Microbial Species in Deep Tissue Lesions of Stage III Hidradenitis Suppurativa: A Retrospective Observational Study

Microbial Species in Deep Tissue Lesions of Stage III Hidradenitis Suppurativa: A Retrospective Observational Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Microbial Species in Deep Tissue Lesions of Stage III Hidradenitis Suppurativa: A Retrospective Observational Study Whitney N. Stanton, Savannah C. Braud, Emily R. Stack, Makena M. Davidson, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8252245/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 24 Jan, 2026 Read the published version in BMC Microbiology → Version 1 posted 22 You are reading this latest preprint version Abstract Background Hidradenitis suppurativa (HS) is an inflammatory skin disease characterized by painful nodules, abscesses, and sinus tract formation. While dysbiosis of the skin microbiome has been implicated in HS pathogenesis, most studies focus on surface flora, leaving the microbial composition of deep tissue lesions poorly characterized, particularly in surgically managed Hurley stage III disease. This study investigates the subcutaneous microbiome of stage III HS requiring surgical intervention, with the goal of identifying microbial patterns and their associations with patient-specific clinical features. Methods A retrospective chart review of 49 patients undergoing surgical excision for HS was performed. Intraoperative subcutaneous tissue samples were cultured under aerobic and anaerobic conditions. Demographic, clinical, and treatment data were analyzed for associations with microbial findings. Results Prevotella species were significantly associated with type II diabetes (OR 16.00) and prior antibiotic use (OR 3.586). Corynebacterium species were more frequently isolated in older patients and the perineal and chest regions. Gram-negative rods correlated with prior antibiotic exposure (OR 14.143), while gram-positive cocci were associated with smoking (OR 5.500). Microbial profiles varied significantly by anatomical site, suggesting location-specific colonization. Conclusions The subcutaneous microbiome in stage III HS remains poorly characterized due to the historical focus on surface lesions and non-surgical populations. Our findings highlight distinct microbial profiles within deep tissue that are influenced by comorbidities, antibiotic exposure, and anatomical sites. Plastic and reconstructive surgeons have a critical role in managing advanced HS and this study provides evidence for targeted perioperative antimicrobials to reduce postoperative complications and improve surgical outcomes. Hidradenitis Suppurativa Microbiome Hurley stage Bacteria Acne inversa Infection Introduction Hidradenitis suppurativa (HS) is a debilitating and chronic condition that affects up to 1.2% of European and US populations 1 . HS is characterized pathologically by follicular hyperkeratosis and lymphocytic perifollicular inflammation followed by rupture of the follicle 2 . As HS progresses, adjacent nodules connect and create dermal tunnels that are not self-resolving and require surgical intervention. Chronic issues of HS include post-inflammatory hyperpigmentation, atrophic and hypertrophic scarring, keloid formation, and in severe cases, contractures 3 . Although subject to increasing research, the etiology, pathogenesis, and optimal management of HS remain poorly understood. In normal human skin, research has shown that the microbiome present within the epidermis extends below the basement membrane. Bacterial components such as DNA encoding for 16S rRNA genes, bacteria-specific antigens, and bacterial ribosomal RNA were ubiquitously detected throughout subcutaneous regions of normal human skin 4 . These findings offered the first evidence of interaction between commensal bacteria and cells within the dermis and subcutaneous tissue. The skin microbiome in and around HS lesions differs significantly from that of healthy skin. Compared with skinfolds in control patients, HS skinfolds have been characterized by an increased abundance of anaerobes throughout the literature 5 – 8 . The role of anaerobes in HS pathogenesis is supported by previous evidence demonstrating the effectiveness of antibiotic regimens that include anaerobic coverage 9 , 10 . Studies using 16S rRNA and next-generation sequencing consistently show that HS lesions are polymicrobial and anaerobe-rich 6 – 8 , 11 . Reduced levels of Cutibacterium acnes in HS lesions have also been demonstrated 11 , 12 . Romaní et al. further demonstrated the higher the Hurley stage, the greater reduction in Cutibacterium acnes and a marked loss of specific Cutibacterium acnes lineages (D1, H1) in lesional skin worsened with disease severity 13 . Further, Naik et al. highlighted anatomic variation, reporting Cutibacterium acnes was significantly reduced in the axilla while lower abundances of Staphylococcus epidermidis and Staphylococcus hominis were only marginally significant in the inguinal folds 11 . Additionally, the mean abundance of Corynebacterium species correlated with a higher Hurley stage. Across nine prospective microbiological studies compiled by Nikolakis et al., bacterial profiles in HS lesions were shown to vary widely based on lesion depth, clinical severity, and method of sampling. Their analysis showed Staphylococcus aureus , historically considered a pathogenic culprit, was rarely the predominant isolate in HS lesions and often present in control samples. Instead, a virulent coagulase-negative bacteria, Staphylococcus lugdunesis , was frequently isolated in early-stage lesions (Hurley I), while anaerobic actinomyces, Prevotella , Porphyromonas , and Milleri group Streptococci predominated in chronic or late-stage lesions (Hurley II/III) 14 . Of note, Guet-Revillet et al. also identified two microbial profiles: Profile A, defined by Staphylococcus lugdunensis and common in early nodules, and Profile B, a polymicrobial anaerobic flora more prevalent in severe lesions. Altogether, these data suggest that HS skinfolds are associated with skin dysbiosis characterized by an increased number of anaerobes, which varies according to the HS site and the clinical severity of the disease. Reconstructive surgery plays a critical role in the comprehensive management of HS, especially in patients with severe disease requiring surgical excision and reconstruction. We were interested in characterizing the subcutaneous microbiome of patients with HS severe enough to necessitate surgical intervention. We further elucidated associations between microbial findings and anatomical locations, comorbidities, and prior antibiotic exposure. Our aim is to better inform surgeons’ preoperative and postoperative antibiotic strategies based on patient demographics, clinical information, and culture results ultimately improving wound healing outcomes and reducing infection risk. Materials and methods A retrospective chart review (IRB: STU20250702) was performed at Texas Health Resources Harris Methodist Hospital in Fort Worth, TX, to analyze the microbial composition of HS lesions in patients diagnosed with HS from October 2023 - March 2025. This observational study adhered to the STROBE guidelines. The study included 49 patients with HS who underwent excisional surgery and a subcutaneous biopsy with culture of their HS lesion(s) as part of their standard-of-care clinical management. Patients with insufficient chart data and those lacking culture results (n = 41) were excluded. Patient demographics and clinical information such as culture results, anatomical sites of lesion involvement, and prior treatment were extracted from medical records. All patients were classified as stage III HS, which reflected the need for surgical intervention. Bacterial cultures were performed on excised subcutaneous tissue using standard aerobic and anaerobic techniques to identify microbial species present in HS lesions. Associations between microbial findings and anatomical locations were explored to assess potential trends in bacterial colonization in HS lesions. Descriptive statistics were used to summarize patient characteristics and culture results. Subcutaneous biopsy procedure: The area of HS was prepped with 10% betadine solution or chlorhexidine and draped before radical excision. The specimen was excised and tissue within chronic HS tunnels were biopsied with special care to exclude healthy skin. The subcutaneous tissue was immediately sent to the microbiology lab for culture. Results The microbiome of HS lesions was characterized in 49 patients undergoing surgical excision with intraoperative culture collection. Eighteen patients had multiple affected sites, totaling 84 distinct HS cases, each representing a unique surgical procedure with corresponding cultures and perioperative data. The mean age at surgery was 36 years (range 19–69). Of the patients, 28 were female and 21 were male. The average body mass index (BMI) was 34.3 (range 15.1–50.5). Most patients identified as Black (n = 25), followed by White (n = 18) and Asian (n = 4). The majority were nonsmokers (n = 32), with 11 former smokers and 6 current smokers. A history of facial acne was present in 6 patients. Autoimmune disease was documented in 5 patients, including rheumatoid arthritis, ulcerative colitis, HIV, ankylosing spondylitis, and lupus. Ten patients had a history of type 2 diabetes mellitus (T2DM), and 12 had a history of hypertension (Table 1 ). Table 1 Overview of Patient Demographics (n = 49) Patient Factors Patients, n (%) Age at surgery, average (range) 36 (19–69) Sex at birth Female 28 (57) Male 21 (43) Race Black 25 (51) White 18 (37) Asian 4 (8) Not reported 2 (4) Ethnicity Hispanic 9 (18) Non-Hispanic 39 (80) Not reported 1 (2) BMI at time of surgery, average (range) 34.3 (15.1–50.5) Smoking history Current 6 (12% Former 11 (22) Never 32 (65) History of facial acne Yes 6 (12) No 43 (88) Autoimmune disease Rheumatoid arthritis 1 (2) Ulcerative colitis 1 (2) HIV 1 (2) Ankylosing spondylitis 1 (2) Lupus 1 (2) History of Type 2 Diabetes Mellitus Yes 10 (20) No 39 (80) History of hypertension Yes 12 (25) No 37 (75) More than one HS lesion 18 (37) Among the 84 HS cases, 67 (80%) had documented antibiotic use within 90 days prior to surgery. The most frequently administered antibiotics were clindamycin (n = 22), doxycycline (n = 19), and cephalexin (n = 10). Combination antibiotic therapy was used in 32 (38%) cases. Biologic therapy was administered in 66 (79%) cases, and 10 (12%) cases had received corticosteroids within 90 days of surgery (Table 2 ). Table 2 Perioperative Factors for Each HS Case (n = 84) Perioperative Factors Cases, n (%) Prior antibiotic use in the 90 days prior to surgery Yes 67 (80) No 17 (20) Antibiotic types Ampicillin/sulbactam (Unasyn) 3 (4) Augmentin 3 (4) Azithromycin 3 (4) TMP/SMX (Bactrim) 9 (11) Cefazolin (Ancef) 5 (6) Cefepime 8 (10) Ceftriaxone (Rocephin) 7 (8) Cephalexin (Keflex) 10 (12) Ciprofloxacin 3 (4) Clindamycin 22 (3 were topical) (26) Doxycycline 19 (23) Ertapenem (Invanz) 7 (8) Linezolid 1 (1) Levofloxacin (Levaquin) 2 (2) Metronidazole (Flagyl) 7 (8) Minocycline 1 (1) Piperacillin/tazobactam (Zosyn) 1 (1) Vancomycin 8 (10) Combination therapy 32 (38) Use of biologics (e.g., Adalimumab (Humira), Infliximab (Remicade), Secukinumab (Cosentyx), Adalimumab-atto (Amjevita​​) Yes 66 (79) No 18 (21) Steroid use in the 90 days prior to surgery Yes 10 (12) No 74 (88) Steroid types Prednisone 6 (60) Dexamethasone 2 (20) Pregnenolone 1 (10) Steroid Injection 1 (10) Univariate logistic regression identified several significant associations between microbial isolates and perioperative factors (Table 3 ). Beta-lactamase–producing organisms were significantly associated with prior antibiotic use (OR 3.365, 95% CI 1.094–2.333). Prevotella species showed significant associations with both prior antibiotic use (OR 3.586, 95% CI 1.171–2.383) and history of T2DM (OR 16.00, 95% CI 1.402–5.143). Corynebacterium species, isolated from deep abscess wound cultures, were significantly associated with increasing age (OR 1.077, 95% CI 1.003–0.145). Gram-positive cocci were more likely to be isolated in patients with a history of smoking (OR 5.500, 95% CI 1.589–2.821), while gram-negative rods were associated with prior antibiotic use (OR 14.143, 95% CI 1.314–4.985). Table 3 Univariate Logistic Regression of Microbial Isolates by Perioperative Factors of Culture Collection Beta-lactamase positive microbes were significantly associated with prior antibiotic use (OR 3.365, 95% CI 0.094, 2.333). Prevotella species showed significant associations with both prior antibiotic use (OR 3.586, 95% CI [0.171, 2.383]) and history of Type 2 Diabetes Mellitus (T2DM) (OR 16.00, 95% CI [0.402, 5.143]). Corynebacterium species in deep abscess wound cultures were significantly associated with age (OR 1.077, 95% CI [0.003, 0.145]). Gram positive cocci (gram stain category) were significantly associated with current or previous smoking (OR 5.500, 95% CI [0.589, 2.821]). Gram negative rods (gram stain category) were significantly associated with prior antibiotic use (OR 14.143, 95% CI [0.314, 4.985]). Culture Type Microbe Age, OR (95% CI) BMI, OR (95% CI) Prior abx use, OR (95% CI) Prior steroid use, OR (95% CI) Presence of autoimmune disease, OR (95% CI) History of T2DM, OR (95% CI) History of current or previous smoking, OR (95% CI) Soft tissue and bone Enteric flora 0.997 (-0.056, 0.050) 0.999 (-0.095, 0.093) 3.667 (-0.651, 3.249) 0.562 (-2.920, 1.769) N/a 3.5 (-1.934, 4.439) 1.071 (-1.582, 1.720) Streptococcus species 1.013 (-0.053, 0.079) 1.023 (-0.109, − .154) 1.687 (-1.907, 2.953) 4.756e-8 (-5.7e3, 5.7e3) N/a 4.7e-8 (-5.5e3, 5.5e3) 0.667 (-2.806, 1.995) Staphylococcus species 1.078 (-0.054, 0.187) 0.940 (-0.217, 0.092) 1.7e7 (-5.7e3, 5.7e3) 0.125 (-4.378, 0.219) N/a 1.2e7 (-5.5e3, 5.5e3) 7.4e7 (-6.6e3, 6.6.e3) Corynebacterium species 0.963 (-0.160, 0.084) 1.127 (-0.077, 0.316) 8.1e-8 (-5.7e3, 5.7e3) 6.6e-8 (-5.7e3, 5.7e3) N/a 1.9e-7 (-5.5e3, 5.5e3) 1.056 (-2.474, 2.582) Skin flora 0.996 (-0.074, 0.065) 0.975 (-0.143, 0.092) 4.500 (-0.570, 3.579) 4.8e-8 (-5.7e3, 5.7e3) N/a 8.00 (-1.385, 5.544) 0.356 (-3.331, 1.263) Anaerobic Gram positive cocci 0.921 (-0.319, 0.155) 1.009 (-0.271, 0.289) 7.7e-8 (-8.4e3, 8.4e3) 7.9e8 (-1.2e4, 1.2e4) 2.4e-7 (-8.0e3, 8.0e3) 1.00 (-2.7e4, 2.7e4) 2.3e-8 (-1.3e4, 1.3e4) Gram negative rods 0.998 (-0.127, 