Antimicrobial susceptibility pattern of urinary tract isolates of citrobacter species in a tertiary care hospital
Introduction: The genus Citrobacter is a distinct group of aerobic Gram-negative bacilli from the Enterobacteriaceae family. It is an opportunistic pathogen that can cause diarrhea, septicemia, meningitis, urinary tract and respiratory system infection. Its isolation in the hospital settings is increasing. It is a present challenge to the clinical microbiologist because of their increased occurrence in nosocomial infection.
Objectives: The current study was done to find out the prevalence and antibiotic susceptibility pattern of Citrobacter species from urinary tract isolates.
Materials and Methods: Urine samples received from January 2013 to December 2013 were considered. A total of 9186 urine samples were considered, out of which 6381 were sterile and 2805 plates had growth.65(2.312%)of the growth plates had Citrobacter species growth. Citrobacter species were identified by conventional biochemical method. Antibiotic sensitivity test was performed by Kirby-Bauer Disc diffusion method.
Results: Out of 65 patients female: male ratio was 17:15.5.The age groups were 0-9years; 8 patients(12.3%),10-19years;3 patients(4.615%),20-29years;11patients (16.9%),30-39years;6patients(9.28%),40-49years;12 patients(18.46%),50-59years;5patients(7.69%),?60years;20 patients(30.76%).The effective agent against Citrobacter species was found to be Imipenem (90.76%) then Cefoperazone-Sulbactum (89.23%) followed by Piperacillin-Tazobactam and Amikacin (87.69%).6 Multidrug resistant strains and 8 were ESBL producers.
Conclusion: From the study it was seen that multidrug resistant strains are emerging. Proper surveillance in the antimicrobial sensitivity of Citrobacter was required. The age group 60 and above was found in majority to have culture positive Citrobacter spp. Depending on antibiotic sensitivity pattern of Citrobacter isolates, the antibiotics should be used. Proper infection control measures should be taken to prevent the spread of the pathogen.
Keywords: Antibiotic Susceptibility, Citrobacter Spp, Multi-Drug Resistant Bacteria, Urinary Tract Infections.
Basavaraj C. Metri, P. Jyothi, Basavaraj V. Peerapur. Antibiotic resistance in Citrobacter spp. isolated from urinary tract infection. Urology Annals Oct - Dec 2013 Vol 5 Issue 4
Barton LL,Walentik CW;Citrobacter diversus urinary tract infection,Am J Dis Child.1982;136;467-468.
Najar M.S, Saldanha C.L., and Banday K.A. Approach to urinary tract infections. Indian J Nephrol. Oct 2009; 19(4): 129–139. http://dx.doi.org/10.4103/0971-4065.59333.
Metri BC, Jyothi P, Peerapur BV. Anti-microbial resistance profile of Citrobacter species in a tertiary care hospital of southern India. Indian J Med Sci 2011; 65:429-35 http://dx.doi.org/10.4103/0019-5359.109259.
Lipsky BA,Hook EW, 3rd Smith AA, Plorde JJ.Citrobacter infection in humans; experience at Seattle veterans Administration Medical Centre and review of literature. Rev Infect Dis.1980; 2; 746 – 760. http://dx.doi.org/10.1093/clinids/2.5.746.
Murray PR, Holmes B,Auken HM. Citrobacter, Enterobacter, Klebsiella, Plesiomonas, Serratia and other members of the enterobacteriaceae In;Borriello SP,Murray PR, Funke G, editors. Topley and Wilson's Microbiology and Microbial infections. 10TH ed. London; Hodder Arnold;2005;pp 1474- 506
Wayne, PA, CLSI document; 2005, Clinical and Laboratory standards Institute Performance standards for antimicrobial susceptibility testing.Fifteenth informational supplement; pp M 100 – S 15.
MY Tula and O.Lyoha; Distribution and Antibiotic susceptibility pattern of bacterial pathogens causing urinary tract infection in Mubi general hospital-Yola, Nigeria; British journal of Medicine and Medical research; 2014; 4(19); 3591- 3602
Samonis G,Anaissie E,Elting L,Bodey GP; Review of Citrobacter bacteremia in cancer patients over a sixteen year period.Eur J Clin Microbiol Infect Dis; 1991;10;479 – 485) http://dx.doi.org/10.1007/BF01963933.
Rong Zhang, Lijiang Yang, Jia Chang Cai, Hong Wei Zhou and Gong-Xiang Chen. High-level carbapenem resistance in a Citrobacter freundii clinical isolate is due to a combination of KPC-2 production and decreased porin expression. Journal of Medical Microbiology (2008), 57, 332–337 http://dx.doi.org/10.1099/jmm.0.47576-0.
Shobha K.L,Gowrish Rao S, Sugandhi Rao, Sreeja C.K ; Prevalance of Extended spectrum Beta-Lactamase in Urinary isolates of Escherichia coli,Klebsiella and Citrobacter species and their antimicrobial susceptibility pattern in a tertiary care hospital;Indian Journal for the practicing Doctor; vol 3,No 6 (2007 –01 – 2007 -02).
Buddha Bahadur Basnet, Kumananda Acharya, Santosh Khanal, Rajan Kumar Dahal;Trends in Antimicrobial resistance among common isolates of urinary tract infection in tertiary care hospital of Nepal; International research journal of pharmaceutical and applied sciences; 2013;3(4); 22-26.
Rabindranath Misra, Nageswari Gundham, Moumita Sardar,Mahadev Ujagare,Kalpana Ungadi,Chanda Vyawahare,Indranath Roy and Savitha Jadav;High prevalence of multidrug resistant citrobacter spp from tertiary care hospital,Pimpri, Pune,India;Journal of Pharmaceutical and biomedical sciences;2012;Dec 25(25),158 – 163.
Gandam Pavani; Drug susceptibility pattern of Klebseilla and citrobacter infections in India; Jounal of Microbiology and biotechnology Research; 2012; 2(4); 619- 620.
K Ashish,S Nachatar,A Aruna;Journal of Clinical and Diagnostic research;2012;6(4);642-644.