Isolation of Yersinia enterocolitica and alpha-hemolytic Streptococcus from a diabetic foot ulcer - a case report

Document Type : Case Report

Authors
Alireza Firouzjahi 1
Sara Ghofrani Tabari 2
Samaneh Rouhi 3
Zahra Ahmadnia 4
Mohammad Ranaee 5
Mehran Shokri 6
Maryam Babajanian 7
1 Associate Professor, Clinical Research Development Unit, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
2 BS, Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
3 PhD, Clinical Research Development Unit, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
4 PhD Student, Clinical Research Development Unit, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
5 Associate Professor, Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
6 Assistant Professor, Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Iran.
7 BS, Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Iran.
10.22034/pjms.2025.2050438.1187
Abstract
Introduction:
Various bacteria are the causative agents of diabetic foot ulcers. Proper and prompt treatment of diabetic foot ulcers is essential, especially with rare and dangerous bacteria. In this case report, a patient with a diabetic foot ulcer infected with Yersinia enterocolitica and alpha-hemolytic Streptococcus has been studied.
Case Personation:
The patient was a 55-year-old woman with a diabetic foot ulcer. The result of the wound culture-confirmed Yersinia enterocolitica and alpha-hemolytic Streptococcus. The patient was treated with antibiotics vancomycin, imipenem, and ceftriaxone, and finally, the patient was discharged with recovery and good condition.
Conclusion:
Yersinia enterocolitica and alpha-hemolytic Streptococcus were isolated from the foot ulcer of a diabetic patient. After treatment with appropriate antibiotics, the patient was discharged. Therefore, regular blood sugar control, rapid diagnosis, and treatment of patients with diabetic ulcers are essential. The immune system of these patients is very weak, so periodic check-ups are recommended to prevent and control ulcers.
Keywords
Yersinia enterocolitica
Alpha-hemolytic Streptococcus
Diabetic
Foot ulcer
  1. Krogstad P, Mendelman PM, Miller VL, Clausen C, Abbott S, Weagant S, et al. Clinical and microbiologic characteristics of cutaneous infection with Yersinia enterocolitica. J Infect Dis 1992;165(4):740-3.

2. Guillier L, Fravalo P, Leclercq A, Thebault A, Kooh P, Cadavez V, et al. Risk factors for sporadic Yersinia enterocolitica infections: a systematic review and meta-analysis. Microbial Risk Analysis 2021;17 (2021):100141.

3. Ikryannikova LN, Lapin KN, Malakhova MV, Filimonova AV, Ilina EN, Dubovickaya VA, et al. Misidentification of alpha-hemolytic streptococci by routine tests in clinical practice.  Infect Genet Evol 2011;11(7):1709-15.

4. Mardani M, Mohammadshahi J, Teimourpour R. Prosthetic knee joint infection caused by α-hemolytic Streptococcus species: a case report. J Med Case Rep 2023;17(1):339.

5. Ambrosch A, Haefner S, Jude E, Lobmann R. Diabetic foot infections: microbiological aspects, current and future antibiotic therapy focusing on methicillin‐resistant Staphylococcus aureus. Wound J 2011;8(6):567-577.

  1. Khalooei A, Mahmoodi Meymand M. Frequency of diabetes foot ulcer and related factors among adult diabetic patients in the diabetes center of Kerman, Iran. Shiraz E-Med J 2020;21(1):e90082. 
  2. Forbes BA. Sahm DF, Weissfeld AS. Bailey and Scott's diagnostic microbiology. 12nd ed. New York, The United States of America: Elsevier; 2007.p: 258-472.
  3. Clinical and laboratory standards institute. M100, Performance standards for antimicrobial susceptibility testing. 28nd ed. Wayne, The United States of America: Clinical and Laboratory Standards Institute; 2018. p:30-80.
  4. Macdonald KE, Boeckh S, Stacey HJ, Jones JD. The microbiology of diabetic foot infections: a meta-analysis. BMC Infect Dis 2021;21 (2021): 770.
  5. Winski R, Xu J, Chan A, Wattengel BA, Puckett A, Huntsman K, et al. Microbiology of diabetic foot infections in US veterans. Clin Diabetes 2025:cd240086.
  6. Rezazadeh M, Hajian F, Radmanesh E, Maghsoudi F, Hazbenejad A, Mobarak S. Investigation of the most common bacterial strains in diabetic foot ulcer patients. Avicenna J Clin Microbiol Infect 2023; 10(2):70-74.
  7. Darwis I, Hidayat H, Wisnu GNPP, Mentari S. Bacteriological profile and antibiotic susceptibility pattern of diabetic foot infections in a tertiary care hospital in Lampung, Indonesia. Malays J Med Sci 2021;28(5):42–53.
  8. DiCaprio KDO, Abulawi A, Carlyn C, Ashley C. S3509 A case of chronic infection with Yersinia enterocolitica misdiagnosed as irritable bowel syndrome: a case report. Am J Gastroenterol 2024; 119(10S): p S2329.
  9. Persaud R, Sukhraj K, Ansari A, Ali R. The bacterial flora of wounds suffered by diabetic patients in Guyana. Int J Innov Res Sci Eng Technol 2015;4(1):18982-18987.
  10. Thomsen RW, Riis AH, Kjeldsen S, Schønheyder HC. Impact of diabetes and poor glycaemic control on risk of bacteraemia with haemolytic streptococci groups A, B, and G. J Infect 2011;63(1):8-16.