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CASE REPORT article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1502337

Identification and Treatment of Enterococcus avium-Induced Diabetic Foot Ulcer: A Case Report and Microbiome Analysis

Provisionally accepted
Yuanling Jin Yuanling Jin 1Tao Zhu Tao Zhu 1Xiao Cai Xiao Cai 1Zheng Fu Zheng Fu 2QiangLong Pan QiangLong Pan 1HaiXia Tu HaiXia Tu 1Yan Li Yan Li 1*ShouXing Wang ShouXing Wang 1*
  • 1 Department of Clinical Laboratory, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
  • 2 Sir Run Run Hospital, Nanjing Medical University, Nanjing, Liaoning Province, China

The final, formatted version of the article will be published soon.

    Abstract Diabetic foot ulcer (DFU) is a severe complication of diabetes. Due to conservative or delayed treatment, the majority of DFU patients frequently miss the optimal treatment window, thereby leading to amputation. Despite being a rare pathogen with low virulence, Enterococcus avium (E. avium) exhibits some antibiotic resistance and can be fatal for immunocompromised patients. This report describes a DFU case, caused by E. avium infection due to exposure to poultry. Wound microbiota was dynamically monitored using bacterial culture followed by 16S rRNA gene sequencing throughout the illness. Combination of antibiotics was administered to control the secondary infection. Case Report A 56-year-old man presented with a two-week history of redness, swelling, heat, pain, and pus discharge from a ruptured wound on his left heel. The patient was diagnosed with osteomyelitis and a Wagner grade 3 diabetic foot ulcer infection, complicated by the soft tissue infection in the left heel. Strain identification and antibiotic susceptibility tests were immediately performed after admission. The patient underwent three debridement procedures at the DFU site. However, we observed recurrent bacterial infections, based on the clinical progression. Second-generation sequencing detected various pathogens. After targeted treatment with Vacuum sealing drainage (VSD) combined with antibiotic bone cement, the patient's condition stabilised. A skin graft was subsequently performed. Antibiotics were used to control the infection and blood glucose level was controlled throughout the treatment. Conclusion Thus, this report provides a comprehensive description of a DFU case, caused by E. avium. Antibiotics and surgical measures should be adjusted according to the pathogens responsible for wound infections in DFU patients. It is important to reduce the mortality and prevent irreversible amputations.

    Keywords: Diabetic foot ulcers, E. avium, Microbiome analysis, Second-generation sequencing technology, Minimal inhibit concentration

    Received: 26 Sep 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Jin, Zhu, Cai, Fu, Pan, Tu, Li and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yan Li, Department of Clinical Laboratory, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
    ShouXing Wang, Department of Clinical Laboratory, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China

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