Diabetic foot infections (DFIs) are a major cause of hospitalization and can lead to lower extremity amputation. In this pilot study, we used a multiomics approach to explore the host–microbe complex within DFIs. We observed minimal differences in the overall microbial composition between PEDIS infection severities, however Staphylococcus aureus and Streptococcus genera were abundant and highly active in most mild to moderate DFIs. Further, we identified the significant enrichment of several virulence factors associated with infection pathogenicity belonging to both Staphylococcus aureus and Streptococcus. In severe DFIs, patients demonstrated a greater microbial diversity and differential gene expression demonstrated the enrichment of multispecies virulence genes suggestive of a complex polymicrobial infection. The host response in patients with severe DFIs was also significantly different as compared to mild to moderate DFIs. This was attributed to the enrichment of host genes associated with inflammation, acute phase response, cell stress and broad immune-related responses, while those associated with wound healing and myogenesis were significantly depleted.

糖尿病足感染 (DFI) 是住院的主要原因，可导致下肢截肢。在这项试点研究中，我们使用了多组学方法来探索 DFI 中的宿主-微生物复合体。我们观察到 PEDIS 感染严重程度之间整体微生物组成的差异很小，但是金黄色葡萄球菌和链球菌属在大多数轻度至中度DFI中含量丰富且高度活跃。此外，我们确定了与属于金黄色葡萄球菌和链球菌的感染致病性相关的几种毒力因子的显着富集。. 在严重的 DFI 中，患者表现出更大的微生物多样性，差异基因表达表明多物种毒力基因的富集，表明存在复杂的多微生物感染。与轻度至中度 DFI 相比，重度 DFI 患者的宿主反应也有显着差异。这归因于与炎症、急性期反应、细胞应激和广泛的免疫相关反应相关的宿主基因的富集，而与伤口愈合和肌生成相关的基因则显着耗尽。