0.123) 1.213 (-0.081, 0.468) 3.8e-8 (-8.4e3, 8.4e3) 8.9e-8 (-7.0e-3, 7.0e3) 1.2e-7 (-8.0e3, 8.0e3) 4.1e-9 (-2.3e4, 2.3e4) 2.5e8 (-7.8e4, 7.8e4) Beta lactamase positive 1.027 (-0.015, 0.069) 0.985 (-0.083, 0.053) 3.365 (1.094, 2.333)* 0.433 (-3.006, 1.331) 2.289 (-0.756, 2.412) 6.400 (-0.116, 3.828) 0.672 (-1.645, 0.851) Bacteroides species 1.055 (-0.014, 0.122) 0.972 (-0.121, 0.063) 1.164 (-1.482, 1.786) 2.1e7 (-4.2e3, 4.2e3) 0.896 (-2.329, 2.108) 1.0e7 (-3.1e3, 3.1e3) 1.900 (-0.981, 2.265) Prevotella species 1.025 (-0.016, 0.065) 0.986 (-0.080, 0.051) 3.586 (1.171, 2.383)* 0.898 (-1.790, 1.575) 1.875 (-0.948, 2.205) 16.00 (1.402, 5.143)* 0.742 (-1.460, 0.864) Cutibacterium species 1.035 (-0.091, 0.160) 0.867 (-0.412, 0.127) 7.7e-8 (-8.4e3, 8.4e3) 7.8e8 (-1.2e4, 1.2e4) 1.4e-5 (-9.0e3, 8.0e3) 1.00 (-2.7e4, 2.7e4) 2.3e-8 (-1.2e4, 1.2e5) Anaerococcus species 1.055 (-0.052, 0.158) 1.122 (-0.216, 0.447) 4.3e3 (-8.4e3, 8.4e3) 1.8e-7 (-7.0e3, 7.0e3) 2.4e-7 (-8.0e3, 8.0e3) 1.3e9 (-2.1e4, 2.14e4) 2.3e-8 (-1.2e4, 1.2e5) Peptostreptococcus species 0.991 (-0.117, 0.098) 1.128 (-0.072, 0.330) 6.8e-8 (-5.1e3, 5.1e3) 5.8e-8 (-7.0e3, 7.0e3) 2.1e-7 (-4.8e3, 4.8e3) 8.2e-8 (-5.3e3, 5.3e3) 39e8 (-7.8e3, 7.8e3) Finegoldia 1.030 (-0.036, 0.094) 1.088 (-0.060,0.229) 3.9e-8 (-5.1e3, 5.1e3) 1.687 (-1.790, 2.837) 1.2e-7 (-4.8e3, 4.8e3) 1.200 (-2.288, 2.653) 4.333 (-0.401, 3.334) Fusobacterium species 0.959 (-0.193, 0.108) 0.974 (-0.219, 0.165) 4.125 (-1.408, 4.242) 1.8e-7 (-7.0e3, 7.0e3) 12.667 (-0.355, 5.433) 1.7e-7 (-5.2e3, 5.2e3) 3.0e-8 (-7.6e3, 7.6e3) Actinomyces species 1.019 (-0.129, 0.166) 0.768 (9-0.598, 0.071) 3.9e8 (-1.2e4, 1.2e4) N/a 2.4e-7 (-8.0e3, 8.0e3) 1.00 (-2.7e4, 2.7e4) 3.2e8 (-1.3e4, 1.3e4) Parvimonas species 1.013 (-0.142, 0.168) 0.902 (-0.367, 0.160) 7.7e-8 (-8.4e3, 8.4e3) 1.8e-7 (-7.0e3, 7.0e3) 2.4e-7 (-8.0e3, 8.0e3) 1.3e9 (-2.1e4, 2.1e4) 2.3e-8 (-1.3e4, 1.3e4) Parabacteroides species 1.024 (-0.078, 0.125) 1.107 (-0.129, 0.332) 4.125 (-1.408, 4.242) 7.9e8 (-1.2e4, 1.2e4) 12.667 (-0.355, 5.433) 4.1e-9 (-2.3e4, 2.3e4) 6.2e-8 (-7.6e3, 7.6e3) Fungal Candida 0.956 (-0.167, 0.076) 0.949 (-0.224, 0.120) 8.4e-8 (-5.2e3, 5.2e3) 7.5e-8 (-7.4e3, 7.4e3) 2.7e-7 (-7.7e3, 7.7e3) 1.00 (-1.5e4, 1.5e4) 2.9e-8 (-8.6e3, 8.6e3) Deep abscess wound Enteric flora 1.026 (-0.020, 0.072) 1.026 (-0.060, 0.111) 1.983 (-0.638, 2.007) 0.781 (-2.456, 1.962) 2.400 (-0.884, 2.635) 2.125 (-1.263, 2.771) 0.463 (-2.380, 0.841) Methicillin resistant Staphylococcus 0.133 (-0.463, 0.059) 0.806 (-0.439, 0.007) 3.8e-8 (-8.4e3, 8.4e3) 7.125 (-0.905, 4.832) 1.2e-7 (-8.0e3, 8.0e3) 1.00 (-1.6e4, 1.6e4) 3.0e-8 (-7.6e3, 7.6e3) Pseudomonas species 1.014 (-0.053, 0.080) 0.939 (-0.186, 0.061) 3.9e-8 (-5.1e3, 5.1e3) 9.2e-8 (-4.3e3, 4.3e3) 1.2e-7 (-4.8e3, 5.8e3) 4.00 (-1.554, 4.326) 0.625 (-2.722, 1.782) Proteus species 1.001 (-0.078, 0.080) 0.971 (-0.153, 0.095) 2.844 (-0.830, 2.921) 5.8e-8 (-7.0e4, 7.0e4) 3.042 (-1.232, 3.456) 1.6e8 (-4.6e3, 4.6e3) 3.1e-8 (-4.6e3, 4.6e3) Corynebacterium species 1.077 (1.003, 0.145)* 0.994 (-0.167, 0.154) 2.031 (-1.753, 3.171) 8.9e-8 (-7.0e3, 7.0e3) 6.250 (-0.708, 4.373) 1.7e-7 (-5.2e3, 5.2e3) 6.2e-8 (-7.6e3, 7.6e3) Enterococcus species 1.013 (-0.142, 0.168) 0.902 (-0.367, 0.160) 7.7e-8 (-8.4e3, 8.4e3) 1.8e-7 (-7.0e3, 7.0e3) 2.4e-7 (-8.0e3, 8.0e3) 1.2e9 (-2.1e4, 2.1e4) 2.3e-8 (-1.3e3, 1.3e3) Streptococcu s species 0.953 (-0.120, 0.024) 1.000 (-0.093, 0.093) 1.837 (-0.864, 2.080) 1.083 (-2.164, 2.324) 1.6e-7 (-2.9e3, 2.9e3) 0.850 (-2.570, 2.245) 1.333 (-1.200, 1.776) Staphylococcus species 0.821 (-0.557, 0.164) 1.168 (-0.200, 0.511) 3.9e8 (-1.2e4, 1.2e4) N/a 2.4e-7 (-8.0e3, 8.0e3) 3.2e-9 (-3.9e4, 3.9e4) 2.3e-8 (-1.3e4, 1.3e4) Candida species 1.010 (-0.150, 0.170) 0.973 (-0.297, 0.242) 7.7e-8 (-8.4e3, 8.4e3) 1.8e-7 (-7.0e3, 7.0e3) 2.4e-7 (-8.0e3, 8.0e3) 1.00 (-2.7e4, 2.7e4) 2.3e-8 (-1.3e4, 1.3e4) Klebsiella species 1.022 (-0.121, 0.165) 0.880 (-0.394, 0.139) 7.7e-8 (-8.4e3, 8.4e3) 1.8e-7 (-7.0e3, 7.0e3) 2.4e-7 (-8.0e3, 8.0e3) 1.00 (-2.7e4, 2.7e4) 2.3e-8 (-1.3e4, 1.3e4) Skin flora 1.034 (-0.044, 0.111) 1.044 (-0.129, 0.214) 2.031 (-1.753, 3.171) 7.125 (-0.905, 4.832) 3.2e-7 (-4.8e3, 4.8e3) 1.7e-7 (-5.2e3, 5.2e3) 1.300 (-2.193, 2.718) Gram stain Gram positive cocci 1.007 (-0.034, 0.048) 0.985 (-0.083, 0.053) 1.739 (-0.589, 1.695) 2.3e-8 (-4.3e3, 4.3e3) 1.140 (-1.586, 1.848) 0.267 (-3.636, 0.993) 5.500 (1.589, 2.821)* Gram positive rods 1.055 (-0.052, 0.158) 1.075 (-0.235, 0.381) 3.9e8 (-1.2e4, 1.2e4) N/a 2.4e-7 (-8.0e3, 8.0e3) 3.2e-9 (-3.9e4, 3.9e4) 1.00 (-2.4e4, 2.4e4) Gram negative rods 1.050 (-0.016, 0.114) 1.029 (-0.118, 0.174) 14.143 (1.314, 4.985)* 1.8e-7 (-7.0e3, 7.0e3) 1.6e-7 (-4.8e3, 4.8e3) 5.2e-8 (-5.2e3, 5.2e3) 2.650 (-1.844, 3.794) OR, odds ratio. CI, confidence interval. BMI, body mass index. Abx, antibiotic. T2DM, Type 2 Diabetes Mellitus. N/a indicates too few factors to run an analysis. Microbial distribution also varied by anatomical site of culture collection (Table 4 ). In soft tissue and bone cultures, Staphylococcus species were significantly more frequently isolated from the axilla, neck, and perineal regions, and were absent in thigh and abdominal sites (χ²(5) = 12.09, p = 0.034). Corynebacterium species were more commonly found in the perineal area, chest, and abdomen (χ²(5) = 17.09, p = 0.004). Skin flora was significantly more prevalent in the perineal area, axilla, and thigh (χ²(5) = 11.20, p = 0.048), indicating site-specific microbial colonization patterns. Table 4 Comparative Analysis of Microbial Isolates by Anatomic Region of Culture Collection There was a statistically significant association between culture location and the presence of Staphylococcus species in tissue/bone cultures (χ²(5) = 12.09, p = 0.034). Staphylococcus species were observed more frequently in cultures from the axilla, neck, and perineal area, while absent in thigh and abdominal cultures. There was a statistically significant association between culture location and the presence of Corynebacterium species in tissue/bone cultures (χ²(5) = 17.09, p = 0.004). Corynebacterium species were observed in cultures from the perineal area, chest, and abdomen, while absent in the neck, axilla, and thigh cultures. There was a statistically significant association between culture location and the presence of skin flora in tissue/bone cultures (χ²(5) = 11.20, p = 0.048). Skin flora was observed in cultures from the perineal area, axilla, and thigh, while absent in neck, chest, and abdominal cultures. Culture Type Microbe Total, N Neck (positive vs. negative) † Perineal area (positive vs. negative) † Axilla (positive vs. negative) † Thigh (positive vs. negative) † Chest (positive vs. negative) † Abdomen (positive vs. negative) † P-value Soft tissue and bone Enteric flora 36 0 vs. 1 9 vs. 9 3 vs. 9 0 vs. 2 0 vs. 2 0 vs. 1 0.344 Streptococcus species 36 0 vs. 1 5 vs. 13 0 vs. 12 0 vs. 2 0 vs. 2 0 vs. 1 0.326 Staphylococcus species 36 1 vs. 0 1 vs. 17 1 vs. 11 0 vs. 2 1 vs. 1 0 vs. 1 0.034* Corynebacterium species 36 0 vs. 1 1 vs. 17 0 vs. 12 0 vs. 2 1 vs. 1 1 vs. 0 0.004* Skin flora 36 0 vs. 1 2 vs. 16 2 vs. 10 2 vs. 0 0 vs. 2 0 vs. 1 0.048* Anaerobic Gram positive cocci 83 0 vs. 1 0 vs. 41 0 vs. 26 0 vs. 5 1 vs. 6 0 vs. 3 0.052 Gram negative rods 83 0 vs. 1 0 vs. 41 2 vs. 24 0 vs. 5 0 vs. 7 0 vs. 3 0.481 Beta lactamase positive 83 0 vs. 1 13 vs. 28 5 vs. 21 1 vs. 4 0 vs. 7 2 vs. 1 0.228 Bacteroides species 83 1 vs. 0 8 vs. 33 2 vs. 24 0 vs. 5 0 vs. 7 0 vs. 3 0.053 Prevotella species 83 0 vs. 1 16 vs. 25 5 vs. 21 1 vs. 4 0 vs. 7 2 vs. 1 0.119 Cutibacterium species 83 0 vs. 1 0 vs. 41 1 vs. 25 0 vs. 5 0 vs. 7 0 vs. 3 0.818 Anaerococcus species 83 0 vs. 1 1 vs. 40 0 vs. 26 0 vs. 5 0 vs. 7 0 vs. 3 0.960 Peptostreptococcus species 83 0 vs. 1 1 vs. 40 2 vs. 24 0 vs. 5 0 vs. 7 0 vs. 3 0.849 Finegoldia 83 0 vs. 1 4 vs. 37 0 vs. 26 0 vs. 5 1 vs. 6 0 vs. 3 0.536 Fusobacterium species 83 0 vs. 1 0 vs. 41 2 vs. 24 0 vs. 5 0 vs. 7 0 vs. 3 0.481 Actinomyces species 83 0 vs. 1 0 vs. 41 1 vs. 25 0 vs. 5 0 vs. 7 0 vs. 3 0.818 Parvimonas species 83 0 vs. 1 0 vs. 41 1 vs. 25 0 vs. 5 0 vs. 7 0 vs. 3 0.818 Parabacteroides species 83 0 vs. 1 2 vs. 39 0 vs. 26 0 vs. 5 0 vs. 7 0 vs. 3 0.835 Fungal Candida 37 0 vs. 1 3 vs. 17 0 vs. 11 0 vs. 1 0 vs. 2 0 vs. 2 0.735 Deep abscess wound Enteric flora 83 0 vs. 1 7 vs. 34 4 vs. 22 2 vs. 3 0 vs. 7 1 vs. 2 0.528 Methicillin resistant Staphylococcus 83 0 vs. 1 0 vs. 41 2 vs. 24 0 vs. 5 0 vs. 7 0 vs. 3 0.481 Pseudomonas species 83 0 vs. 1 3 vs. 38 1 vs. 25 2 vs. 3 0 vs. 7 0 vs. 3 0.097 Proteus species 83 0 vs. 1 1 vs. 40 2 vs. 24 0 vs. 5 1 vs. 6 0 vs. 3 0.731 Corynebacterium species 83 0 vs. 1 1 vs. 40 1 vs. 25 1 vs. 4 0 vs. 7 0 vs. 3 0.489 Enterococcus species 83 0 vs. 1 0 vs. 41 1 vs. 25 0 vs. 5 0 vs. 7 0 vs. 3 0.818 Streptococcus species 83 0 vs. 1 5 vs. 36 2 vs. 24 0 vs. 5 2 vs. 5 0 vs. 3 0.591 Staphylococcus species 83 0 vs. 1 0 vs. 41 1 vs. 25 0 vs. 5 0 vs. 7 0 vs. 3 0.818 Candida species 83 0 vs. 1 1 vs. 40 0 vs. 26 0 vs. 5 0 vs. 7 0 vs. 3 0.960 Klebsiella species 83 0 vs. 1 1 vs. 40 0 vs. 26 0 vs. 5 0 vs. 7 0 vs. 3 0.960 Skin flora 83 0 vs. 1 2 vs. 39 1 vs. 25 0 vs. 5 0 vs. 7 0 vs. 3 0.978 Gram stain Gram positive cocci 83 0 vs. 1 9 vs. 32 7 vs. 19 3 vs. 2 3 vs. 4 1 vs. 3 0.447 Gram positive rods 83 0 vs. 1 1 vs. 40 0 vs. 26 0 vs. 5 0 vs. 7 0 vs. 3 0.960 Gram negative rods 83 0 vs. 1 2 vs. 39 0 vs. 26 1 vs. 4 0 vs. 7 0 vs. 3 0.366 † Values represent the number of cultures taken from each anatomic location among patients positive for versus (vs.) negative for the listed microbe. P-values were derived from Chi-square. Bolded values with an asterisk indicate statistical significance at p < 0.05. Discussion HS is a chronic, multifactorial inflammatory skin condition that significantly impacts patients’ quality of life. The complex interplay of prior treatments, comorbidities, and demographic variability limits the understanding of the underlying disease biology. Despite growing interest in the role of the superficial tissue microbiome in HS, a key gap remains in our understanding of the microbial composition of deep tissue lesions in surgically managed cases, and how these microbial communities relate to patient-specific factors. Our study addresses this gap by providing a culture-based analysis of subcutaneous tissues obtained during surgical intervention in stage III HS patients. We identified distinct microbial colonization patterns across anatomical sites and analyzed associations between specific bacterial taxa and clinical variables including antibiotic exposure, comorbidities, and demographic characteristics. Our findings reinforce and extend prior work implicating anaerobic bacteria, particularly Prevotella and Corynebacterium species, in the pathogenesis of HS 6–8 . While Prevotella has previously been linked to HS lesions 6 , our study highlights its statistically significant presence in subcutaneous tissues and association with T2DM and prior antibiotic use. This relationship suggests that systemic metabolic disturbances and antibiotic-driven dysbiosis may promote an anaerobic-dominant environment conducive to Prevotella overgrowth, which is important when considering perioperative antibiotic use for patients. We additionally identified the presence of Corynebacterium species as a statistically significant finding in deep tissue cultures, particularly in older patients and in anatomical locations such as the perineal area and chest. Previous studies have associated Corynebacterium with higher Hurley stages and more severe disease 7 , 11 . However, Ring et al. found Corynebacterium to dominate in normal human groin and axillary microbiotas, highlighting its potential dual role as both a commensal organism and a pathogen depending on the context 8 , 12 . Its frequent isolation in deep tissues, beyond superficial lesions, raises the possibility that Corynebacterium plays an active role in sustaining inflammation or promoting lesion chronicity, potentially through biofilm formation. These observations highlight an underexplored microbial target that may influence both prognosis and therapeutic response in advanced HS. Our data also reinforced the diminished presence of Cutibacterium acnes in HS lesions, as described in sequencing studies 8 , 11 , 13 and in a recent systematic review by Soto-Morena et al 15 . Though our culture-based method has limitations in detecting this anaerobe, the consistent reduction in Cutibacterium acnes observed across the literature suggests its depletion may play a role in disrupting the skin's microbial balance, possibly allowing opportunistic pathogens to colonize HS lesions. Future studies should explore the feasibility of topical and oral replacement therapy using beneficial C. acnes strains to restore microbiome balance and alleviate HS symptoms as proposed by Romani et al 13 . Staphylococcus species, while traditionally considered skin commensals or acute infection agents, were significantly more frequently isolated from the axilla, neck, and perineal sites in our study. This aligns with earlier work from Guet-Revillet et al., suggesting Staphylococcus lugdunensis and Staphylococcus aureus may play region-specific roles in HS lesion microbiology 6 . Notably, although Staphylococcus aureus has typically comprised a minor portion of the microbial community in sequencing studies, its increased prevalence in stage III lesions observed here implies a potentially greater role in chronic or advanced disease stages, where compromised skin barriers may facilitate colonization. Site-specific microbial variation was statistically significant, supporting the hypothesis that HS is not a uniform disease entity but one shaped by anatomical, immunological, and environmental factors. For example, the perineal area demonstrated significantly higher levels of both Corynebacterium and skin flora, while the axilla exhibited more frequent isolation of Staphylococcus species. These findings emphasize the need for location-tailored therapeutic strategies and further elucidation of regional microbiota-skin interactions. The strong association between gram-negative rods and prior antibiotic use suggests that antibiotic pressure may select for resistant or opportunistic bacteria, complicating management and necessitating judicious antibiotic stewardship. Similarly, beta-lactamase–producing organisms were significantly more common in patients with prior antibiotic exposure, showing the impact of prior treatment on subsequent