Clinical Significance of Citrobacter Isolates

Abstract

Little is know about the clinical significance of isolating Citrobacter in the clinical laboratory. During a one-year period, 116 Citrobacter isolates were obtained from 77 patients with 83 suspected infectious episodes. The majority of the suspected infectious episodes involved the urinary tract (45%) or respiratory tract (41%). Citrobacter diversus was associated with 42% of the episodes, Citrobacter freundii with 29%, and Citrobacter species with 29%. In 42% of the suspected infectious episodes, the presence of Citrobacter was considered clinically significant; in the others, the significance of the Citrobacter isolates was indeterminate or considered to be commensal. Two thirds of the significant infections were hospital-acquired. Most patients (73%) from whom Citrobacter was cultured had underlying diseases or factors predisposing to infection. These data suggest that Citrobacter is a cause of significant opportunistic nosocomial infection in the hospital.

Epidemiological Risk Factors for Isolation of Ceftriaxone-Resistant versus -Susceptible Citrobacter freundii in Hospitalized Patients

“…It is known that C. freundii isolation has been particularly seen in patients with significant comorbidities (23,30,41).…”

“…They have also been associated with intra-abdominal infections, meningitis, and hospital-acquired bacteremias (1,5,7,9,10,16,23,30,31,41). Among C. freundii isolates, resistance to broad-spectrum cephalosporins (ceftriaxone and ceftazidime), piperacillin, and piperacillintazobactam has been reported to be between 39.1 and 47.8% and may be increasing (4,36,39,40,44).…”

Nosocomial <i>Citrobacter</i> Infection in Neonatal Intensive Care Unit in a Hospital of Nepal

“…In most occasions these Citrobacter spp. are of low virulence and do not cause disease but they can be a source to multiple infections, like respiratory tract, urinary tract, intra-peritoneal, wound, sepsis, meningitis, and brain abscess 2 . This pathogen infl icted neonates in health care settings in 1978 and since then this has emerged as a successful nosocomial pathogen of neonates [1][2][3] .…”

In vitro susceptibility of Citrobacter species to various antimicrobial agents

“…Differences in susceptibility between C. freundii and C. diversus, especially for penicillins and cephalosporins, have been reported previously (3,9,12). Both species have been found to be susceptible to aminoglycosides and imipenem and most susceptible to the quinolones (1, 3, 4, 7, 8, 10, 13, 16).…”