1522. The Infected Diabetic Foot: 16S rRNA Sequencing to Characterize the Ecology of Diabetic Foot Osteomyelitis
Session: Poster Abstract Session: Clinical Infectious Diseases: Diabetic Foot Infections
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • PosterIDWeek_vanAsten_09_02_15.pdf (574.6 kB)
  • Background: Little is known about the diversity of bacteria in diabetic foot osteomyelitis (DFO) and the contribution of anaerobic and fastidious organisms to these infections. This study aimed to better characterize the bacterial ecology of DFO using a modern 16S rRNA gene sequencing approach. 

    Methods: We obtained 34 bone samples from patients admitted to our hospital with a moderate to severe diabetic foot infection. We analysed the distribution of the 16S rRNA gene sequences in the bone samples, using an Illumina MiSeq Personal Sequencer. We compared the genera that were detected with the cultured pathogens in the bone samples with conventional techniques. 

    Results: Staphylococcus spp. was identified in all of the sequenced bone samples that were negative with conventional techniques. Mixed genera were present in 83.3% (5 of 6) of the negative samples. In the 23 samples that had positive results with both techniques, Staphylococcus, Corynebacterium, Streptococcus and Propionibacterium spp. were detected in 20, 18, 13, and 11 samples respectively. More anaerobes were detected with 16S rRNA sequencing compared to conventional techniques (86.9% vs 23.1%) and more polymicrobial infections were present (91.3% vs 64.0%). 

    Conclusion: Anaerobic and fastidious organisms may play a bigger role in osteomyelitis than previously reported. Further studies with bigger populations are needed to understand the clinical importance of the microbial diversity of diabetic foot osteomyelitis.

    Suzanne Van Asten, MD1, Javier La Fontaine, DPM1, Edgar Peters, MD, PhD2, Kavita Bhavan, MD3, Paul Kim, DPM, MS4 and Lawrence Lavery, DPM1, (1)Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, (2)Internal Medicine, VU University Medical Center, Amsterdam, Netherlands, (3)Infectious Disease, UT Southwestern Medical Center, Dallas, TX, (4)Plastic Surgery, Georgetown University Hospital, Washington, DC

    Disclosures:

    S. Van Asten, None

    J. La Fontaine, None

    E. Peters, None

    K. Bhavan, None

    P. Kim, None

    L. Lavery, None

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