Decubitus Ulcers are Polymicrobial, Treatment Should be Tailored to Patients' Wound Microflora

Decubitus ulcers, also known as bedsores or pressure ulcers, affect millions of hospitalized patients each year. The microflora of chronic wounds such as ulcers most commonly exist in the biofilm phenotype and have been known to significantly impair normal healing trajectories.

Smith, et al. (2010) used bacterial tag-encoded FLX amplicon pyrosequencing (bTEFAP), a universal bacterial identification method, to identify bacterial populations in 49 decubitus ulcers. Diversity estimators were utilized and wound community compositions analyzed in relation to metadata such as age, race, gender and comorbidities. Their research was published in BMC Medical Genomics.

The researchers report that decubitus ulcers are polymicrobial in nature with no single bacterium exclusively colonizing the wounds. They say that the microbial community among such ulcers is highly variable; while there are between three and 10 primary populations in each wound there can be hundreds of different species present many of which are in trace amounts. There is no clearly significant differences in the microbial ecology of decubitus ulcer in relation to metadata except when considering diabetes, they add. The microbial populations and composition in the decubitus ulcers of diabetics may be significantly different from the communities in non-diabetics.

Smith, et al. (2010) conclude that based upon the continued elucidation of chronic wound bioburdens as polymicrobial infections, it is recommended that, in addition to traditional biofilm-based wound care strategies, an antimicrobial/antibiofilm treatment program be tailored to each patient's respective wound microflora.

Reference: Smith DM, Snow DE, Rees E, Zischkau AM, Hanson JD, Wolcott RD, Sun Y, White J, Kumar S and Dowd SE. Evaluation of the bacterial diversity of pressure ulcers using bTEFAP pyrosequencing. BMC Medical Genomics 2010, 3:41doi:10.1186/1755-8794-3-41.