Diabetic Foot Ulcer with Alcaligenes faecalis Infection

Abstract

<b><i>Background:</i></b> Diabetic foot ulcers are an increasingly common complex problem and are associated with a very considerable health care burden. Diabetic foot ulcer with <i>Alcaligenes faecalis</i> infection is rarely reported in the literature. We report a case series of diabetic foot ulcer with <i>A. faecalis</i> infection treated at our facility. <b><i>Methods:</i></b> We conducted a retrospective analysis of all patients with diabetic foot ulcer with <i>A. faecalis</i> infection seen from January 2014 to April 2019. We analyzed the clinical characteristics, ulcer lesion classification, comorbidities, prior intravenous antibiotic use within 3 months, wound culture, antibiotics sensitivity test, and clinical outcomes of these patients. <b><i>Results:</i></b> Eight cases of diabetic foot ulcer with <i>A. faecalis</i> infection were seen in 5 males and 3 females. Mean age was 54.6 years. All patients had other comorbidities, and all ulcer lesions were of chronic duration (&#x3e;14 days). All wound cultures revealed polymicrobial infection, with 2 cases of diabetic foot with extensive drug-resistant <i>A. faecalis</i> infection found in 2019. All patients needed intravenous antibiotic therapy and surgical interventions for the chronic ulcer lesion. The wound failed to heal in 3 patients. <b><i>Conclusions:</i></b> All diabetic foot ulcers with <i>A. faecalis</i> infection were of chronic duration (&#x3e;14 days) and had polymicrobial infection. Extensive drug-resistant <i>A. faecalis</i> emerged in 2019. Definitive antibiotic therapy is necessary for all infected wounds and should be based on both the culture results and susceptibility data. All patients will need appropriate wound care, and most will need rapid surgical intervention for an optimal outcome.