The Skin Microbiota in Patients Hospitalized for Cellulitis and Association With Outcome

Duncan R. Cranendonk; Floor Hugenholtz; Jan M. Prins; Paul H. M. Savelkoul; Andries E. Budding; W. Joost Wiersinga; Duncan R. Cranendonk; W. Joost Wiersinga; Andy I. M. Hoepelman; Jan Jelrik Oosterheert; Michiel A. van Agtmael; Judith Branger; Kees Brinkman; Fanny N. Lauw; Annemarie H. Pijlman; Sanjay U. C. Sankatsing; Robin Soetekouw; Jan Veenstra; Peter J. de Vries; DANCE Consortium

doi:10.1093/cid/ciy709

The Skin Microbiota in Patients Hospitalized for Cellulitis and Association With Outcome

Duncan R. Cranendonk^*, Floor Hugenholtz, Jan M. Prins, Paul H. M. Savelkoul, Andries E. Budding, W. Joost Wiersinga, Duncan R. Cranendonk, W. Joost Wiersinga, Andy I. M. Hoepelman, Jan Jelrik Oosterheert, Michiel A. van Agtmael, Judith Branger, Kees Brinkman, Fanny N. Lauw, Annemarie H. Pijlman, Sanjay U. C. Sankatsing, Robin Soetekouw, Jan Veenstra, Peter J. de Vries, DANCE Consortium

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background. The skin microbiota plays a key role in the pathogenesis of several skin diseases, but its role in cellulitis remains unknown. We investigated the skin microbiota in patients with cellulitis, studied whether its analysis could help determine the causative pathogen, and explored whether skin microbiota composition was associated with clinical outcomes.

Methods. We prospectively included 58 patients hospitalized for cellulitis. Skin swabs obtained from the lesion sites were compared with swabs from identical sites on the contralateral unaffected limbs and with swabs obtained from 19 age-and sex-matched control subjects without cellulitis. Bacterial profiling of the skin microbiota was performed by interspacer profiling (IS-pro).

Results. A large interpersonal variation in the skin microbiota composition of patients hospitalized with cellulitis was observed. Firmicutes were the dominant phylum, and Staphylococcus and Streptococcus the dominant genera. In most patients, a strong correlation between the microbiota of the affected lesion and the microbiota of the unaffected, contralateral limb was seen. Overall, the composition of the cellulitis microbiota could not be distinguished from the skin microbiota of controls. No consistent association could be found between traditional culture results and skin microbiota signatures in patients with cellulitis. Lastly, we found that neither microbiota composition nor diversity were associated with clinical parameters and outcomes in patients with cellulitis.

Conclusions. In this exploratory study on the skin microbiota in patients hospitalized with cellulitis, we were unable to identify a typical cellulitis microbiota. The diagnostic and prognostic information that could be derived from skin microbiota profiling in this patient cohort was limited.

Original language	English
Pages (from-to)	1292-1299
Number of pages	8
Journal	Clinical Infectious Diseases
Volume	68
Issue number	8
DOIs	https://doi.org/10.1093/cid/ciy709
Publication status	Published - 15 Apr 2019

Keywords

cellulitis
skin microbiota
diversity
clinical outcome
DIVERSITY

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10.1093/cid/ciy709

Cite this

Cranendonk, D. R., Hugenholtz, F., Prins, J. M., Savelkoul, P. H. M., Budding, A. E., Wiersinga, W. J., Cranendonk, D. R., Wiersinga, W. J., Hoepelman, A. I. M., Oosterheert, J. J., van Agtmael, M. A., Branger, J., Brinkman, K., Lauw, F. N., Pijlman, A. H., Sankatsing, S. U. C., Soetekouw, R., Veenstra, J., de Vries, P. J., & DANCE Consortium (2019). The Skin Microbiota in Patients Hospitalized for Cellulitis and Association With Outcome. Clinical Infectious Diseases, 68(8), 1292-1299. https://doi.org/10.1093/cid/ciy709