microbial profiles. This study also observed statistically significant microbial patterns in relation to behavioral and systemic comorbidities. Smoking history was associated with an increased prevalence of gram-positive cocci, aligning with established data that smoking alters skin immune responses and microbiota of the oral cavity and gut 19 – 22 . Thompson et al. found that the class of gram-positive Actinobacteria, which is further divided into 16 orders including Corynebacteriales , were more prevalent in the skin of patients who smoked. Furthermore, older age correlated with higher isolation of Corynebacterium , a finding that may reflect immunosenescence or age-related shifts in skin barrier integrity. Current HS standard-of-care treatment is detailed in the United Kingdom British Association of Dermatologists (BAD), the European Dermatology Forum S1/S2-k guideline (EDF S1/S2-k), and the North American Hidradenitis Suppurativa Foundation/Canadian Hidradenitis Suppurativa Foundation (HSF/CHSF) guidelines (Table 5 ). The UK (BAD) 23 , European (EDF S1/S2-k) 24 , and North American (HSF/CHSF) 25 share a consistent multimodal framework emphasizing lifestyle modification, medical management, and surgery as complementary components of care. All three guidelines recommend topical clindamycin for mild disease, oral tetracyclines as first-line systemic therapy for mild-to-moderate cases, and combination clindamycin plus rifampin when response is inadequate. Biologic therapy is reserved for moderate-to-severe or refractory disease, while surgery (deroofing, wide excision, flap reconstruction) is indicated for chronic, tunnel-predominant HS. The European guidelines uniquely distinguish inactive, scar-based disease where surgery may be first-line, whereas UK and North American guidelines typically reserve surgery for post-medical failure. Notably, IV ertapenem appears only in European and North American protocols. Both UK and North American guidance emphasize antibiotic stewardship. Table 5 Comparison of Key Features Across UK, European, and North American HS Guidelines This table summarizes the current HS management pathways, including first-line antimicrobial therapy, escalation thresholds for systemic or biologic treatment, and timing of surgical referral. Data were compiled from the British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (2018), the European Dermatology Forum S1/S2-k guideline (2022), and the North American Hidradenitis Suppurativa Foundation/Canadian HS Foundation consensus (2019). All recommend a multimodal, stepwise strategy integrating antibiotics, biologics, surgery, and lifestyle modification while emphasizing antimicrobial stewardship. Region First-line Therapy Escalation Criteria Notes on Duration / Stewardship UK (BAD) Topical 1% clindamycin twice daily. Oral doxycycline 100 mg or lymecycline 408 mg daily for 12 weeks. If inadequate response → clindamycin 300 mg + rifampin 300 mg BID for 10–12 weeks, then consider retinoids/dapsone → if lack of response, begin adalimumab 40 mg weekly → surgical management 12-week assessment includes pain VAS, QoL, lesion count/number of flares in the last month Consider antibiotic treatment break to reduce resistance Europe (EDF S1/S2‑k) Tetracycline 500 mg BID for 12 weeks. Consider adding topical clindamycin 1% BID for 12 weeks, oral clindamycin 300 mg BID for 12 weeks, resorcinol 15% peel BID, and Intralesional triamcinolone 10–40 mg/ml If inadequate response → clindamycin 300 mg + rifampin 300 mg BID for 10–12 weeks → biologics (adalimumab, secukinumab, bimekizumab). Surgery for non-inflammatory/tunnel-dominant disease. In severe active HS, consider ertapenem 1 g IV Guidelines distinguish inflammatory vs. non-inflammatory disease state; uses IHS4 severity score North America (HSF/CHSF) Tetracyclines (doxycycline 100 mg daily/BID, minocycline 100 mg BID) for 12 weeks If inadequate response → clindamycin 300 mg BID + rifampin 300 mg BID for 8–12 weeks → moxifloxacin 400 mg daily + metronidazole 500 mg TID + rifampin 300 mg BID → IV ertapenem 1 g as a 1-time rescue therapy for 6 weeks or as a bridge to surgery → Escalate to biologics (adalimumab 40 mg every other week; infliximab; anakinra 100 mg daily, ustekinumab 45–90 mg q12 weeks) → surgery Antibiotic benefit vs. resistance risk emphasized Our findings suggest that the microbiome is not merely a bystander in HS pathogenesis but may actively shape treatment response and surgical outcomes. As international guidelines evolve, integrating microbiome-informed strategies such as biopsy-guided antibiotic selection and judicious use of prolonged antibiotic courses could enhance clinical outcomes while mitigating resistance risk. Future studies should evaluate whether microbiome-based risk stratification or preoperative microbial mapping improves postoperative healing, recurrence rates, and long-term disease control. Ultimately, aligning surgical decision-making with microbial ecology represents a promising avenue to personalize care in advanced HS. Drawbacks: Our study has important drawbacks that must be considered when interpreting the results. The high rate of recent antibiotic use (80%) may have biased the culture results by altering the skin microbiome prior to sampling. In several cases, preoperative IV antibiotics were administered prior to culture collection potentially leading to suppression of certain organisms, especially fastidious anaerobes and antibiotic-sensitive species. Additionally, microbiota vary widely between anatomical sites such as the axilla, groin, and gluteal clefts making it difficult to generalize the findings. While culture can identify common aerobic and anaerobic pathogens, they lack the sensitivity and specificity of DNA-based methods such as 16S rRNA gene sequencing which can detect a broader and more detailed range of microorganisms 7 . On the other hand, 16S rRNA gene sequencing is sensitive and specific, but its accuracy is largely dependent on method of collection. Samples obtained from deep surgical sites are much more clinically meaningful than those collected from superficial swabs. Additionally, the relatively small sample size of 49 patients obtained from the same institution, retrospective study design, the focus exclusively on stage III patients, and lack of a control group limits the generalizability of the findings. Overall, these drawbacks may have led to an underestimation of microbial diversity and identification of pathogens in HS lesions. Future studies should include larger, more diverse sample sizes with various Hurley staging, and utilize molecular-based techniques to more accurately describe pathogens. While this study highlights microbial associations, causality cannot be inferred. Conclusion A definitive pathogenic role for bacteria has yet to be established for HS, though it has been proposed that disrupted innate immunity potentially triggered by microbial factors could play a significant role 14 . Our findings demonstrate the complex and site-dependent microbial ecology of HS lesions in severe disease. HS lesions harbor distinct microbiomes and are divergent from those without HS. The observed associations between anaerobic dominance, prior antibiotic use, T2DM, smoking, and age highlight key clinical factors that may influence microbial colonization. Tailored treatment approaches that consider site-specific microbiota and patient-specific risk factors may offer improved outcomes in the management of HS. Abbreviations HS Hidradenitis Suppurativa T2DM Type 2 Diabetes Mellitus BAD British Association of Dermatologists EDF S1/S2-k European Dermatology Forum S1/S2-k guideline HSF/CHSF North American Hidradenitis Suppurativa Foundation/Canadian Hidradenitis Suppurativa Foundation Declarations Ethics approval : This study was approved by the University of Texas Southwestern and Texas Health Resources Institutional Review Board (#: STU20250702). This study adhered to the Declaration of Helsinki. Consent to participate : The University of Texas Southwestern and Texas Health Resources Institutional Review Board approved a full HIPAA waiver for consent to participate in this study as this study comprised a retrospective chart review. Consent for publication : Our manuscript does not contain individual data or images that would compromise anonymity, so this is not applicable. Competing interests : WS: The author has no relevant financial disclosures. Funding: None. Author Contribution WS was a major contributor in writing the manuscript.SB analyzed and performed statistical analysis.ES analyzed and performed statistical analysis.MD was a major contributor in writing the manuscript.MC was a major contributor in writing the manuscript.NF was a major contributor in writing the manuscript.KG edited and provided infectious disease expertise.MP edited and provided surgical expertise.All authors read and approved the final manuscript. Acknowledgements: None. Clinical trial number : Not applicable. Data Availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. References Alotaibi HM, Incidence. Risk Factors, and Prognosis of Hidradenitis Suppurativa Across the Globe: Insights from the Literature. Clin Cosmet Investig Dermatol. 2023;16:545–52. 10.2147/CCID.S402453 . von Laffert M, Helmbold P, Wohlrab J, Fiedler E, Stadie V, Marsch WC. Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis. Exp Dermatol Jun. 2010;19(6):533–7. 10.1111/j.1600-0625.2009.00915.x . Jenkins T, Isaac J, Edwards A, Okoye GA. Hidradenitis Suppurativa. Dermatol Clin Jul. 2023;41(3):471–9. 10.1016/j.det.2023.02.001 . Nakatsuji T, Chiang HI, Jiang SB, Nagarajan H, Zengler K, Gallo RL. The microbiome extends to subepidermal compartments of normal skin. Nat Commun. 2013;4:1431. 10.1038/ncomms2441 . 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British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018. Br J Dermatol May. 2019;180(5):1009–17. 10.1111/bjd.17537 . Zouboulis CC, Bechara FG, Benhadou F, et al. European S2k guidelines for hidradenitis suppurativa/acne inversa part 2: Treatment. J Eur Acad Dermatol Venereol May. 2025;39(5):899–941. 10.1111/jdv.20472 . Alikhan A, Sayed C, Alavi A, et al. North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part I: Diagnosis, evaluation, and the use of complementary and procedural management. J Am Acad Dermatol Jul. 2019;81(1):76–90. 10.1016/j.jaad.2019.02.067 . Additional Declarations No competing interests reported. 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Golden","email":"","orcid":"","institution":"Texas Health Fort Worth Harris Methodist Hospital","correspondingAuthor":false,"prefix":"","firstName":"Kevin","middleName":"B.","lastName":"Golden","suffix":""},{"id":560560842,"identity":"d9507c48-921a-4391-bf57-1e000db1e065","order_by":7,"name":"Maxim Pekarev","email":"","orcid":"","institution":"Texas Christian University","correspondingAuthor":false,"prefix":"","firstName":"Maxim","middleName":"","lastName":"Pekarev","suffix":""}],"badges":[],"createdAt":"2025-12-01 15:53:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8252245/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8252245/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12866-026-04744-y","type":"published","date":"2026-01-24T15:57:54+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":98289972,"identity":"b7d16443-d44c-492f-83e0-d822dc866fbc","added_by":"auto","created_at":"2025-12-16 08:02:23","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":121371,"visible":true,"origin":"","legend":"","description":"","filename":"MicrobialSpeciesinDeepTissueLesionsofStageIIIHSBCMMicro.docx","url":"https://assets-eu.researchsquare.com/files/rs-8252245/v1/1750813f5257cc39b000652f.docx"},{"id":98289968,"identity":"b88b9bf4-4bb9-49a7-84d4-fd6407d67b26","added_by":"auto","created_at":"2025-12-16 08:02:23","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":8326,"visible":true,"origin":"","legend":"","description":"","filename":"5a2bf8d29a344d01948243ce73543d14.json","url":"https://assets-eu.researchsquare.com/files/rs-8252245/v1/6515cbb924cedba7cafba158.json"},{"id":98289969,"identity":"4cb6044c-c982-4c29-84ec-0c52c66b95d1","added_by":"auto","created_at":"2025-12-16 08:02:23","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":153443,"visible":true,"origin":"","legend":"","description":"","filename":"5a2bf8d29a344d01948243ce73543d141enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8252245/v1/4252d2ba2b428efd6b59a948.xml"},{"id":98434090,"identity":"4d57428a-96e8-4868-92d0-3a2d4bd9e6e1","added_by":"auto","created_at":"2025-12-17 16:51:30","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":149256,"visible":true,"origin":"","legend":"","description":"","filename":"5a2bf8d29a344d01948243ce73543d141structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8252245/v1/b4fdfc77177a77bde20233a8.xml"},{"id":98289971,"identity":"2b089823-d429-4ea1-823f-5a12244ce6d9","added_by":"auto","created_at":"2025-12-16 08:02:23","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":164431,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8252245/v1/6280cb8d5e3d93534de87178.html"},{"id":101152658,"identity":"c6d23611-afdd-4996-af03-00f0cb1af582","added_by":"auto","created_at":"2026-01-26 16:12:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1667319,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8252245/v1/aa83d6a0-47c8-4cb1-9a6f-240b0451ce43.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Microbial Species in Deep Tissue Lesions of Stage III Hidradenitis Suppurativa: A Retrospective Observational Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHidradenitis suppurativa (HS) is a debilitating and chronic condition that affects up to 1.2% of European and US populations\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. HS is characterized pathologically by follicular hyperkeratosis and lymphocytic perifollicular inflammation followed by rupture of the follicle\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. As HS progresses, adjacent nodules connect and create dermal tunnels that are not self-resolving and require surgical intervention. Chronic issues of HS include post-inflammatory hyperpigmentation, atrophic and hypertrophic scarring, keloid formation, and in severe cases, contractures\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. Although subject to increasing research, the etiology, pathogenesis, and optimal management of HS remain poorly understood.