<i>In vitro</i>susceptibility and resistance phenotypes in contemporary<i>Citrobacter</i>isolates in a University Hospital in Crete, Greece

Maraki, Sofia; Vardakas, Konstantinos Z.; Mavromanolaki, Viktoria-Eirini; Kyriakidou, Margarita; Spais, George S.; Kofteridis, Diamantis P.; Samonis, George; Falagas, Matthew E.

doi:10.1080/23744235.2017.1297896

Cited by 15 publications

(22 citation statements)

References 32 publications

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“…The global CNSC population was similarly diverse, but C. freundii was again the most prevalent species observed, which may be due to its higher rate of antibiotic resistance compared to other Citrobacter spp. (43, 44).…”

Section: Discussionmentioning

confidence: 99%

Clinical and genomic epidemiology of carbapenem-non-susceptibleCitrobacterspp. at a tertiary healthcare center over two decades

Babiker

Evans

Griffith

et al. 2020

Preprint

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22Carbapenem-non-susceptible Citrobacter spp. (CNSC) are increasingly recognized as healthcare-23 associated pathogens. Information regarding their clinical epidemiology, genetic diversity, and 24 mechanisms of carbapenem resistance is lacking. We examined microbiology records of adult 25 patients at the University of Pittsburgh Medical Center (UMPC) Presbyterian Hospital (PUH) from 26 2000-2018 for CNSC, as defined by ertapenem non-susceptibility. Over this timeframe, the 27 proportion of CNSC increased from 4% to 10% (P=0.03), as did carbapenem daily defined 28 doses/1000 patient days (6.52 to 34.5, R 2 =0.831, P<0.001), which correlated with the observed 29 increase in CNSC (lag=0 years, R 2 =0.660). Twenty CNSC isolates from 19 patients at PUH and 30 other UPMC hospitals were available for further analysis, including whole-genome short-read 31 sequencing and additional antimicrobial susceptibility testing. Of the 19 patients, nearly all 32 acquired CNSC in the healthcare setting and over half had polymicrobial cultures containing at 33 least one other organism. Among the 20 CNSC isolates, C. freundii was the predominant species 34 identified (60%). CNSC genomes were compared with genomes of carbapenem-susceptible 35Citrobacter spp. from UPMC, and with other publicly available CNSC genomes. Isolates encoding 36 carbapenemases (blaKPC-2, blaKPC-3, and blaNDM-1) were also long-read sequenced, and their 37 carbapenemase-encoding plasmid sequences were compared with one another and with publicly 38 available sequences. Phylogenetic analysis of 102 UPMC Citrobacter spp. genomes showed that 39 CNSC from our setting did not cluster together. Similarly, a global phylogeny of 64 CNSC 40 genomes showed a diverse population structure. Our findings suggest that both local and global 41 CNSC populations are genetically diverse, and that CNSC harbor carbapenemase-encoding 42 plasmids found in other Enterobacterales. 43 isolated from a specimen collected within 72 hours following hospital admission; isolates collected 91 after 72 hours were considered healthcare-associated (22). Clinical characteristics and outcomes 92 of patients with CNSC isolates that underwent further characterization were collected through 93 retrospective chart review. The primary clinical outcome was in-hospital mortality and/or transfer 94 to hospice. 95 96 CNSC isolate characterization 97 Initial species assignment was performed using standard clinical microbiology laboratory 98 methods, and was confirmed or modified after whole-genome sequencing. Carbapenem non-99 susceptibility was initially determined by standard clinical microbiology laboratory methods, and 100 was confirmed by the Kirby-Bauer disk diffusion method as per the 2017 Clinical Laboratory 101 Standards Institute (CLSI) interpretative criteria (20). Susceptibility to additional agents was 102 determined by the broth microdilution method (20). Presence of carbapenemase enzyme activity 103 was assessed by modified carbapenem inactivation (mCIM) test (23). 104 105 Genome sequencing and a...

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Section: Discussionmentioning

confidence: 99%

Clinical and genomic epidemiology of carbapenem-non-susceptibleCitrobacterspp. at a tertiary healthcare center over two decades

Babiker

Evans

Griffith

et al. 2020

Preprint

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“…(7) Santos ve ark. (12) Citrobacter freundii'nin çoklu ilaç direnci ve bu direnç iletişiminin moleküler mekanizması incelenmiş olup VITEK 2 ile tanımlanan C.freundii suşlarının 16 S rDNA sekansları ile doğrulama testleri yapılmıştır.…”

Section: Discussionunclassified

“…için antibiyotik duyarlılıklarıyla ilgili çok fazla yayın olmamakla beraber sadece bu verilere bakı-larak bile etkenlerin antibiyotik duyarlılık-ları coğrafi olarak farklılıklar gösterdiği görülmektedir. Çalışmamızda ve yapılan diğer çalışmalarda (5,7,8,10,14) Citrobacter'lere karşı en etkili antibiyotiklerin aminoglikozid ve karbapenemler grubu antibiyotikler olduğu belirlenmiştir.…”

Section: Discussionunclassified

Antibiotic Resistance of Citrobacter Strains Isolated Between 2015 and 2017

Atmaca¹,

Özekinci²,

Yakut³

et al. 2017

Ankem Derg

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ÖZET Anahtar sözcükler: antibiyotik direnci, Citrobacter SUMMARY Antibiotic Resistance of Citrobacter Strains Isolated Between 2015 and 2017 Citrobacter is a group of bacteria that causes hospital-acquired infections mostly in newborn and immunosuppressed patients. The aim of this study to antibiotic resistance of Citrobacter strains isolated from clinical specimens between April 2015 and March 2017 as infection agents. 37 C.freundii and 35 other Citrobacter strains, totally 72 Citrobacter strains were isolated. When MIC values of isolates were taken into consideration altogether, rate of resistance were as follows : 99 % to ampicillin, 25 % to ceftazidime, 22 % to trimethoprim/sulfamethoxazole and aztreonam, 15 % to ciprofloxacin, 11 % to piperasillin/ tazobactam and gentamisin, 10 % to cefepime, % 1 to meropenem and % 0 to amikacin, amikacin and meropenem are determined