@article{a7935b888a20494bb252ea667f57c4df,

title = "The Skin Microbiota in Patients Hospitalized for Cellulitis and Association With Outcome",

abstract = "Background. The skin microbiota plays a key role in the pathogenesis of several skin diseases, but its role in cellulitis remains unknown. We investigated the skin microbiota in patients with cellulitis, studied whether its analysis could help determine the causative pathogen, and explored whether skin microbiota composition was associated with clinical outcomes.Methods. We prospectively included 58 patients hospitalized for cellulitis. Skin swabs obtained from the lesion sites were compared with swabs from identical sites on the contralateral unaffected limbs and with swabs obtained from 19 age-and sex-matched control subjects without cellulitis. Bacterial profiling of the skin microbiota was performed by interspacer profiling (IS-pro).Results. A large interpersonal variation in the skin microbiota composition of patients hospitalized with cellulitis was observed. Firmicutes were the dominant phylum, and Staphylococcus and Streptococcus the dominant genera. In most patients, a strong correlation between the microbiota of the affected lesion and the microbiota of the unaffected, contralateral limb was seen. Overall, the composition of the cellulitis microbiota could not be distinguished from the skin microbiota of controls. No consistent association could be found between traditional culture results and skin microbiota signatures in patients with cellulitis. Lastly, we found that neither microbiota composition nor diversity were associated with clinical parameters and outcomes in patients with cellulitis.Conclusions. In this exploratory study on the skin microbiota in patients hospitalized with cellulitis, we were unable to identify a typical cellulitis microbiota. The diagnostic and prognostic information that could be derived from skin microbiota profiling in this patient cohort was limited.",

keywords = "cellulitis, skin microbiota, diversity, clinical outcome, DIVERSITY",

author = "Cranendonk, {Duncan R.} and Floor Hugenholtz and Prins, {Jan M.} and Savelkoul, {Paul H. M.} and Budding, {Andries E.} and Wiersinga, {W. Joost} and Cranendonk, {Duncan R.} and Wiersinga, {W. Joost} and Hoepelman, {Andy I. M.} and Oosterheert, {Jan Jelrik} and {van Agtmael}, {Michiel A.} and Judith Branger and Kees Brinkman and Lauw, {Fanny N.} and Pijlman, {Annemarie H.} and Sankatsing, {Sanjay U. C.} and Robin Soetekouw and Jan Veenstra and {de Vries}, {Peter J.} and {DANCE Consortium}",

note = "Funding Information: Financial support. This work was supported by the Netherlands Organisation for Health Research and Development (ZonMW; grant number 836011024 to W. J. W.). Publisher Copyright: {\textcopyright} 2018 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.",

year = "2019",

month = apr,

day = "15",

doi = "10.1093/cid/ciy709",

language = "English",

volume = "68",

pages = "1292--1299",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "8",

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Cranendonk, DR, Hugenholtz, F, Prins, JM, Savelkoul, PHM, Budding, AE, Wiersinga, WJ, Cranendonk, DR, Wiersinga, WJ, Hoepelman, AIM, Oosterheert, JJ, van Agtmael, MA, Branger, J, Brinkman, K, Lauw, FN, Pijlman, AH, Sankatsing, SUC, Soetekouw, R, Veenstra, J, de Vries, PJ & DANCE Consortium 2019, 'The Skin Microbiota in Patients Hospitalized for Cellulitis and Association With Outcome', Clinical Infectious Diseases, vol. 68, no. 8, pp. 1292-1299. https://doi.org/10.1093/cid/ciy709

TY - JOUR

T1 - The Skin Microbiota in Patients Hospitalized for Cellulitis and Association With Outcome

AU - Cranendonk, Duncan R.

AU - Hugenholtz, Floor

AU - Prins, Jan M.

AU - Savelkoul, Paul H. M.

AU - Budding, Andries E.

AU - Wiersinga, W. Joost

AU - Cranendonk, Duncan R.

AU - Wiersinga, W. Joost

AU - Hoepelman, Andy I. M.