\u003c/p\u003e \u003cp\u003eIn normal human skin, research has shown that the microbiome present within the epidermis extends below the basement membrane. Bacterial components such as DNA encoding for 16S rRNA genes, bacteria-specific antigens, and bacterial ribosomal RNA were ubiquitously detected throughout subcutaneous regions of normal human skin\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. These findings offered the first evidence of interaction between commensal bacteria and cells within the dermis and subcutaneous tissue.\u003c/p\u003e \u003cp\u003eThe skin microbiome in and around HS lesions differs significantly from that of healthy skin. Compared with skinfolds in control patients, HS skinfolds have been characterized by an increased abundance of anaerobes throughout the literature\u003csup\u003e\u003cspan additionalcitationids=\"CR6 CR7\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. The role of anaerobes in HS pathogenesis is supported by previous evidence demonstrating the effectiveness of antibiotic regimens that include anaerobic coverage\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eStudies using 16S rRNA and next-generation sequencing consistently show that HS lesions are polymicrobial and anaerobe-rich\u003csup\u003e\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Reduced levels of \u003cem\u003eCutibacterium acnes\u003c/em\u003e in HS lesions have also been demonstrated\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Roman\u0026iacute; et al. further demonstrated the higher the Hurley stage, the greater reduction in \u003cem\u003eCutibacterium acnes\u003c/em\u003e and a marked loss of specific \u003cem\u003eCutibacterium acnes\u003c/em\u003e lineages (D1, H1) in lesional skin worsened with disease severity\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Further, Naik et al. highlighted anatomic variation, reporting \u003cem\u003eCutibacterium acnes\u003c/em\u003e was significantly reduced in the axilla while lower abundances of \u003cem\u003eStaphylococcus epidermidis\u003c/em\u003e and \u003cem\u003eStaphylococcus hominis\u003c/em\u003e were only marginally significant in the inguinal folds\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Additionally, the mean abundance of \u003cem\u003eCorynebacterium\u003c/em\u003e species correlated with a higher Hurley stage.\u003c/p\u003e \u003cp\u003eAcross nine prospective microbiological studies compiled by Nikolakis et al., bacterial profiles in HS lesions were shown to vary widely based on lesion depth, clinical severity, and method of sampling. Their analysis showed \u003cem\u003eStaphylococcus aureus\u003c/em\u003e, historically considered a pathogenic culprit, was rarely the predominant isolate in HS lesions and often present in control samples. Instead, a virulent coagulase-negative bacteria, \u003cem\u003eStaphylococcus lugdunesis\u003c/em\u003e, was frequently isolated in early-stage lesions (Hurley I), while anaerobic actinomyces, \u003cem\u003ePrevotella\u003c/em\u003e, \u003cem\u003ePorphyromonas\u003c/em\u003e, and Milleri group \u003cem\u003eStreptococci\u003c/em\u003e predominated in chronic or late-stage lesions (Hurley II/III)\u003csup\u003e14\u003c/sup\u003e. Of note, Guet-Revillet et al. also identified two microbial profiles: Profile A, defined by \u003cem\u003eStaphylococcus lugdunensis\u003c/em\u003e and common in early nodules, and Profile B, a polymicrobial anaerobic flora more prevalent in severe lesions.\u003c/p\u003e \u003cp\u003eAltogether, these data suggest that HS skinfolds are associated with skin dysbiosis characterized by an increased number of anaerobes, which varies according to the HS site and the clinical severity of the disease. Reconstructive surgery plays a critical role in the comprehensive management of HS, especially in patients with severe disease requiring surgical excision and reconstruction. We were interested in characterizing the subcutaneous microbiome of patients with HS severe enough to necessitate surgical intervention. We further elucidated associations between microbial findings and anatomical locations, comorbidities, and prior antibiotic exposure. Our aim is to better inform surgeons\u0026rsquo; preoperative and postoperative antibiotic strategies based on patient demographics, clinical information, and culture results ultimately improving wound healing outcomes and reducing infection risk.\u003c/p\u003e"},{"header":"Materials and methods","content":" \u003cp\u003e A retrospective chart review (IRB: STU20250702) was performed at Texas Health Resources Harris Methodist Hospital in Fort Worth, TX, to analyze the microbial composition of HS lesions in patients diagnosed with HS from October 2023 - March 2025. This observational study adhered to the STROBE guidelines. The study included 49 patients with HS who underwent excisional surgery and a subcutaneous biopsy with culture of their HS lesion(s) as part of their standard-of-care clinical management. Patients with insufficient chart data and those lacking culture results (n\u0026thinsp;=\u0026thinsp;41) were excluded. Patient demographics and clinical information such as culture results, anatomical sites of lesion involvement, and prior treatment were extracted from medical records. All patients were classified as stage III HS, which reflected the need for surgical intervention. Bacterial cultures were performed on excised subcutaneous tissue using standard aerobic and anaerobic techniques to identify microbial species present in HS lesions. Associations between microbial findings and anatomical locations were explored to assess potential trends in bacterial colonization in HS lesions. Descriptive statistics were used to summarize patient characteristics and culture results.\u003c/p\u003e \u003cp\u003eSubcutaneous biopsy procedure: The area of HS was prepped with 10% betadine solution or chlorhexidine and draped before radical excision. The specimen was excised and tissue within chronic HS tunnels were biopsied with special care to exclude healthy skin. The subcutaneous tissue was immediately sent to the microbiology lab for culture.\u003c/p\u003e"},{"header":"Results","content":" \u003cp\u003eThe microbiome of HS lesions was characterized in 49 patients undergoing surgical excision with intraoperative culture collection. Eighteen patients had multiple affected sites, totaling 84 distinct HS cases, each representing a unique surgical procedure with corresponding cultures and perioperative data.\u003c/p\u003e \u003cp\u003eThe mean age at surgery was 36 years (range 19\u0026ndash;69). Of the patients, 28 were female and 21 were male. The average body mass index (BMI) was 34.3 (range 15.1\u0026ndash;50.5). Most patients identified as Black (n\u0026thinsp;=\u0026thinsp;25), followed by White (n\u0026thinsp;=\u0026thinsp;18) and Asian (n\u0026thinsp;=\u0026thinsp;4). The majority were nonsmokers (n\u0026thinsp;=\u0026thinsp;32), with 11 former smokers and 6 current smokers. A history of facial acne was present in 6 patients. Autoimmune disease was documented in 5 patients, including rheumatoid arthritis, ulcerative colitis, HIV, ankylosing spondylitis, and lupus. Ten patients had a history of type 2 diabetes mellitus (T2DM), and 12 had a history of hypertension (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eOverview of Patient Demographics (n\u0026thinsp;=\u0026thinsp;49)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient Factors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatients, \u003cem\u003en (%)\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge at surgery, \u003cem\u003eaverage (range)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (19\u0026ndash;69)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex at birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (57)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (43)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRace\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (51)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot reported\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEthnicity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHispanic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-Hispanic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39 (80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot reported\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI at time of surgery, \u003cem\u003eaverage (range)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34.3 (15.1\u0026ndash;50.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCurrent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (12%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFormer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (22)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (65)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of facial acne\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43 (88)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAutoimmune disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRheumatoid arthritis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUlcerative colitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnkylosing spondylitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLupus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of Type 2 Diabetes Mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39 (80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than one HS lesion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAmong the 84 HS cases, 67 (80%) had documented antibiotic use within 90 days prior to surgery. The most frequently administered antibiotics were clindamycin (n\u0026thinsp;=\u0026thinsp;22), doxycycline (n\u0026thinsp;=\u0026thinsp;19), and cephalexin (n\u0026thinsp;=\u0026thinsp;10). Combination antibiotic therapy was used in 32 (38%) cases. Biologic therapy was administered in 66 (79%) cases, and 10 (12%) cases had received corticosteroids within 90 days of surgery (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePerioperative Factors for Each HS Case (n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerioperative Factors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCases, \u003cem\u003en (%)\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrior antibiotic use in the 90 days prior to surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67 (80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAntibiotic types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmpicillin/sulbactam (Unasyn)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAugmentin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAzithromycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTMP/SMX (Bactrim)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (11)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCefazolin (Ancef)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCefepime\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCeftriaxone (Rocephin)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCephalexin (Keflex)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCiprofloxacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClindamycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22 (3 were topical) (26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDoxycycline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eErtapenem (Invanz)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLinezolid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevofloxacin (Levaquin)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMetronidazole (Flagyl)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMinocycline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePiperacillin/tazobactam (Zosyn)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVancomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCombination therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (38)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse of biologics (e.g., Adalimumab (Humira), Infliximab (Remicade), Secukinumab (Cosentyx), Adalimumab-atto (Amjevita​​)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66 (79)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (21)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSteroid use in the 90 days prior to surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74 (88)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSteroid types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrednisone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (60)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDexamethasone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePregnenolone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSteroid Injection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eUnivariate logistic regression identified several significant associations between microbial isolates and perioperative factors (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Beta-lactamase\u0026ndash;producing organisms were significantly associated with prior antibiotic use (OR 3.365, 95% CI 1.094\u0026ndash;2.333). \u003cem\u003ePrevotella\u003c/em\u003e species showed significant associations with both prior antibiotic use (OR 3.586, 95% CI 1.171\u0026ndash;2.383) and history of T2DM (OR 16.00, 95% CI 1.402\u0026ndash;5.143). \u003cem\u003eCorynebacterium\u003c/em\u003e species, isolated from deep abscess wound cultures, were significantly associated with increasing age (OR 1.077, 95% CI 1.003\u0026ndash;0.145). Gram-positive cocci were more likely to be isolated in patients with a history of smoking (OR 5.500, 95% CI 1.589\u0026ndash;2.821), while gram-negative rods were associated with prior antibiotic use (OR 14.143, 95% CI 1.314\u0026ndash;4.985).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate Logistic Regression of Microbial Isolates by Perioperative Factors of Culture Collection Beta-lactamase positive microbes were significantly associated with prior antibiotic use (OR 3.365, 95% CI 0.094, 2.333). \u003cem\u003ePrevotella\u003c/em\u003e species showed significant associations with both prior antibiotic use (OR 3.586, 95% CI [0.171, 2.383]) and history of Type 2 Diabetes Mellitus (T2DM) (OR 16.00, 95% CI [0.402, 5.143]). \u003cem\u003eCorynebacterium\u003c/em\u003e species in deep abscess wound cultures were significantly associated with age (OR 1.077, 95% CI [0.003, 0.145]). Gram positive cocci (gram stain category) were significantly associated with current or previous smoking (OR 5.500, 95% CI [0.589, 2.821]). Gram negative rods (gram stain category) were significantly associated with prior antibiotic use (OR 14.143, 95% CI [0.314, 4.985]).