A Comparison of Bacterial Composition in Diabetic Ulcers and Contralateral Intact Skin

Viktoria Gontcharova1, Eunseog Youn3, Yan Sun1, Randall D Wolcott2, Scot E Dowd1, 4, *
1 Medical Biofilm Research Institute, 4321 Marsha Sharp Freeway, Lubbock, TX 79407
2 Southwest Regional Wound Care Clinic, 2002 Oxford Ave, Lubbock TX 79410
3 Texas Tech University, Computer Science Department, P.O. Box 43104, Lubbock, TX 79409-3104
4 Research and Testing Laboratory, Lubbock, TX

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© Gontcharova et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Research and Testing Laboratory, 4321 Marsha Sharp Fwy., Lubbock, TX 79407, USA; Tel: 806-789-6879; E-mail:


An extensive portion of the healthcare budget is allocated to chronic human infection. Chronic wounds in particular are a major contributor to this financial burden. Little is known about the types of bacteria which may contribute to the chronicity, biofilm and overall bioburden of the wound itself. In this study we compare the bacteriology of wounds and associated intact skin. Wound and paired intact skin swabs (from a contralateral location) were collected. The bacterial diversity was determined using bacterial Tag-encoded FLX amplicon pyrosequencing (bTEFAP). Diversity analysis showed intact skin to be significantly more diverse than wounds on both the species and genus levels (3% and 5% divergence). Furthermore, wounds show heightened levels of anaerobic bacteria, like Peptoniphilus, Finegoldia, and Anaerococcus, and other detrimental genera such as Corynebacterium and Staphylococcus. Although some of these and other bacterial genera were found to be common between intact skin and wounds, notable opportunistic wound pathogens were found at lower levels in intact skin. Principal Component Analysis demonstrated a clear separability of the two groups. The findings of the study not only greatly support the hypothesis of differing bacterial composition of intact skin and wounds, but also contribute additional insight into the ecology of skin and wound microflora. The increased diversity and lowered levels of opportunistic pathogens found in skin make the system highly distinguishable from wounds.

Keywords: Biofilm, skin, bacteria, diversity, pyrosequencing, chronic wounds, bTEFAP, microbiome.