Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27601572
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 261.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 261.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 261.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 261.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\27601572
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 mBio
2016 ; 7
(5
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Redefining the Chronic-Wound Microbiome: Fungal Communities Are Prevalent,
Dynamic, and Associated with Delayed Healing
#MMPMID27601572
Kalan L
; Loesche M
; Hodkinson BP
; Heilmann K
; Ruthel G
; Gardner SE
; Grice EA
mBio
2016[Sep]; 7
(5
): ä PMID27601572
show ga
Chronic nonhealing wounds have been heralded as a silent epidemic, causing
significant morbidity and mortality especially in elderly, diabetic, and obese
populations. Polymicrobial biofilms in the wound bed are hypothesized to disrupt
the highly coordinated and sequential events of cutaneous healing. Both
culture-dependent and -independent studies of the chronic-wound microbiome have
almost exclusively focused on bacteria, omitting what we hypothesize are
important fungal contributions to impaired healing and the development of
complications. Here we show for the first time that fungal communities (the
mycobiome) in chronic wounds are predictive of healing time, associated with poor
outcomes, and form mixed fungal-bacterial biofilms. We longitudinally profiled
100, nonhealing diabetic-foot ulcers with high-throughput sequencing of the
pan-fungal internal transcribed spacer 1 (ITS1) locus, estimating that up to 80%
of wounds contain fungi, whereas cultures performed in parallel captured only 5%
of colonized wounds. The "mycobiome" was highly heterogeneous over time and
between subjects. Fungal diversity increased with antibiotic administration and
onset of a clinical complication. The proportions of the phylum Ascomycota were
significantly greater (P = 0.015) at the beginning of the study in wounds that
took >8 weeks to heal. Wound necrosis was distinctly associated with pathogenic
fungal species, while taxa identified as allergenic filamentous fungi were
associated with low levels of systemic inflammation. Directed culturing of wounds
stably colonized by pathogens revealed that interkingdom biofilms formed between
yeasts and coisolated bacteria. Combined, our analyses provide enhanced
resolution of the mycobiome during impaired wound healing, its role in chronic
disease, and impact on clinical outcomes. IMPORTANCE: Wounds are an
underappreciated but serious complication for a diverse spectrum of diseases.
High-risk groups, such as persons with diabetes, have a 25% lifetime risk of
developing a wound that can become chronic. The majority of microbiome research
related to chronic wounds is focused on bacteria, but the association of fungi
with clinical outcomes remains to be elucidated. Here we describe the dynamic
fungal communities in 100 diabetic patients with foot ulcers. We found that
communities are unstable over time, but at the first clinical presentation, the
relative proportions of different phyla predict healing times. Pathogenic fungi
not identified by culture reside in necrotic wounds and are associated with a
poor prognosis. In wounds stably colonized by fungi, we identified yeasts capable
of forming biofilms in concert with bacteria. Our findings illuminate the
associations of the fungal mycobiome with wound prognosis and healing.
free
free
free