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026minus;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCulture Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMicrobe\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAge, OR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBMI, OR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePrior abx use, OR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePrior steroid use, OR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ePresence of autoimmune disease, OR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eHistory of T2DM, OR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHistory of current or previous smoking, OR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eSoft tissue and bone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEnteric flora\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.997 (-0.056, 0.050)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.999 (-0.095, 0.093)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.667 (-0.651, 3.249)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.562 (-2.920, 1.769)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eN/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.5 (-1.934, 4.439)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.071 (-1.582, 1.720)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eStreptococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.013 (-0.053, 0.079)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.023 (-0.109, \u0026minus;\u0026thinsp;.154)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.687 (-1.907, 2.953)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.756e-8 (-5.7e3, 5.7e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eN/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.7e-8 (-5.5e3, 5.5e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.667 (-2.806, 1.995)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eStaphylococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.078 (-0.054, 0.187)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.940 (-0.217, 0.092)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.7e7 (-5.7e3, 5.7e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.125 (-4.378, 0.219)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eN/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.2e7 (-5.5e3, 5.5e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e7.4e7 (-6.6e3, 6.6.e3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCorynebacterium\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.963 (-0.160, 0.084)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.127 (-0.077, 0.316)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.1e-8 (-5.7e3, 5.7e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.6e-8 (-5.7e3, 5.7e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eN/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.9e-7 (-5.5e3, 5.5e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.056 (-2.474, 2.582)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSkin flora\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.996 (-0.074, 0.065)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.975 (-0.143, 0.092)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.500 (-0.570, 3.579)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.8e-8 (-5.7e3, 5.7e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eN/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8.00 (-1.385, 5.544)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.356 (-3.331, 1.263)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"12\" rowspan=\"13\"\u003e \u003cp\u003eAnaerobic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram positive cocci\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.921 (-0.319, 0.155)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.009 (-0.271, 0.289)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.7e-8 (-8.4e3, 8.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.9e8 (-1.2e4, 1.2e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (-2.7e4, 2.7e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.3e-8 (-1.3e4, 1.3e4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram negative rods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.998 (-0.127, 0.123)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.213 (-0.081, 0.468)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.8e-8 (-8.4e3, 8.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.9e-8 (-7.0e-3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.2e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.1e-9 (-2.3e4, 2.3e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.5e8 (-7.8e4, 7.8e4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBeta lactamase positive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.027 (-0.015, 0.069)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.985 (-0.083, 0.053)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e3.365 (1.094, 2.333)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.433 (-3.006, 1.331)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.289 (-0.756, 2.412)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.400 (-0.116, 3.828)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.672 (-1.645, 0.851)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eBacteroides\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.055 (-0.014, 0.122)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.972 (-0.121, 0.063)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.164 (-1.482, 1.786)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.1e7 (-4.2e3, 4.2e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.896 (-2.329, 2.108)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.0e7 (-3.1e3, 3.1e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.900 (-0.981, 2.265)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ePrevotella\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.025 (-0.016, 0.065)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.986 (-0.080, 0.051)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e3.586 (1.171, 2.383)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.898 (-1.790, 1.575)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.875 (-0.948, 2.205)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e16.00 (1.402, 5.143)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.742 (-1.460, 0.864)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCutibacterium\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.035 (-0.091, 0.160)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.867 (-0.412, 0.127)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.7e-8 (-8.4e3, 8.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.8e8 (-1.2e4, 1.2e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.4e-5 (-9.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (-2.7e4, 2.7e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.3e-8 (-1.2e4, 1.2e5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eAnaerococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.055 (-0.052, 0.158)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.122 (-0.216, 0.447)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.3e3 (-8.4e3, 8.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.8e-7 (-7.0e3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.3e9 (-2.1e4, 2.14e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.3e-8 (-1.2e4, 1.2e5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ePeptostreptococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.991 (-0.117, 0.098)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.128 (-0.072, 0.330)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.8e-8 (-5.1e3, 5.1e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.8e-8 (-7.0e3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.1e-7 (-4.8e3, 4.8e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8.2e-8 (-5.3e3, 5.3e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e39e8 (-7.8e3, 7.8e3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eFinegoldia\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.030 (-0.036, 0.094)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.088 (-0.060,0.229)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.9e-8 (-5.1e3, 5.1e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.687 (-1.790, 2.837)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.2e-7 (-4.8e3, 4.8e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.200 (-2.288, 2.653)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4.333 (-0.401, 3.334)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eFusobacterium\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.959 (-0.193, 0.108)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.974 (-0.219, 0.165)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.125 (-1.408, 4.242)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.8e-7 (-7.0e3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12.667 (-0.355, 5.433)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.7e-7 (-5.2e3, 5.2e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.0e-8 (-7.6e3, 7.6e3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eActinomyces\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.019 (-0.129, 0.166)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.768 (9-0.598, 0.071)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.9e8 (-1.2e4, 1.2e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eN/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (-2.7e4, 2.7e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.2e8 (-1.3e4, 1.3e4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eParvimonas\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.013 (-0.142, 0.168)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.902 (-0.367, 0.160)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.7e-8 (-8.4e3, 8.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.8e-7 (-7.0e3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.3e9 (-2.1e4, 2.1e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.3e-8 (-1.3e4, 1.3e4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eParabacteroides\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.024 (-0.078, 0.125)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.107 (-0.129, 0.332)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.125 (-1.408, 4.242)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.9e8 (-1.2e4, 1.2e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12.667 (-0.355, 5.433)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.1e-9 (-2.3e4, 2.3e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6.2e-8 (-7.6e3, 7.6e3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFungal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCandida\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.956 (-0.167, 0.076)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.949 (-0.224, 0.120)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.4e-8 (-5.2e3, 5.2e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.5e-8 (-7.4e3, 7.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.7e-7 (-7.7e3, 7.7e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (-1.5e4, 1.5e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.9e-8 (-8.6e3, 8.6e3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"10\" rowspan=\"11\"\u003e \u003cp\u003eDeep abscess wound\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEnteric flora\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.026 (-0.020, 0.072)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.026 (-0.060, 0.111)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.983 (-0.638, 2.007)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.781 (-2.456, 1.962)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.400 (-0.884, 2.635)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.125 (-1.263, 2.771)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.463 (-2.380, 0.841)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMethicillin resistant \u003cem\u003eStaphylococcus\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.133 (-0.463, 0.059)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.806 (-0.439, 0.007)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.8e-8 (-8.4e3, 8.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.125 (-0.905, 4.832)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.2e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (-1.6e4, 1.6e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.0e-8 (-7.6e3, 7.6e3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ePseudomonas\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.014 (-0.053, 0.080)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.939 (-0.186, 0.061)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.9e-8 (-5.1e3, 5.1e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.2e-8 (-4.3e3, 4.3e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.2e-7 (-4.8e3, 5.8e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.00 (-1.554, 4.326)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.625 (-2.722, 1.782)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eProteus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.001 (-0.078, 0.080)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.971 (-0.153, 0.095)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.844 (-0.830, 2.921)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.8e-8 (-7.0e4, 7.0e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.042 (-1.232, 3.456)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.6e8 (-4.6e3, 4.6e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.1e-8 (-4.6e3, 4.6e3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCorynebacterium\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.077 (1.003, 0.145)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.994 (-0.167, 0.154)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.031 (-1.753, 3.171)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.9e-8 (-7.0e3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.250 (-0.708, 4.373)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.7e-7 (-5.2e3, 5.2e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6.2e-8 (-7.6e3, 7.6e3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eEnterococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.013 (-0.142, 0.168)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.902 (-0.367, 0.160)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.7e-8 (-8.4e3, 8.