Infectious Disease Compendium

Citrobacter

Microbiology

A gram-negative rod includes C. amalonaticus, C. diversus, C. freundii, C. koseri.

Epidemiologic Risks

Bowel organism. Also found in water and soil.

Syndromes

Nosocomial bacteremia, pneumonia and UTI.

There was a food-borne outbreak at a hospital of VIM carbapenemase-expressing Citrobacter freundii traced to machines that mixed pudding and salad. They think the machine initially got colonized from carrots (PubMed).

Treatment

Aminoglycosides, carbapenems, quinolones, aztreonam, cefepime. It depends on the strain and where acquired. Hospital-acquired tend to be more resistant.

Notes

Beta-lactamase inhibitor combinations do not work well in vivo even if sensitive in vitro.

It can accumulate uranium; perhaps with the N. Korea kerfuffle, I should put it in my hot tub.

Curious Cases

Relevant links to my Medscape blog

When is a knee infection like a lemon?

Horsing Around

Best Morning Ever

Last Update: 07/03/18.