1. Fusobacterium necrophorum This anaerobic, gram-negative bacterium is known for its association with necrotizing infections and sepsis. It is frequently found in deep soft tissue infections and can cause severe tissue damage due to its virulence factors such as leukotoxins and hemolysins (Bolstad et al., 2022). The high prevalence of F. necrophorum in this wound microbiome suggests a central pathogenic contribution.
2. Wohlfahrtiimonas chitiniclastica This gram-negative species is typically associated with wound infections, particularly in cases mediated by fly larvae. It is often an opportunistic pathogen thriving in necrotic tissue and is linked to polymicrobial infections (Tóth et al., 2021). Its presence may indicate environmental contamination or secondary colonization.
3. Bacteroides fragilis As a member of the Bacteroides group, B. fragilis plays a significant role in mixed infections. This gram-negative anaerobe is known for producing toxins that promote inflammatory responses and its ability to develop antibiotic resistance (Wexler, 2021). Its presence may contribute to the chronic persistence of the infection.
4. Streptococcus dysgalactiae This beta-hemolytic streptococcus belongs to the group of pyogenic bacteria. It is a common cause of soft tissue infections and plays a role in exacerbating tissue inflammation and impairing wound healing. Additionally, it can cause systemic complications through its production of superantigens (Barnham et al., 2020).
5. Peptostreptococcus anaerobius Peptostreptococcus anaerobius is a strictly anaerobic, gram-positive coccus frequently found in chronic wound infections. Its presence indicates a hypoxic environment that provides ideal growth conditions for anaerobic bacteria (Brook, 2022).
6. Parvimonas micra This anaerobic, gram-positive coccus is known for its involvement in mixed infections, particularly in chronic wounds and dental infections. It can delay wound healing through biofilm production and the induction of inflammation (Murphy & Frick, 2023).
Overall Assessment and Clinical Significance The composition of the microbiome suggests a polymicrobial infection predominantly involving anaerobic pathogens. The high prevalence of Fusobacterium necrophorum and Wohlfahrtiimonas chitiniclastica indicates the potential for both tissue damage and systemic complications. The presence of Bacteroides fragilis and other anaerobic cocci points to an established infection that may be difficult to treat due to biofilm formation and resistance mechanisms.
1. Probiotic Therapies: Probiotics contain live microorganisms that can provide health benefits when administered in adequate amounts. Specific bacteria are being studied for wound therapy that exhibit antimicrobial properties or support wound healing.
Lactobacillus species: Various Lactobacillus strains, such as Lactobacillus plantarum and Lactobacillus reuteri, inhibit pathogenic germs like Fusobacterium necrophorum through the production of lactic acid and bacteriocins. Additionally, they promote epithelial regeneration and exhibit anti-inflammatory effects (Peral et al., 2020).
Bacillus subtilis: This probiotic organism produces enzymes such as amylases and proteases that can break down biofilms, a common cause of chronic wound infections (Wang et al., 2022).
Topical Probiotics: Probiotic creams or gels containing live bacteria can be applied directly to the wound. Studies show that these applications can reduce infections and accelerate healing (Sharifi-Rad et al., 2021).
2. Prebiotic Therapies: Prebiotic therapies utilize nutrients that stimulate the growth of health-promoting microorganisms. They can be applied locally to wounds or administered systemically.
Inulin and fructooligosaccharides (FOS) promote the growth of beneficial bacteria such as Lactobacillus and Bifidobacterium, which have anti-inflammatory effects and can displace pathogenic germs (Gibson et al., 2021).
Medical honey, such as Manuka honey, has antibacterial properties and supports the colonization of beneficial bacteria. The sugars and enzymes it contains promote a healthy microbiome in the wound (Maddocks et al., 2020).
3. Synbiotic Approaches: Synbiotics combine probiotics and prebiotics to achieve synergistic effects. These can be applied, for example, in the form of topical products containing both live microorganisms and their specific nutrients.
4. Phage-Assisted Probiotic Therapy: The combination of probiotics and bacterium-specific phages that selectively kill pathogenic bacteria is an innovative approach. This strategy can maintain a healthy microbial community while combating infections (Kortright et al., 2020).
5. Additional Experimental Approaches:
Microbiome transplantation: Preliminary studies are investigating whether the application of healthy skin microbiome material can help displace pathogenic microorganisms in wounds.
Antimicrobial peptides: These can be expressed in probiotic bacteria to specifically eliminate pathogenic microorganisms.
Conclusion:
Probiotic and prebiotic approaches offer promising potential for the treatment of wound infections, particularly in chronic or antibiotic-resistant cases. They can restore balance in the wound microbiome, promote healing, and reduce the need for antibiotics. Further clinical studies are required to validate dosages, application methods, and long-term effects.
Literature Personalized Supportive Therapies
Notes: We would like to point out that the results of molecular genetic tests should always be considered and interpreted in a clinical context.
Specialist in Medical Genetics Biologist