Academic Journal
Antimicrobial resistance and virulence in polymicrobial chronic wound infections: A metagenomic perspective.
| Τίτλος: | Antimicrobial resistance and virulence in polymicrobial chronic wound infections: A metagenomic perspective. |
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| Συγγραφείς: | Sadia H; Capital University of Science and Technology, Islamabad, Pakistan., Amin A; Capital University of Science and Technology, Islamabad, Pakistan. Electronic address: arshia.butt@cust.edu.pk., Khalid N; School of Food and Agricultural Sciences, University of Management and Technology, Lahore, Pakistan; College of Health Sciences, Abu Dhabi University, Abu Dhabi 59911, United Arab Emirates. Electronic address: nauman.khalid@adu.ac.ae., Ahmed I; National Culture Collection of Pakistan (NCCP), Land Resources Research Institute (LRRI), National Agricultural Research Centre (NARC), Islamabad, Pakistan. Electronic address: iftikhar.ahmed@parc.gov.pk. |
| Πηγή: | Journal of infection and public health [J Infect Public Health] 2026 Aug; Vol. 19 (8), pp. 103280. Date of Electronic Publication: 2026 Jun 03. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: England NLM ID: 101487384 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1876-035X (Electronic) Linking ISSN: 18760341 NLM ISO Abbreviation: J Infect Public Health Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford : Elsevier, 2008- |
| Ιατρικοί όροι (MeSH): | Wound Infection*/microbiology , Drug Resistance, Bacterial*/genetics , Bacteria*/drug effects , Bacteria*/genetics , Bacteria*/classification , Bacteria*/isolation & purification , Bacteria*/pathogenicity , Coinfection*/microbiology, Anti-Bacterial Agents/pharmacology ; Virulence Factors/genetics ; Drug Resistance, Multiple, Bacterial/genetics ; Humans ; Virulence ; Metagenomics ; Pakistan ; Chronic Disease ; Biofilms |
| Περίληψη: | Background: Chronic wound infections represent a significant clinical and public health challenge due to their polymicrobial nature and the increasing burden of antimicrobial resistance (AMR). Conventional culture-based diagnostics often fail to capture the full microbial diversity and resistance potential associated with these infections. Methods: Chronic wound samples persisting for more than 15 days were collected from patients at a tertiary-care hospital in Pakistan. Samples are categorized into five groups: lower leg (ll-H1), upper leg (ul-H2), foot (ft-H3), chest (ct-H4) and catheter (ca-H5). Shotgun metagenomic sequencing was employed alongside routine culture-based methods to characterize microbial communities, antimicrobial resistance genes, and virulence determinants. Taxonomic and functional profiling were performed to assess microbial diversity and resistance patterns across wound subgroups. Results: Metagenomic analysis revealed a predominance of Proteobacteria, Bacteroidetes, and Actinobacteria. Clinically relevant pathogens, including Achromobacter xylosoxidans, Staphylococcus aureus, and Pseudomonas aeruginosa, were frequently detected, along with less commonly reported taxa such as Achromobacter insolitus and Stenotrophomonas maltophilia. Multiple antimicrobial resistance gene clusters and biofilm-associated virulence factors were identified, indicating substantial multidrug resistance potential. Site-specific analysis showed that Pseudomonas aeruginosa dominated ul-H2 (∼32%), while Enterobacter hormaechei was most abundant in ft-H3 (∼40%). Culture-based methods primarily recovered common aerobic pathogens, whereas metagenomics detected additional opportunistic and unculturable taxa, highlighting the limitations of routine diagnostics. Resistome analysis identified ARGs conferring resistance to β-lactams, aminoglycosides, fluoroquinolones, tetracyclines, and macrolides. Conclusions: Chronic wound infections in Pakistan harbor diverse polymicrobial communities with substantial antimicrobial resistance and virulence potential. Shotgun metagenomics provides a more comprehensive characterization than culture-based methods by detecting additional pathogens and resistance determinants across wound sites. These findings support the integration of metagenomic diagnostics to improve clinical decision-making, strengthen antimicrobial stewardship, and guide infection control strategies in resource-limited healthcare settings. (Copyright © 2026 The Author(s). Published by Elsevier Ltd.. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest The authors declare that they have no competing interests. |
| Contributed Indexing: | Keywords: Antibiotic resistance genes; Antimicrobial resistance; Chronic wound infections; Genomic analysis; Public health interventions |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents) 0 (Virulence Factors) |
| Entry Date(s): | Date Created: 20260605 Date Completed: 20260717 Latest Revision: 20260717 |
| Update Code: | 20260718 |
| DOI: | 10.1016/j.jiph.2026.103280 |
| PMID: | 42247807 |
| Βάση Δεδομένων: | MEDLINE |
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