J Infect Dis：糖尿病患者足部菌群与常人不同
2013-01-21 J Infect Dis CMT 吴君德 整理
一项美国研究显示，糖尿病患者足部葡萄球菌属的数量下降，但金黄色葡萄球菌数量仍较多，且细菌多样性较高，可能影响患者伤口的感染风险。论文2013年1月8日在线发表于《感染性疾病杂志》（J Infect Dis）。 该研究对男性门诊患者的4处皮肤（前臂1处，足部3处）进行拭子取样，并对样本分别进行细菌（葡萄球菌、金黄色葡萄球菌）及真菌特异性引物及探针定量聚合酶链式反应（PC
一项美国研究显示，糖尿病患者足部葡萄球菌属的数量下降，但金黄色葡萄球菌数量仍较多，且细菌多样性较高，可能影响患者伤口的感染风险。论文2013年1月8日在线发表于《感染性疾病杂志》（J Infect Dis）。
该研究对男性门诊患者的4处皮肤（前臂1处，足部3处）进行拭子取样，并对样本分别进行细菌（葡萄球菌、金黄色葡萄球菌）及真菌特异性引物及探针定量聚合酶链式反应（PCR），以及对前臂及足底样本进行高通量16S rRNA测序。
结果对糖尿病组及对照组（各30例）的定量PCR分析显示，两组间任何部位的总细菌或真菌数均无差异。NUC基因拷贝数定量显示，糖尿病患者足底部的金黄色葡萄球菌数量增加。高通量16S rRNA测序显示，对照组足部主要是葡萄球菌，而糖尿病组的菌属则更为多样。
Background
Diabetic foot infections are a leading cause of lower extremity amputations. Our study examines the microbiota of diabetic skin prior to ulcer development or infection.
Methods
In a case-control study, outpatient males were recruited at a veterans hospital. Subjects were swabbed at four cutaneous sites, one from the forearm and three from the foot. Quantitative PCR (qPCR) with primers and probes specific for bacteria, Staphylococcus sp, Staphylococcus aureus, and fungi were performed on all samples. High-throughput 16S rRNA sequencing was performed on forearm and plantar foot samples.
Results
qPCR analysis in 30 diabetic and 30 control subjects showed no differences in total numbers of bacteria or fungi at any site. Increased log10 Staphylococcus aureus, quantified by nuc gene copies, were present in diabetic men at the plantar foot. High-throughput 16S rRNA sequencing found that for the foot, controls (n=24) are dominated by Staphylococcus, while diabetics (n=23) were more diverse at the genus level. The forearm microbiota had similar diversity in diabetic and control groups.
Conclusions
The feet of diabetic men had decreased populations of Staphylococcus sps, while maintaining larger populations of S. aureus, and increased bacterial diversity compared to controls. These ecologic changes may affect risk for wound infections.
作者：J Infect Dis
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