Bacterial diversity of diabetic foot ulcers: current status and future prospectives

Fatemah Sadeghpour Heravi, Martha Zakrzewski, Karen Vickery, David G. Armstrong, Honghua Hu

Research output: Contribution to journalReview articlepeer-review

42 Citations (Scopus)
11 Downloads (Pure)


Diabetic foot ulcers (DFUs) and diabetic foot infections (DFIs) are associated with reduced patient quality of life, lower-extremity amputation, hospitalization, and high morbidity and mortality. Diverse bacterial communities have been identified in DFUs/DFIs, playing a significant role in infection prognosis. However, due to the high heterogeneity of bacterial communities colonized in DFUs/DFIs, culture-based methods may not isolate all of the bacterial population or unexpected microorganisms. Recently, high sensitivity and specificity of DNA (metagenomics) and RNA (metatranscriptomics) technologies have addressed limitations of culture-based methods and have taken a step beyond bacterial identification. As a consequence, new advances obtained from DNA- and RNA-based techniques for bacterial identification can improve therapeutic approaches. This review evaluated the current state of play in aetiology of DFUs/DFIs on culture and molecular approaches, and discussed the impact of metagenomic and metatranscriptomic methods in bacterial identification approaches.

Original languageEnglish
Article number1935
Pages (from-to)1-18
Number of pages18
JournalJournal of Clinical Medicine
Issue number11
Publication statusPublished - 10 Nov 2019

Bibliographical note

Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • diabetic foot ulcers
  • diabetic foot infections
  • microbiology
  • culture
  • culturomics
  • 16S rRNA sequencing
  • microbiota
  • metagenomics
  • metatranscriptomics


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