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

Abstract

Introduction: Neonatal Citrobacter infection is either acquired horizontally or vertically as a nosocomial infection. The source of nosocomial Citrobacter is either hands of medical staff or the innate objects. Objective: The aim of this study was to study nosocomial Citrobacter infection in neonates admitted in Neonatal Intensive Care Unit (NICU) and trace the source of infection. Methods: The study was conducted in NICU in a hospital in Kathmandu, Nepal during a period of January to March 2010. Specimens were collected from neonates, hands of medical staff and innate objects and were processed using a standard microbiological method. Results: The prevalence of neonatal nosocomial infection was 32.6% (29/89). Citrobacter spp. was isolated in 11 neonates admitted in NICU with the prevalence rate of 37.9% (11/29) among other pathogens. Umbilical cord infection was most common (n=8). These isolates were grouped into five antibiotypes (I, 4; II, 3; III, 2; IV, I; V, 1). All of these isolates were multi-drug resistant showing susceptibility towards quinolones. The isolate of Citrobacter spp. was also recovered from a nasal prong which was grouped with 4 other clinical strains. Conclusion: Multi-drug resistant nosocomial Citrobacter spp. was inflicting neonates in NICU and the source of this pathogen was traced to nasal prong. Nosocomial Citrobacter infection is a common problem of neonates in NICU. This will lead to increase neonatal mortality if infection prevention and control practices are not initiated.

High load of multi-drug resistant nosocomial neonatal pathogens carried by cockroaches in a neonatal intensive care unit at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia

“…This finding is important as it points to one of the significant vectors for transmission of this emerging neonatal pathogen. The fact that the isolates showed a multi-drug resistant pattern is in agreement with a study by Khadka et al [32]. In that study, the sensitivity of Citrobacter species to floroquinolones was shown to be higher, which is in agreement with our findings of good sensitivity for Norfloxacin and Ciprofloxacin.…”

Molecular phylogenetic profiling of gut‐associated bacteria in larvae and adults of flesh flies

“…Citrobacter spp. were implicated as causes of neonatal nosocomial infections in a randomized population‐based study in Nepal (Khadka et al ., ). Recently, a study conducted in a neonatal intensive care unit in Ethiopia showed Citrobacter to be the second most common isolate from cockroaches, thereby suggesting its relevance as an emerging multidrug‐resistant neonatal pathogen (Tilahun et al ., ).…”

Molecular Characterization of Citrobacter freundii Isolated from Neonates in Neonatal Intensive Care Unit of Nepal

“…infection is prevalent in Nepal, it is unfortunate that no systematic molecular studies have been conducted, however the isolation of Citrobacter spp. have been described 2,8,9 . In this study, we have shown the emergence of C. freundii carrying class 1 integron element and bla CTX-M and bla TEM-1 ESBL genes for the fi rst time in Nepal.…”

“…are most common 1 . Citrobacter nosocomial infection in neonates is a cause of substantial rise in morbidity and mortality of neonates in the hospital in Nepal and globally 1,2,3,4 . The poor infection prevention and control practices have been a major determining factor for the spread of this nosocomial pathogen 1 .…”

“…We have recently described the isolation of Citrobacter spp. from various clinical and non-clinical specimens originated from the neonates admitted in Neonatal Intensive Care Unit (NICU) 2 . In light with this fact, here we compared the genotypes of C. freundii isolated from the clinical and non-clinical sources and…”