes exists as structured communities within the tissue architecture of chronic wound infections. The diagnosis of this multilayered polymicrobial infection led to a microbe-adapted antibiotic therapy, targeting the polymicrobial nature of this infection in addition to a standard local wound treatment. However, a complete wound closure could not be achieved due to the long-lasting extensive destruction of tissue. |
format | Online Article Text |
id | pubmed-3974921 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-39749212014-04-05 Distinct polymicrobial populations in a chronic foot ulcer with implications for diagnostics and anti-infective therapy Imirzalioglu, Can Sethi, Shneh Schneider, Christian Hain, Torsten Chakraborty, Trinad Mayser, Peter Domann, Eugen BMC Res Notes Case Report BACKGROUND: Polymicrobial infections caused by combinations of different bacteria are being detected with an increasing frequency. The evidence of such complex infections is being revealed through the use of novel molecular and culture-independent methods. Considerable progress has been made in the last decade regarding the diagnostic application of such molecular techniques. In particular, 16S rDNA-based sequencing and even metagenomic analyses have been successfully used to study the microbial diversity in ecosystems and human microbiota. Here, we utilized denaturing high-performance liquid chromatography (DHPLC) as a diagnostic tool for identifying different bacterial species in complex clinical samples of a patient with a chronic foot ulcer. CASE PRESENTATION: A 45-year-old female suffered from a chronic 5x5cm large plantar ulcer located in the posterior calcaneal area with subcutaneous tissue infection and osteomyelitis. The chronic ulcer developed over a period of 8 years. Culture and DHPLC revealed a distinct and location-dependent polymicrobial infection of the ulcer. The analysis of a superficial biopsy revealed a mixture of Staphylococcus aureus, Proteus vulgaris, and Fusobacterium nucleatum, whereas the tissue-deep biopsy harbored a mixture of four different bacterial species, namely Gemella morbillorum, Porphyromonas asaccharolytica, Bacteroides fragilis, and Arcanobacterium haemolyticum. CONCLUSIONS: This clinical case highlights the difficulties in assessing polymicrobial infections where a mixture of fastidious, rapid and slow growing bacteria as well as anaerobes exists as structured communities within the tissue architecture of chronic wound infections. The diagnosis of this multilayered polymicrobial infection led to a microbe-adapted antibiotic therapy, targeting the polymicrobial nature of this infection in addition to a standard local wound treatment. However, a complete wound closure could not be achieved due to the long-lasting extensive destruction of tissue. BioMed Central 2014-03-29 /pmc/articles/PMC3974921/ /pubmed/24679105 http://dx.doi.org/10.1186/1756-0500-7-196 Text en Copyright © 2014 Imirzalioglu et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. |
spellingShingle | Case Report Imirzalioglu, Can Sethi, Shneh Schneider, Christian Hain, Torsten Chakraborty, Trinad Mayser, Peter Domann, Eugen Distinct polymicrobial populations in a chronic foot ulcer with implications for diagnostics and anti-infective therapy |
title | Distinct polymicrobial populations in a chronic foot ulcer with implications for diagnostics and anti-infective therapy |
title_full | Distinct polymicrobial populations in a chronic foot ulcer with implications for diagnostics and anti-infective therapy |
title_fullStr | Distinct polymicrobial populations in a chronic foot ulcer with implications for diagnostics and anti-infective therapy |
title_full_unstemmed | Distinct polymicrobial populations in a chronic foot ulcer with implications for diagnostics and anti-infective therapy |
title_short | Distinct polymicrobial populations in a chronic foot ulcer with implications for diagnostics and anti-infective therapy |
title_sort | distinct polymicrobial populations in a chronic foot ulcer with implications for diagnostics and anti-infective therapy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974921/ https://www.ncbi.nlm.nih.gov/pubmed/24679105 http://dx.doi.org/10.1186/1756-0500-7-196 |
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