Could necrotizing fasciitis be caused by a polymicrobial infection?

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A team including University of Maryland (MD, USA) and University of Texas Medical Branch (TX, USA) researchers have found that a flesh-eating disease that was misidentified as a single microbe infection, is actually caused by two variant strains of a single species.

In two previous studies, the team used genetic analysis to discover that a culture from a patient with necrotizing fasciitis contained two strains, which they termed necrotizing fasciitis 1 (NF1) and necrotizing fasciitis 2 (NF2). In contrast, traditional diagnostic methods could only identify that a single bacterial species, Aeromonas hydrophila, was involved.

When infecting on their own, each of the two strains caused non-fatal symptoms. However, when combined, the two strains interacted to cause a near-fatal flesh-eating infection, which led to a quadruple amputation in the original patient.

In the current study, published in the Proceedings of the National Academy of Sciences, the team used genetic manipulation to demonstrate the genetic differences between each strain.  By swapping around the genetic features which differ between the strains, the team forced NF1 to behave like NF2, and vice versa.

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