(WHS-K1.02) ANALYSIS OF 9,241 WOUND SPECIMENS REVEALS SIX MAJOR MICROBIOME COMMUNITY TYPES AND METEOROLOGICAL ASSOCIATIONS
Thursday, May 16, 2024
9:15 AM – 10:15 AM East Coast USA Time
Background: Colonizing microbiota are known contributors to chronic wound persistence. Though differential microbes likely relate to wound management success, there is limited understanding of the major types of microbial communities that are encountered. Prior work in the skin microbiome has shown that geographic and seasonal meteorological variation relates to differences in external microbiota, however it is unknown whether that link translates to a chronic infected wound.
Methods: We set out to describe the microbial composition of the wound microbiome by retrospective analysis of 9,241 specimens submitted from clinics in 43 states for microbial profiling that included matched qPCR, 16S rRNA and ITS gene sequencing. Historical sequence and qPCR data were obtained from MicroGen DX, a CAP/CLIA diagnostic sequencing provider, as matched to patient samples submitted under relevant wound test service between 2018 and 2020. Community state types (CSTs) were identified using the Dirichlet multinomial method. The CSTs were modeled for association to meteorological variables by multinomial logistic regression.
Results: Six CSTs were identified based on bacterial profiles that significantly related to differences in qPCR-estimated bacterial load, alpha diversity, fungal positivity, and bacterial morphotype (e.g., anaerobes). CSTs were unequally distributed across demographic factors such as sex, age, and wound location (p < 0.05). For example, men had a 3.6-14.5% increased prevalence of CSTs with high load and anaerobic content (CST3/4) versus a 5.5-18.2% decreased prevalence of CSTs characterized by low bacterial load (CST2/6). The probability of observing CSTs was linked to meteorological variance, particularly temperature and relative humidity. For example, the relative probability of encountering a given CST ranged from -243% to +61% depending on local weather patterns. The most climate sensitive CSTs were characterized by high anaerobic content and load, or low bacterial load not suggestive of infection.
Conclusions: The CSTs identified provide an intuitive description of the types of microbes commonly found and are suggestive of microbial profiles that may warrant different therapeutic approaches. These CSTs provide valuable insights into common assemblages of microbes that will appear in a wound infection, though study in a prospective cohort is required to determine whether the CSTs relate to patient outcomes. Lastly, a statistical association linked the likelihood of observing different CSTs with local meteorological variation, providing the first evidence that wound clinics may encounter different types of infectious profiles and that differences in observation are potentially explained by spatiotemporal weather gradients.