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.8e-7 (-7.0e3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.2e9 (-2.1e4, 2.1e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.3e-8 (-1.3e3, 1.3e3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eStreptococcu\u003c/em\u003es species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.953 (-0.120, 0.024)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.000 (-0.093, 0.093)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.837 (-0.864, 2.080)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.083 (-2.164, 2.324)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.6e-7 (-2.9e3, 2.9e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.850 (-2.570, 2.245)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.333 (-1.200, 1.776)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eStaphylococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.821 (-0.557, 0.164)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.168 (-0.200, 0.511)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.9e8 (-1.2e4, 1.2e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eN/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.2e-9 (-3.9e4, 3.9e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.3e-8 (-1.3e4, 1.3e4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCandida\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.010 (-0.150, 0.170)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.973 (-0.297, 0.242)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.7e-8 (-8.4e3, 8.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.8e-7 (-7.0e3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (-2.7e4, 2.7e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.3e-8 (-1.3e4, 1.3e4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eKlebsiella\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.022 (-0.121, 0.165)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.880 (-0.394, 0.139)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.7e-8 (-8.4e3, 8.4e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.8e-7 (-7.0e3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (-2.7e4, 2.7e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.3e-8 (-1.3e4, 1.3e4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSkin flora\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.034 (-0.044, 0.111)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.044 (-0.129, 0.214)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.031 (-1.753, 3.171)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.125 (-0.905, 4.832)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.2e-7 (-4.8e3, 4.8e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.7e-7 (-5.2e3, 5.2e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.300 (-2.193, 2.718)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eGram stain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram positive cocci\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.007 (-0.034, 0.048)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e0.985 (-0.083, 0.053)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.739 (-0.589, 1.695)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.3e-8 (-4.3e3, 4.3e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.140 (-1.586, 1.848)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.267 (-3.636, 0.993)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e5.500 (1.589, 2.821)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram positive rods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.055 (-0.052, 0.158)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.075 (-0.235, 0.381)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.9e8 (-1.2e4, 1.2e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eN/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4e-7 (-8.0e3, 8.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.2e-9 (-3.9e4, 3.9e4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.00 (-2.4e4, 2.4e4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram negative rods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.050 (-0.016, 0.114)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c4\"\u003e \u003cp\u003e1.029 (-0.118, 0.174)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e14.143 (1.314, 4.985)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.8e-7 (-7.0e3, 7.0e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.6e-7 (-4.8e3, 4.8e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.2e-8 (-5.2e3, 5.2e3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.650 (-1.844, 3.794)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eOR, odds ratio. CI, confidence interval. BMI, body mass index. Abx, antibiotic. T2DM, Type 2 Diabetes Mellitus. N/a indicates too few factors to run an analysis.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMicrobial distribution also varied by anatomical site of culture collection (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). In soft tissue and bone cultures, \u003cem\u003eStaphylococcus\u003c/em\u003e species were significantly more frequently isolated from the axilla, neck, and perineal regions, and were absent in thigh and abdominal sites (χ\u0026sup2;(5)\u0026thinsp;=\u0026thinsp;12.09, p\u0026thinsp;=\u0026thinsp;0.034). \u003cem\u003eCorynebacterium\u003c/em\u003e species were more commonly found in the perineal area, chest, and abdomen (χ\u0026sup2;(5)\u0026thinsp;=\u0026thinsp;17.09, p\u0026thinsp;=\u0026thinsp;0.004). Skin flora was significantly more prevalent in the perineal area, axilla, and thigh (χ\u0026sup2;(5)\u0026thinsp;=\u0026thinsp;11.20, p\u0026thinsp;=\u0026thinsp;0.048), indicating site-specific microbial colonization patterns.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparative Analysis of Microbial Isolates by Anatomic Region of Culture Collection There was a statistically significant association between culture location and the presence of \u003cem\u003eStaphylococcus\u003c/em\u003e species in tissue/bone cultures (χ\u0026sup2;(5)\u0026thinsp;=\u0026thinsp;12.09, p\u0026thinsp;=\u0026thinsp;0.034). \u003cem\u003eStaphylococcus\u003c/em\u003e species were observed more frequently in cultures from the axilla, neck, and perineal area, while absent in thigh and abdominal cultures. There was a statistically significant association between culture location and the presence of \u003cem\u003eCorynebacterium\u003c/em\u003e species in tissue/bone cultures (χ\u0026sup2;(5)\u0026thinsp;=\u0026thinsp;17.09, p\u0026thinsp;=\u0026thinsp;0.004). \u003cem\u003eCorynebacterium\u003c/em\u003e species were observed in cultures from the perineal area, chest, and abdomen, while absent in the neck, axilla, and thigh cultures. There was a statistically significant association between culture location and the presence of skin flora in tissue/bone cultures (χ\u0026sup2;(5)\u0026thinsp;=\u0026thinsp;11.20, p\u0026thinsp;=\u0026thinsp;0.048). Skin flora was observed in cultures from the perineal area, axilla, and thigh, while absent in neck, chest, and abdominal cultures.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCulture Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMicrobe\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal, N\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNeck (positive vs. negative)\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePerineal area (positive vs. negative)\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAxilla (positive vs. negative)\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eThigh (positive vs. negative)\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eChest (positive vs. negative)\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eAbdomen (positive vs. negative)\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eSoft tissue and bone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEnteric flora\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9 vs. 9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 vs. 9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.344\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eStreptococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 vs. 13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.326\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eStaphylococcus\u003c/b\u003e \u003cb\u003especies\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e36\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e1 vs. 0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1 vs. 17\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1 vs. 11\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0 vs. 2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1 vs. 1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0 vs. 1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.034*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eCorynebacterium\u003c/b\u003e \u003cb\u003especies\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e36\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0 vs. 1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1 vs. 17\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0 vs. 12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0 vs. 2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1 vs. 1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e1 vs. 0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.004*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSkin flora\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e36\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0 vs. 1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e2 vs. 16\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2 vs. 10\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e2 vs. 0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0 vs. 2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0 vs. 1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.048*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"12\" rowspan=\"13\"\u003e \u003cp\u003eAnaerobic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram positive cocci\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 vs. 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 vs. 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram negative rods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 vs. 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 vs. 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.481\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBeta lactamase positive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 vs. 28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 vs. 21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 vs. 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.228\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eBacteroides\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 vs. 0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 vs. 33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 vs. 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ePrevotella\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 vs. 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 vs. 21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 vs. 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.119\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCutibacterium\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 vs. 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 vs. 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.818\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eAnaerococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 vs. 40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.960\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ePeptostreptococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 vs. 40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 vs. 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.849\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eFinegoldia\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 vs. 37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 vs. 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.536\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eFusobacterium\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 vs. 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 vs. 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.481\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eActinomyces\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 vs. 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 vs. 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.818\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eParvimonas\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 vs. 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 vs. 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.818\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eParabacteroides\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 vs. 39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.835\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFungal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCandida\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 vs. 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.735\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"10\" rowspan=\"11\"\u003e \u003cp\u003eDeep abscess wound\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEnteric flora\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7 vs. 34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 vs. 22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 vs. 