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“…Yapılmış olan çalışmalarda (2,3,5,6,7,8,13) ve bizim çalışmamızda da Citrobacter türlerinden en fazla C.freundii izole edilmesine rağmen Hindistan'da yapılan çalışmada (11) C.koseri ilk sırayı almıştır. Bu da Citrobacter türlerinin dağılımlarında coğrafi olarak farklılık olabileceğini göstermektedir.…”

Section: Gereç Ve Yöntemunclassified

“…Bu çalışmada, Ordu Üniversitesi Eğitim ve Araştırma Hastanesi Mikrobiyoloji Laboratuvarı'nda çeşitli klinik örneklerden izole edilen Citrobacter izolatlarının, tür düzeyinde tayini ve çeşitli antimikrobiyal maddelere olan direnç durumlarının saptanması ile bu verilere katkı sağlanması amaçlanmıştır. (8) . Diğer bir çalışmada ise Samonis ve ark.…”

Section: Introductionunclassified

Evaluation of Antibiotic Resistance of Citrobacter Strains Isolated from Various Clinical Samples in a University Hospital Between 2014-2018

Calgin¹,

Çetinkol²

2019

Ankem Derg

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ÖZ İnsan gastrointestinal sistemini kolonize edebilen Citrobacter suşları, aynı zamanda riskli popülasyonlarda ciddi enfeksiyonlara da neden olabilmektedir. Klinik örneklerde tespit edildiklerinde duyarlılıklarının belirlenmesi, doğru tedavinin uygulanarak direnç gelişiminin önlenmesi için gereklidir. Bu çalışmada Mart 2014 ile Haziran 2018 tarihleri arasında Ordu Üniversitesi Eğitim ve Araştırma Hastanesi mikrobiyoloji laboratuvarına poliklinik ve servislerden gönderilen çeşitli klinik örneklerden elde edilmiş olan Citrobacter izolatlarının antibiyogram sonuçlarının retrospektif olarak değerlendirilmesi amaçlanmıştır. İncelenen 116 Citrobacter suşunun 67'si Citrobacter freundii, 33'ü Citrobacter koseri ve 16'sı diğer Citrobacter türleri olarak tanımlanmıştır (yedi Citrobacter youngae, altı Citrobacter braakii, iki Citrobacter amalonaticus, bir Citrobacter farmeri). Bu suşlar en fazla idrar örneklerinden izole edilmiş olup antimikrobiyal direnç oranları sırasıyla aşağıdaki şekilde saptanmıştır: amikasin % 3, gentamisin % 7, meropenem % 10, trimetoprim/ sülfametoksazol % 13, imipenem % 14, siprofloksasin % 15, piperasilin/tazobaktam % 17, sefepim % 20 ve seftazidim % 28 olarak saptanmıştır. Citrobacter suşları ülkemizde hala birçok antibiyotiğe duyarlı olarak tespit edilmektedir. Çalışmamızda amikasin ve gentamisinin Citrobacter infeksiyonları için iyi bir tedavi alternatifi olduğu sonucuna varılmıştır. ABSTRACTCitrobacter strains are capable of colonizing in the human gastrointestinal tract, and can also cause severe infections in populations with risk factors. When detected in clinical specimens, the identification of the sensitivity is necessary to prevent the development of resistance by the initiation of adequate treatment. This study aimed to evaluate the antibiogram results of Citrobacter isolates that were obtained from various clinical samples that were collected from outpatient clinics and services and examined in the microbiology laboratory A total of 116 Citrobacter strains were examined, 67 were identified as Citrobacter freundii, 33 were Citrobacter koseri, and 16 were identified as other Citrobacter species (seven Citrobacter youngae, six Citrobacter braakii, two Citrobacter amalonaticus, one Citrobacter farmeri). The strains were mostly isolated from urine samples, and their antimicrobial resistance rates were as follows, respectively: amikacin 3 %, gentamicin 7 %, meropenem 10 %, trimethoprim/ sulphamethoxazole 13 %, imipenem 14 %, ciprofloxacin 15 %, piperacillin/tazobactam 17 %, cefepime 20 %, and ceftazidime 28 %. Citrobacter strains are still susceptible to various antibiotics in our country. It has been concluded that amikacin and gentamicin are good treatment alternatives for Citrobacter infections.

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In vitrosusceptibility and resistance phenotypes in contemporaryCitrobacterisolates in a University Hospital in Crete, Greece

Abstract: Although Citrobacter species in general were susceptible, antibiotic susceptibility testing is required for the detection of resistant isolates.

Cited by 15 publications

References 32 publications

Clinical and genomic epidemiology of carbapenem-non-susceptibleCitrobacterspp. at a tertiary healthcare center over two decades

Clinical and genomic epidemiology of carbapenem-non-susceptibleCitrobacterspp. at a tertiary healthcare center over two decades

Antibiotic Resistance of Citrobacter Strains Isolated Between 2015 and 2017

Evaluation of Antibiotic Resistance of Citrobacter Strains Isolated from Various Clinical Samples in a University Hospital Between 2014-2018

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