Diabetic foot wound infections are predominantly polymicrobial. However, 'conventional' microbiological culture does not identify all the bacteria potentially involved in these infections and requires time, which can have a negative impact by delaying treatment and/or the prescription of appropriate antibiotic therapy.
Real-time metagenomics analysis using Oxford Nanopore Technologies' MinION technology has demonstrated sufficient power to identify virtually all microbial genomes in a given sample, providing additional information on their antibiotic resistance profile and in silico prediction of genes encoding virulence factors within than 4 hours. Based on these rapid results, a management protocol could be defined specifically for each patient with a view to personalised medicine.
The aim is to study the diversity of bacterial and fungal species identified using the MinION method and compare this diversity with the results obtained using conventional methods (routine culture) from bone biopsies taken from DFOM patients.
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147 bone biopsies from 43 diabetic patients collected in the orthopedic surgery operating room
Cohort
Retrospective
Not listed
Number of bacterial and fungal species found in a conventional bone biopsy
Number of species found by each method (presence/absence and species identification): bacterial and fungal species detected in bone biopsies by the two methods (conventional culture vs MinION
Number of bacterial and fungal species found with the MiniON device
Number of species found by each method (presence/absence and species identification): bacterial and fungal species detected in bone biopsies by the two methods (conventional culture vs MinION
Description of the bone microbiota of diabetic foot osteomyelitis using the MinION method
Typology of microbial species found using the MinION method. The MinION™ Mk1D is the next generation of portable nanopore sequencing devices. Improved thermal dissipation capabilities of the MinION Mk1D significantly enhances sequencing performance, enabling highly accurate real-time sequencing in an even wider range of environments than its predecessor, the MinION Mk1B.
Description of the bone microbiota of diabetic foot osteomyelitis using the conventional method (MALDI-TOF)
Typology of microbial species found using the MALDI-TOF method. The MALDI-TOF (Matrix Assisted Laser Desorption Ionization - Time of Flight) instrument is a mass spectrometer that combines a matrix-assisted laser ionization source (MALDI) with a time-of-flight analyzer (TOF). One of the important characteristics of mass spectrometry is peak sharpness, measured by the resolution of the mass spectrometer. Resolution is defined as the ratio of the peak mass m to the full width at half maximum Δm. The higher the resolution, the sharper the peaks. This makes it possible to visualize two molecules with similar masses. MALDI-TOF instruments can be equipped with a reflection (electrostatic mirror or "ion mirror") that deflects ions with an electric field, thereby doubling the length of the ion flight path and increasing the resolution of the instrument. A MALDI-TOF mass spectrometer can achieve resolutions of 5000 in linear mode (without reflection) and 20000 with reflecton.
New potentially pathogenic species in diabetic foot osteomyelitis in relation to wound progression.
Degree of wound healing at 3 months, 6 months and one year, depending on the presence or absence of different microbial species.
New potentially pathogenic species in diabetic foot osteomyelitis in relation to wound progression.
Degree of wound healing at 3 months, 6 months and one year, depending on the presence or absence of different microbial species.
Gender of patients providing samples
Male/female/Non-binary
Age of patients providing samples
In years
Body mass index of patients providing samples
The formula is BMI = kg/m2; kg is a person's weight in kilograms and m2 is height in meters squared
Wound grade
Wagner Grade 1: Partial- or full-thickness ulcer (superficial ulcer) Wagner Grade 2: Deep ulcer extended to ligament, tendon, joint capsule, bone, or deep fascia without abscess or osteomyelitis (OM) Wagner Grade 3: Deep abscess, OM, or joint sepsis. Wagner Grade 4: Partial-foot gangrene.
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