Background: Proper identification of the polymicrobial microorganisms in patients with limb -threatening diabetic foot ulcers (LTDFUs) using conventional culture is insufficient. This prospective study evaluates the potential value of adjuvant molecular testing assisting in identify fastidious micro-organisms in LTDFUs compared to standard treatment alone. Methods: Ninety patients with LTDFUs received interdisciplinary and standard antibiotic treatment in a referral diabetic foot center. A simultaneous 16S amplicon sequencing (16S AS) specimen along with conventional culture collected at admission was used to retrospectively evaluate the microbiological findings and its association with amputation outcomes. Results: The microorganism count revealed by 16S AS overwhelmed that of conventional culturing (17 vs. 3 bacteria/ulcer respectively). The Stenotrophomonas spp. revealed in 29 patients were highly correlated with major (above ankle) amputation (OR: 4.76, 95% CI 1.01 -22.56), while only one had been concomitantly identified by conventional culturing. Thus, there were 27 cases without proper antibiotics coverage during treatment.
[1]Chang Gung Mem Hosp, Dept Internal Med, Div Endocrinol & Metab, Taoyuan City, Taiwan.
[2]Chang Gung Mem Hosp, Genom Med Core Lab, Linkou 333, Taoyuan, Taiwan.
[3]Chang Gung Mem Hosp, Dept Pediat, Div Pediat Infect Dis, Taoyuan City, Taiwan.
[4]Univ Southern Calif USC, Dept Surg, Southwestern Acad Limb Salvage Alliance SALSA, Keck Sch Med, Los Angeles, CA USA.
[5]Chang Gung Univ, Coll Med, Taoyuan City, Taiwan.
[6]Chang Gung Mem Hosp, Div Endocrinol & Metab, 5 Fusing St, Taoyuan City 333, Taiwan.
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