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?
Last Update: 07/03/18.