Topography of distinct Staphylococcus aureus types in chronic wounds of patients with epidermolysis bullosa

PLoS One. 2013 Jun 25;8(6):e67272. doi: 10.1371/journal.pone.0067272. Print 2013.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bandages / microbiology
  • Epidermolysis Bullosa / microbiology*
  • Humans
  • Phylogeny
  • Staphylococcus aureus / isolation & purification*
  • Staphylococcus aureus / physiology
  • Wounds and Injuries / microbiology*

Grants and funding

This work was supported by the Commission of the European Union (grant LSHG-CT-2006-037469), the Top Institute Pharma (project T4-213), and the Dutch Butterfly Child Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.