Chronic wounds represent a large and growing disease burden. Infection and biofilm formation are two of the leading impediments of wound healing, suggesting an important role for the microbiome of these wounds. Debridement is a common and effective treatment for chronic wounds. We analyzed the bacterial content of the wound surface from 20 outpatients with chronic wounds before and immediately after debridement, as well as healthy skin. Given the large variation observed among different wounds, we introduce a Bayesian statistical method that models patient-to-patient variability and identify several genera that were significantly enriched in wounds vs. healthy skin. We found no difference between the microbiome of the original wound surface and that exposed by a single episode of sharp debridement, suggesting that this debridement did not directly alter the wound microbiome. However, we found that aerobes and especially facultative anaerobes were significantly associated with wounds that did not heal within 6 months. The facultative anaerobic genus Enterobacter was significantly associated with lack of healing. The results suggest that an abundance of facultative anaerobes is a negative prognostic factor in the chronic wound microbiome, possibly due to the increased robustness of such communities to different metabolic environments.

中文翻译：

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愈合的微生物预测因子和清创术对慢性伤口微生物组的短期影响。

慢性伤口代表着巨大且不断增长的疾病负担。感染和生物膜形成是伤口愈合的两个主要障碍，表明这些伤口的微生物组具有重要作用。清创术是治疗慢性伤口的一种常见且有效的方法。我们分析了 20 名慢性伤口门诊患者在清创前和清创后即刻以及健康皮肤的创面细菌含量。鉴于在不同伤口之间观察到的巨大差异，我们引入了一种贝叶斯统计方法，该方法模拟了患者与患者之间的差异，并确定了几个在伤口与健康皮肤中显着丰富的属。我们发现原始伤口表面的微生物组与一次锐器清创暴露的微生物组之间没有差异，这表明这种清创术并没有直接改变伤口微生物组。然而，我们发现需氧菌，尤其是兼性厌氧菌与 6 个月内未愈合的伤口显着相关。兼性厌氧肠杆菌属与缺乏愈合显着相关。结果表明，大量的兼性厌氧菌是慢性伤口微生物组的负面预后因素，可能是由于这些群落对不同代谢环境的稳健性增加。