Extensively drug-resistant Alcaligenes faecalis infection

BMC Infect Dis. 2020 Nov 11;20(1):833. doi: 10.1186/s12879-020-05557-8.

Abstract

Background: Alcaligenes faecalis is usually causes opportunistic infections in humans. Alcaligenes faecalis infection is often difficult to treat due to its increased resistance to several antibiotics. The results from a clinical study of patients with Alcaligenes faecalis infection may help improve patients' clinical care.

Methods: We conducted a retrospective analysis of all patients presenting with Alcaligenes faecalis infection from January 2014 to December 2019. The medical records of all patients were reviewed for demographic information, clinical symptoms and signs, comorbidities, use of intravenous antibiotics within the past three months, bacterial culture, antibiotics sensitivity test, and clinical outcomes.

Results: Sixty-one cases of Alcaligenes faecalis infection were seen during the study period, including 25 cases of cystitis, nine cases of diabetic foot infection, eight cases of pneumonia, seven cases of acute pyelonephritis, three cases of bacteremia, and nine cases of infection at specific sites. Thirty-seven patients (60.7%) had a history of receiving intravenous antibiotics within three months of the diagnosis. Fifty-one (83.6%) cases were mixed with other bacterial infections. Extensively drug-resistant infections have been reported since 2018. The best sensitivity rate to Alcaligenes faecalis was 66.7% for three antibiotics (imipenem, meropenem, and ceftazidime) in 2019. Two antibiotics (ciprofloxacin and piperacillin/tazobactam) sensitivity rates to A. faecalis were less than 50%.

Conclusions: The most frequent Alcaligenes faecalis infection sites, in order, are the bloodstream, urinary tract, skin and soft tissue, and middle ear. The susceptibility rate of Alcaligenes faecalis to commonly used antibiotics is decreasing. Extensively drug-resistant Alcaligenes faecalis infections have emerged.

Keywords: Alcaligenes faecalis infection; Extensively drug-resistant.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcaligenes faecalis / drug effects*
  • Alcaligenes faecalis / genetics
  • Alcaligenes faecalis / isolation & purification
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • Ceftazidime / therapeutic use*
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Female
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / microbiology
  • Humans
  • Imipenem / therapeutic use*
  • Male
  • Meropenem / therapeutic use*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Imipenem
  • Ceftazidime
  • Meropenem