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.528\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMethicillin resistant \u003cem\u003eStaphylococcus\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 vs. 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 vs. 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.481\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ePseudomonas\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 vs. 38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 vs. 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.097\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eProteus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 vs. 40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 vs. 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 vs. 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.731\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCorynebacterium\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 vs. 40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 vs. 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 vs. 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.489\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eEnterococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 vs. 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 vs. 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.818\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eStreptococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 vs. 36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 vs. 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.591\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eStaphylococcus\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 vs. 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 vs. 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.818\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCandida\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 vs. 40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.960\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eKlebsiella\u003c/em\u003e species\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 vs. 40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.960\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSkin flora\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 vs. 39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 vs. 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.978\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eGram stain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram positive cocci\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9 vs. 32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 vs. 19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 vs. 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3 vs. 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.447\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram positive rods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 vs. 40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 vs. 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.960\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGram negative rods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 vs. 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 vs. 39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 vs. 26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 vs. 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 vs. 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 vs. 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.366\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003e\u003csup\u003e\u0026dagger;\u003c/sup\u003e Values represent the number of cultures taken from each anatomic location among patients positive for versus (vs.) negative for the listed microbe. P-values were derived from Chi-square. Bolded values with an asterisk indicate statistical significance at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eHS is a chronic, multifactorial inflammatory skin condition that significantly impacts patients\u0026rsquo; quality of life. The complex interplay of prior treatments, comorbidities, and demographic variability limits the understanding of the underlying disease biology. Despite growing interest in the role of the superficial tissue microbiome in HS, a key gap remains in our understanding of the microbial composition of deep tissue lesions in surgically managed cases, and how these microbial communities relate to patient-specific factors. Our study addresses this gap by providing a culture-based analysis of subcutaneous tissues obtained during surgical intervention in stage III HS patients. We identified distinct microbial colonization patterns across anatomical sites and analyzed associations between specific bacterial taxa and clinical variables including antibiotic exposure, comorbidities, and demographic characteristics.\u003c/p\u003e \u003cp\u003eOur findings reinforce and extend prior work implicating anaerobic bacteria, particularly \u003cem\u003ePrevotella\u003c/em\u003e and \u003cem\u003eCorynebacterium\u003c/em\u003e species, in the pathogenesis of HS\u003csup\u003e6\u0026ndash;8\u003c/sup\u003e. While \u003cem\u003ePrevotella\u003c/em\u003e has previously been linked to HS lesions\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e, our study highlights its statistically significant presence in subcutaneous tissues and association with T2DM and prior antibiotic use. This relationship suggests that systemic metabolic disturbances and antibiotic-driven dysbiosis may promote an anaerobic-dominant environment conducive to \u003cem\u003ePrevotella\u003c/em\u003e overgrowth, which is important when considering perioperative antibiotic use for patients.\u003c/p\u003e \u003cp\u003eWe additionally identified the presence of \u003cem\u003eCorynebacterium\u003c/em\u003e species as a statistically significant finding in deep tissue cultures, particularly in older patients and in anatomical locations such as the perineal area and chest. Previous studies have associated \u003cem\u003eCorynebacterium\u003c/em\u003e with higher Hurley stages and more severe disease\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. However, Ring et al. found \u003cem\u003eCorynebacterium\u003c/em\u003e to dominate in normal human groin and axillary microbiotas, highlighting its potential dual role as both a commensal organism and a pathogen depending on the context \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Its frequent isolation in deep tissues, beyond superficial lesions, raises the possibility that \u003cem\u003eCorynebacterium\u003c/em\u003e plays an active role in sustaining inflammation or promoting lesion chronicity, potentially through biofilm formation. These observations highlight an underexplored microbial target that may influence both prognosis and therapeutic response in advanced HS.\u003c/p\u003e \u003cp\u003eOur data also reinforced the diminished presence of \u003cem\u003eCutibacterium acnes\u003c/em\u003e in HS lesions, as described in sequencing studies\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e and in a recent systematic review by Soto-Morena et al\u003csup\u003e15\u003c/sup\u003e. Though our culture-based method has limitations in detecting this anaerobe, the consistent reduction in \u003cem\u003eCutibacterium acnes\u003c/em\u003e observed across the literature suggests its depletion may play a role in disrupting the skin's microbial balance, possibly allowing opportunistic pathogens to colonize HS lesions. Future studies should explore the feasibility of topical and oral replacement therapy using beneficial \u003cem\u003eC. acnes\u003c/em\u003e strains to restore microbiome balance and alleviate HS symptoms as proposed by Romani et al\u003csup\u003e13\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cem\u003eStaphylococcus\u003c/em\u003e species, while traditionally considered skin commensals or acute infection agents, were significantly more frequently isolated from the axilla, neck, and perineal sites in our study. This aligns with earlier work from Guet-Revillet et al., suggesting \u003cem\u003eStaphylococcus lugdunensis\u003c/em\u003e and \u003cem\u003eStaphylococcus aureus\u003c/em\u003e may play region-specific roles in HS lesion microbiology \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Notably, although \u003cem\u003eStaphylococcus aureus\u003c/em\u003e has typically comprised a minor portion of the microbial community in sequencing studies, its increased prevalence in stage III lesions observed here implies a potentially greater role in chronic or advanced disease stages, where compromised skin barriers may facilitate colonization.\u003c/p\u003e \u003cp\u003eSite-specific microbial variation was statistically significant, supporting the hypothesis that HS is not a uniform disease entity but one shaped by anatomical, immunological, and environmental factors. For example, the perineal area demonstrated significantly higher levels of both \u003cem\u003eCorynebacterium\u003c/em\u003e and skin flora, while the axilla exhibited more frequent isolation of \u003cem\u003eStaphylococcus\u003c/em\u003e species. These findings emphasize the need for location-tailored therapeutic strategies and further elucidation of regional microbiota-skin interactions.\u003c/p\u003e \u003cp\u003eThe strong association between gram-negative rods and prior antibiotic use suggests that antibiotic pressure may select for resistant or opportunistic bacteria, complicating management and necessitating judicious antibiotic stewardship. Similarly, beta-lactamase\u0026ndash;producing organisms were significantly more common in patients with prior antibiotic exposure, showing the impact of prior treatment on subsequent microbial profiles.\u003c/p\u003e \u003cp\u003eThis study also observed statistically significant microbial patterns in relation to behavioral and systemic comorbidities. Smoking history was associated with an increased prevalence of gram-positive cocci, aligning with established data that smoking alters skin immune responses and microbiota of the oral cavity and gut\u003csup\u003e\u003cspan additionalcitationids=\"CR20 CR21\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Thompson et al. found that the class of gram-positive Actinobacteria, which is further divided into 16 orders including \u003cem\u003eCorynebacteriales\u003c/em\u003e, were more prevalent in the skin of patients who smoked. Furthermore, older age correlated with higher isolation of \u003cem\u003eCorynebacterium\u003c/em\u003e, a finding that may reflect immunosenescence or age-related shifts in skin barrier integrity.\u003c/p\u003e \u003cp\u003eCurrent HS standard-of-care treatment is detailed in the United Kingdom British Association of Dermatologists (BAD), the European Dermatology Forum S1/S2-k guideline (EDF S1/S2-k), and the North American Hidradenitis Suppurativa Foundation/Canadian Hidradenitis Suppurativa Foundation (HSF/CHSF) guidelines (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). The UK (BAD)\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e, European (EDF S1/S2-k)\u003csup\u003e24\u003c/sup\u003e, and North American (HSF/CHSF)\u003csup\u003e25\u003c/sup\u003e share a consistent multimodal framework emphasizing lifestyle modification, medical management, and surgery as complementary components of care. All three guidelines recommend topical clindamycin for mild disease, oral tetracyclines as first-line systemic therapy for mild-to-moderate cases, and combination clindamycin plus rifampin when response is inadequate. Biologic therapy is reserved for moderate-to-severe or refractory disease, while surgery (deroofing, wide excision, flap reconstruction) is indicated for chronic, tunnel-predominant HS. The European guidelines uniquely distinguish inactive, scar-based disease where surgery may be first-line, whereas UK and North American guidelines typically reserve surgery for post-medical failure. Notably, IV ertapenem appears only in European and North American protocols. Both UK and North American guidance emphasize antibiotic stewardship.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eComparison of Key Features Across UK, European, and North American HS Guidelines\u003c/b\u003e This table summarizes the current HS management pathways, including first-line antimicrobial therapy, escalation thresholds for systemic or biologic treatment, and timing of surgical referral. Data were compiled from the British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (2018), the European Dermatology Forum S1/S2-k guideline (2022), and the North American Hidradenitis Suppurativa Foundation/Canadian HS Foundation consensus (2019). All recommend a multimodal, stepwise strategy integrating antibiotics, biologics, surgery, and lifestyle modification while emphasizing antimicrobial stewardship.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFirst-line Therapy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEscalation Criteria\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNotes on Duration / Stewardship\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUK (BAD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTopical 1% clindamycin twice daily. Oral doxycycline 100 mg or lymecycline 408 mg daily for 12 weeks.