AU - Oosterheert, Jan Jelrik

AU - van Agtmael, Michiel A.

AU - Branger, Judith

AU - Brinkman, Kees

AU - Lauw, Fanny N.

AU - Pijlman, Annemarie H.

AU - Sankatsing, Sanjay U. C.

AU - Soetekouw, Robin

AU - Veenstra, Jan

AU - de Vries, Peter J.

AU - DANCE Consortium

N1 - Funding Information: Financial support. This work was supported by the Netherlands Organisation for Health Research and Development (ZonMW; grant number 836011024 to W. J. W.). Publisher Copyright: © 2018 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.

PY - 2019/4/15

Y1 - 2019/4/15

N2 - Background. The skin microbiota plays a key role in the pathogenesis of several skin diseases, but its role in cellulitis remains unknown. We investigated the skin microbiota in patients with cellulitis, studied whether its analysis could help determine the causative pathogen, and explored whether skin microbiota composition was associated with clinical outcomes.Methods. We prospectively included 58 patients hospitalized for cellulitis. Skin swabs obtained from the lesion sites were compared with swabs from identical sites on the contralateral unaffected limbs and with swabs obtained from 19 age-and sex-matched control subjects without cellulitis. Bacterial profiling of the skin microbiota was performed by interspacer profiling (IS-pro).Results. A large interpersonal variation in the skin microbiota composition of patients hospitalized with cellulitis was observed. Firmicutes were the dominant phylum, and Staphylococcus and Streptococcus the dominant genera. In most patients, a strong correlation between the microbiota of the affected lesion and the microbiota of the unaffected, contralateral limb was seen. Overall, the composition of the cellulitis microbiota could not be distinguished from the skin microbiota of controls. No consistent association could be found between traditional culture results and skin microbiota signatures in patients with cellulitis. Lastly, we found that neither microbiota composition nor diversity were associated with clinical parameters and outcomes in patients with cellulitis.Conclusions. In this exploratory study on the skin microbiota in patients hospitalized with cellulitis, we were unable to identify a typical cellulitis microbiota. The diagnostic and prognostic information that could be derived from skin microbiota profiling in this patient cohort was limited.

AB - Background. The skin microbiota plays a key role in the pathogenesis of several skin diseases, but its role in cellulitis remains unknown. We investigated the skin microbiota in patients with cellulitis, studied whether its analysis could help determine the causative pathogen, and explored whether skin microbiota composition was associated with clinical outcomes.Methods. We prospectively included 58 patients hospitalized for cellulitis. Skin swabs obtained from the lesion sites were compared with swabs from identical sites on the contralateral unaffected limbs and with swabs obtained from 19 age-and sex-matched control subjects without cellulitis. Bacterial profiling of the skin microbiota was performed by interspacer profiling (IS-pro).Results. A large interpersonal variation in the skin microbiota composition of patients hospitalized with cellulitis was observed. Firmicutes were the dominant phylum, and Staphylococcus and Streptococcus the dominant genera. In most patients, a strong correlation between the microbiota of the affected lesion and the microbiota of the unaffected, contralateral limb was seen. Overall, the composition of the cellulitis microbiota could not be distinguished from the skin microbiota of controls. No consistent association could be found between traditional culture results and skin microbiota signatures in patients with cellulitis. Lastly, we found that neither microbiota composition nor diversity were associated with clinical parameters and outcomes in patients with cellulitis.Conclusions. In this exploratory study on the skin microbiota in patients hospitalized with cellulitis, we were unable to identify a typical cellulitis microbiota. The diagnostic and prognostic information that could be derived from skin microbiota profiling in this patient cohort was limited.

KW - cellulitis

KW - skin microbiota

KW - diversity

KW - clinical outcome

KW - DIVERSITY

U2 - 10.1093/cid/ciy709

DO - 10.1093/cid/ciy709

M3 - Article

C2 - 30321312

SN - 1058-4838

VL - 68

SP - 1292

EP - 1299

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 8

ER -