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Pressure ulcers microbiota dynamics and wound evolution.

Catherine Dunyach-Remy1, Florian Salipante2, Jean-Philippe Lavigne3

  • 1Virulence Bactérienne et Infections Chroniques, INSERM U1047, Université de Montpellier, Department of Microbiology and Hospital Hygiene, CHU Nîmes, Univ Montpellier, Nîmes, France. catherine.remy@chu-nimes.fr.

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Bacterial overgrowth, particularly Anaerococcus and Finegoldia, hinders pressure ulcer (PU) healing in spinal cord injury (SCI) patients. Proteus and Morganella at 28 days indicate poor wound outcomes, suggesting potential therapeutic targets.

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Area of Science:

  • Microbiology
  • Wound Healing
  • Spinal Cord Injury Research

Background:

  • Pressure ulcers (PUs) are a significant complication for spinal cord injury (SCI) patients.
  • The bacterial etiology of delayed PU healing in SCI is not well understood.
  • Characterizing the cutaneous microbiota is crucial for understanding PU pathogenesis in SCI.

Purpose of the Study:

  • To investigate the evolution of the cutaneous microbiota in pressure ulcers (PUs) of spinal cord injury (SCI) patients.
  • To identify bacterial species associated with non-healing or worsening PUs.
  • To explore potential microbial biomarkers for PU degradation in SCI.

Main Methods:

  • Prospective pilot study including 24 SCI patients with PUs.
  • Collection of PU tissue biopsies at baseline (D0) and 28 days (D28).
  • 16S rRNA gene-based sequencing (V3-V4 region) for microbiota analysis.

Main Results:

  • At D0, higher relative abundance of Anaerococcus and Finegoldia was linked to poorer wound outcomes at D28.
  • At D28, Proteus and Morganella were exclusively found in stagnated or worsened wounds.
  • A pathogroup including Proteus, Morganella, Anaerococcus, and Peptoniphilus was associated with wound degradation.

Conclusions:

  • Specific bacterial genera (Anaerococcus, Finegoldia) at baseline may predict poor PU healing in SCI patients.
  • The presence of Proteus and Morganella at 28 days indicates wound deterioration.
  • Proteus emerges as a potential therapeutic target for managing pressure ulcers in SCI.