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIf inadequate response \u0026rarr; clindamycin 300 mg\u0026thinsp;+\u0026thinsp;rifampin 300 mg BID for 10\u0026ndash;12 weeks, then consider retinoids/dapsone \u0026rarr; if lack of response, begin adalimumab 40 mg weekly \u0026rarr; surgical management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12-week assessment includes pain VAS, QoL, lesion count/number of flares in the last month\u003c/p\u003e \u003cp\u003eConsider antibiotic treatment break to reduce resistance\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEurope (EDF S1/S2‑k)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTetracycline 500 mg BID for 12 weeks. Consider adding topical clindamycin 1% BID for 12 weeks, oral clindamycin 300 mg BID for 12 weeks, resorcinol 15% peel BID, and Intralesional triamcinolone 10\u0026ndash;40 mg/ml\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIf inadequate response \u0026rarr; clindamycin 300 mg\u0026thinsp;+\u0026thinsp;rifampin 300 mg BID for 10\u0026ndash;12 weeks \u0026rarr; biologics (adalimumab, secukinumab, bimekizumab). Surgery for non-inflammatory/tunnel-dominant disease. In severe active HS, consider ertapenem 1 g IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGuidelines distinguish inflammatory vs. non-inflammatory disease state; uses IHS4 severity score\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNorth America (HSF/CHSF)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTetracyclines (doxycycline 100 mg daily/BID, minocycline 100 mg BID) for 12 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIf inadequate response \u0026rarr; clindamycin 300 mg BID\u0026thinsp;+\u0026thinsp;rifampin 300 mg BID for 8\u0026ndash;12 weeks \u0026rarr; moxifloxacin 400 mg daily\u0026thinsp;+\u0026thinsp;metronidazole 500 mg TID\u0026thinsp;+\u0026thinsp;rifampin 300 mg BID \u0026rarr; IV ertapenem 1 g as a 1-time rescue therapy for 6 weeks or as a bridge to surgery \u0026rarr; Escalate to biologics (adalimumab 40 mg every other week; infliximab; anakinra 100 mg daily, ustekinumab 45\u0026ndash;90 mg q12 weeks) \u0026rarr; surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAntibiotic benefit vs. resistance risk emphasized\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eOur findings suggest that the microbiome is not merely a bystander in HS pathogenesis but may actively shape treatment response and surgical outcomes. As international guidelines evolve, integrating microbiome-informed strategies such as biopsy-guided antibiotic selection and judicious use of prolonged antibiotic courses could enhance clinical outcomes while mitigating resistance risk. Future studies should evaluate whether microbiome-based risk stratification or preoperative microbial mapping improves postoperative healing, recurrence rates, and long-term disease control. Ultimately, aligning surgical decision-making with microbial ecology represents a promising avenue to personalize care in advanced HS.\u003c/p\u003e\n\u003ch3\u003eDrawbacks:\u003c/h3\u003e\n\u003cp\u003eOur study has important drawbacks that must be considered when interpreting the results. The high rate of recent antibiotic use (80%) may have biased the culture results by altering the skin microbiome prior to sampling. In several cases, preoperative IV antibiotics were administered prior to culture collection potentially leading to suppression of certain organisms, especially fastidious anaerobes and antibiotic-sensitive species. Additionally, microbiota vary widely between anatomical sites such as the axilla, groin, and gluteal clefts making it difficult to generalize the findings.\u003c/p\u003e \u003cp\u003eWhile culture can identify common aerobic and anaerobic pathogens, they lack the sensitivity and specificity of DNA-based methods such as 16S rRNA gene sequencing which can detect a broader and more detailed range of microorganisms\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. On the other hand, 16S rRNA gene sequencing is sensitive and specific, but its accuracy is largely dependent on method of collection. Samples obtained from deep surgical sites are much more clinically meaningful than those collected from superficial swabs.\u003c/p\u003e \u003cp\u003eAdditionally, the relatively small sample size of 49 patients obtained from the same institution, retrospective study design, the focus exclusively on stage III patients, and lack of a control group limits the generalizability of the findings. Overall, these drawbacks may have led to an underestimation of microbial diversity and identification of pathogens in HS lesions. Future studies should include larger, more diverse sample sizes with various Hurley staging, and utilize molecular-based techniques to more accurately describe pathogens. While this study highlights microbial associations, causality cannot be inferred.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eA definitive pathogenic role for bacteria has yet to be established for HS, though it has been proposed that disrupted innate immunity potentially triggered by microbial factors could play a significant role\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Our findings demonstrate the complex and site-dependent microbial ecology of HS lesions in severe disease. HS lesions harbor distinct microbiomes and are divergent from those without HS. The observed associations between anaerobic dominance, prior antibiotic use, T2DM, smoking, and age highlight key clinical factors that may influence microbial colonization. Tailored treatment approaches that consider site-specific microbiota and patient-specific risk factors may offer improved outcomes in the management of HS.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHidradenitis Suppurativa\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eT2DM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eType 2 Diabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBAD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBritish Association of Dermatologists\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEDF S1/S2-k\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEuropean Dermatology Forum S1/S2-k guideline\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHSF/CHSF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNorth American Hidradenitis Suppurativa Foundation/Canadian Hidradenitis Suppurativa Foundation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003e \u003cb\u003eEthics approval\u003c/b\u003e:\u003c/strong\u003e \u003cp\u003e This study was approved by the University of Texas Southwestern and Texas Health Resources Institutional Review Board (#: STU20250702). This study adhered to the Declaration of Helsinki.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003e \u003cb\u003eConsent to participate\u003c/b\u003e:\u003c/strong\u003e \u003cp\u003e The University of Texas Southwestern and Texas Health Resources Institutional Review Board approved a full HIPAA waiver for consent to participate in this study as this study comprised a retrospective chart review.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003e \u003cb\u003eConsent for publication\u003c/b\u003e:\u003c/strong\u003e \u003cp\u003eOur manuscript does not contain individual data or images that would compromise anonymity, so this is not applicable.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003e \u003cb\u003eCompeting interests\u003c/b\u003e:\u003c/h2\u003e \u003cp\u003eWS: The author has no relevant financial disclosures.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eNone.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eWS was a major contributor in writing the manuscript.SB analyzed and performed statistical analysis.ES analyzed and performed statistical analysis.MD was a major contributor in writing the manuscript.MC was a major contributor in writing the manuscript.NF was a major contributor in writing the manuscript.KG edited and provided infectious disease expertise.MP edited and provided surgical expertise.All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgements:\u003c/h2\u003e \u003cp\u003eNone.\u003c/p\u003e \u003cp\u003e \u003cb\u003eClinical trial number\u003c/b\u003e: Not applicable.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAlotaibi HM, Incidence. 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British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018. Br J Dermatol May. 2019;180(5):1009\u0026ndash;17. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/bjd.17537\u003c/span\u003e\u003cspan address=\"10.1111/bjd.17537\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZouboulis CC, Bechara FG, Benhadou F, et al. European S2k guidelines for hidradenitis suppurativa/acne inversa part 2: Treatment. J Eur Acad Dermatol Venereol May. 2025;39(5):899\u0026ndash;941. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/jdv.20472\u003c/span\u003e\u003cspan address=\"10.1111/jdv.20472\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlikhan A, Sayed C, Alavi A, et al. North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part I: Diagnosis, evaluation, and the use of complementary and procedural management. J Am Acad Dermatol Jul. 2019;81(1):76\u0026ndash;90. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jaad.2019.02.067\u003c/span\u003e\u003cspan address=\"10.1016/j.jaad.2019.02.067\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-microbiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"mcro","sideBox":"Learn more about [BMC Microbiology](http://bmcmicrobiol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/mcro","title":"BMC Microbiology","twitterHandle":"#bmcmicrobiology","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Hidradenitis Suppurativa, Microbiome, Hurley stage, Bacteria, Acne inversa, Infection","lastPublishedDoi":"10.21203/rs.3.rs-8252245/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8252245/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHidradenitis suppurativa (HS) is an inflammatory skin disease characterized by painful nodules, abscesses, and sinus tract formation. While dysbiosis of the skin microbiome has been implicated in HS pathogenesis, most studies focus on surface flora, leaving the microbial composition of deep tissue lesions poorly characterized, particularly in surgically managed Hurley stage III disease. This study investigates the subcutaneous microbiome of stage III HS requiring surgical intervention, with the goal of identifying microbial patterns and their associations with patient-specific clinical features.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA retrospective chart review of 49 patients undergoing surgical excision for HS was performed. Intraoperative subcutaneous tissue samples were cultured under aerobic and anaerobic conditions. Demographic, clinical, and treatment data were analyzed for associations with microbial findings.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003e \u003cem\u003ePrevotella\u003c/em\u003e species were significantly associated with type II diabetes (OR 16.00) and prior antibiotic use (OR 3.586). \u003cem\u003eCorynebacterium\u003c/em\u003e species were more frequently isolated in older patients and the perineal and chest regions. Gram-negative rods correlated with prior antibiotic exposure (OR 14.143), while gram-positive cocci were associated with smoking (OR 5.500). Microbial profiles varied significantly by anatomical site, suggesting location-specific colonization.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe subcutaneous microbiome in stage III HS remains poorly characterized due to the historical focus on surface lesions and non-surgical populations. Our findings highlight distinct microbial profiles within deep tissue that are influenced by comorbidities, antibiotic exposure, and anatomical sites. Plastic and reconstructive surgeons have a critical role in managing advanced HS and this study provides evidence for targeted perioperative antimicrobials to reduce postoperative complications and improve surgical outcomes.\u003c/p\u003e","manuscriptTitle":"Microbial Species in Deep Tissue Lesions of Stage III Hidradenitis Suppurativa: A Retrospective Observational Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-16 08:02:19","doi":"10.21203/rs.3.rs-8252245/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-18T05:32:02+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-17T09:56:52+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-16T20:32:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"334724794831335316362169674487459864315","date":"2025-12-16T20:17:36+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-16T13:01:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-15T12:23:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"251593346757920488542937377589869713592","date":"2025-12-15T07:58:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"7499079674091241735782258955258519548","date":"2025-12-13T14:18:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"103811099598242319950345417821542959483","date":"2025-12-13T09:33:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"140377167141609741385257790671747765582","date":"2025-12-13T09:09:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"175727321864724012878379140519293368880","date":"2025-12-13T09:05:56+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-11T21:36:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"236105155092909685427165602764885880500","date":"2025-12-11T21:11:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"123863286752621115597753024324323847040","date":"2025-12-11T13:42:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"315733854845667547096259847244398109793","date":"2025-12-11T09:02:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"334193889343062706301664166092760826326","date":"2025-12-11T08:46:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"54817702560852756613950299967273782153","date":"2025-12-11T08:11:15+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-11T08:04:43+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-11T08:03:34+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-10T03:37:45+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-10T03:25:10+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Microbiology","date":"2025-12-10T03:17:09+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-microbiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"mcro","sideBox":"Learn more about [BMC Microbiology](http://bmcmicrobiol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/mcro","title":"BMC Microbiology","twitterHandle":"#bmcmicrobiology","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c82428bd-ce32-4614-b756-a930972fa2be","owner":[],"postedDate":"December 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-01-26T16:09:31+00:00","versionOfRecord":{"articleIdentity":"rs-8252245","link":"https://doi.org/10.1186/s12866-026-04744-y","journal":{"identity":"bmc-microbiology","isVorOnly":false,"title":"BMC Microbiology"},"publishedOn":"2026-01-24 15:57:54","publishedOnDateReadable":"January 24th, 2026"},"versionCreatedAt":"2025-12-16 08:02:19","video":"","vorDoi":"10.1186/s12866-026-04744-y","vorDoiUrl":"https://doi.org/10.1186/s12866-026-04744-y","workflowStages":[]},"version":"v1","identity":"rs-8252245","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8252245","identity":"rs-8252245","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}