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Displayed a rather low diversity and was composed basically of phylotypes known as PAOs, such as the “ Candidatus Accumulibacter”-like phylotype, members of the genus Pseudomonas, and the Tetrasphaera-related actinobacteria. For this update we searched the following databases to July 2012: the Cochrane Skin Group Specialised Register, medex insurance massachusetts CENTRAL in The Cochrane Library, MEDLINE (from 1946), EMBASE (from 1974), and CINAHL (from 1981).