Abstract
The opportunistic pathogen Staphylococcus aureus is known to interfere with wound healing and represents a significant risk factor for wound infections and invasive disease. It is generally assumed that one individual is predominantly colonized by one S. aureus type. Nevertheless, patients with the genetic blistering disease epidermolysis bullosa (EB) often carry multiple S. aureus types. We therefore investigated whether different S. aureus types are present in individual wounds of EB patients and, if so, how they are spatially distributed. The staphylococcal topography in chronic wounds was mapped by replica-plating of used bandages and subsequent typing of S. aureus isolates. Individual chronic wounds of five patients contained up to six different S. aureus types. Unexpectedly, distinct S. aureus types formed micro-colonies that were located in close proximity and sometimes even overlapped. While some adjacent S. aureus isolates were closely related, others belonged to distinct molecular complexes. We conclude that the general assumption that one individual is predominantly colonized by one type of S. aureus does not apply to chronic wounds of EB patients. We consider this observation important, not only for EB patients, but also for other patients with chronic wounds in view of the potential risk for severe staphylococcal infections.
Highlights
Staphylococcus aureus is a Gram-positive bacterium that colonizes,30% of the healthy human population [1]
The presence of multiple S. aureus types has been reported in healthy individuals and in patients with particular diseases, such as cystic fibrosis, atopic dermatitis and the genetic blistering disease epidermolysis bullosa (EB) [4,5,6,7,8]
The presence of multiple S. aureus types was found to be exceptionally high in EB patients with chronic wounds, who were shown to carry up to four S. aureus types at one time point of sampling [7]
Summary
Staphylococcus aureus is a Gram-positive bacterium that colonizes ,30% of the healthy human population [1]. The presence of multiple S. aureus types was found to be exceptionally high in EB patients with chronic wounds, who were shown to carry up to four S. aureus types at one time point of sampling [7]. As shown in our previous studies, high-level wound colonization in EB patients by multiple types of S. aureus predominantly relates to the presence of chronic wounds, rather than the type of EB from which the investigated patients suffer [7,8].
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