Multi-drug Resistant Citrobacter freundii Isolates in a Burn Hospital in Northeast of Iran: A Single-Center Cross-sectional Study

Bazgir, Zahra Norouzi; Mirzaei, Bahman; Haghshenas, Mohammad Reza; Goli, Hamid Reza; Shafaie, Ebrahim

doi:10.32598/rmm.8.2.893.1

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…Plesiomonas shigelloides had significantly correlation with ARGs belonging to beta-lactam, chloramphenicol, multidrug resistance, etc., the same as Bacteroides fragilis , Escherichia-Shigella , Citrobacter , and Aeromonas . These were consistent with previous studies ( Ekundayo and Okoh, 2020 ; Norouzi Bazgir et al, 2020 ; Zhu et al, 2020 ; Li et al, 2021 ; Hassoubah, 2023 ). For instance, Ekundayo and Okoh (2020) have reported that Plesiomonas shigelloides in freshwater showed resistance to antibiotics and part of them had multi-resistance.…”

Section: Discussionsupporting

confidence: 94%

Seasonal distribution of human-to-human pathogens in airborne PM2.5 and their potential high-risk ARGs

Zuo,

Pan,

Huang

et al. 2024

Front. Microbiol.

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Airborne microorganisms, an emerging global health threat, have attracted extensive studies. However, few attentions have been paid to the seasonal distribution of airborne pathogens, in particular their associations with antibiotic resistance genes (ARGs). To this end, two-week daily PM2.5 samples were consecutively collected from Nanchang in four seasons, and the human-to-human pathogens were screened based on high-throughput sequencing. The results showed that there were 20 pathogenic taxa in PM2.5 in Nanchang, and the highest relative abundance of pathogens was observed in winter (5.84%), followed by summer (3.51%), autumn (2.66%), and spring (1.80%). Although more than half of pathogenic taxa were shared by the four seasons, the analysis of similarities showed that pathogenic community was shaped by season (r = 0.16, p < 0.01). Co-occurrence network analysis disclosed significant interactions among pathogens in each season. Moreover, some dominant pathogens such as Plesiomonas shigelloides, Bacteroides fragilis, and Escherichia-Shigella were hub pathogens. In addition, PICRUSt2 predicted that there were 35 high-risk ARG subtypes in PM2.5, and the pathogens had strongly positive correlations with these ARGs. Even some pathogens like Plesiomonas shigelloides, Bacteroides fragilis, Aeromonas, Citrobacter, may be multi-drug resistant pathogens, including beta-lactam, aminoglycosides, chloramphenicol and multi-drug resistances, etc. Both air pollutants and meteorological conditions contributed to the seasonal variation of airborne pathogenic bacteria (r = 0.15, p < 0.01), especially CO, O3, PM2.5, temperature and relative humidity. This study furthers our understanding of airborne pathogens and highlights their associations with ARGs.

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Section: Discussionsupporting

confidence: 94%

Seasonal distribution of human-to-human pathogens in airborne PM2.5 and their potential high-risk ARGs

Zuo,

Pan,

Huang

et al. 2024

Front. Microbiol.

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Epidemiology of Citrobacter spp. infections among hospitalized patients: a systematic review and meta-analysis

Fonton,

Hassoun-Kheir,

Harbarth

2024

BMC Infect Dis

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Background Infections due to Citrobacter species are increasingly observed in hospitalized patients and are often multidrug-resistant. Yet, the magnitude and burden of Citrobacter spp. resistance in the hospital setting have not been reported. We aimed to evaluate the epidemiology of Citrobacter spp. infections among hospitalized patients, their main resistance patterns and Citrobacter spp. involvement in hospital outbreaks. Methods We conducted a systematic review and meta-analysis of published literature (PROSPERO registration Jan-2023, CRD42023390084). We searched Embase, Medline and grey literature for studies on hospitalized patients diagnosed with Citrobacter spp. infections, and nosocomial outbreaks due to Citrobacter spp. published during the years 2000–2022. We included observational, interventional, surveillance studies and outbreak reports. Outcomes of interest were the frequency of Citrobacter spp. infections among hospitalized patients and 3rd generation cephalosporin and/or carbapenem resistance percentages in these infections. We used random-effects models to generate pooled outcome estimates and evaluated risk of bias and quality of reporting of outbreaks. Results We screened 1609 deduplicated publications, assessed 148 full-texts, and included 41 studies (15 observational, 13 surveillance and 13 outbreak studies). Citrobacter spp. urinary tract- and bloodstream infections were most frequently reported, with Citrobacter freundii being the main causative species. Hospital-acquired infection occurred in 85% (838/990) of hospitalized patients with Citrobacter infection. After 2010, an increasing number of patients with Citrobacter spp. infections was reported in observational studies. Pooled frequency estimates for Citrobacter spp. infections could not be generated due to lack of data. The pooled prevalence of ESBL and carbapenemase producers among Citrobacter isolates were 22% (95%CI 4–50%, 7 studies) and 18% (95%CI 0–63%, 4 studies), respectively. An increased frequency of reported Citrobacter outbreaks was observed after 2016, with an infection/colonization ratio of 1:3 and a case-fatality ratio of 7% (6/89 patients). Common outbreak sources were sinks, toilets, contaminated food and injection material. Implemented preventive measures included environmental cleaning, isolation of positive patients and reinforcement of hand hygiene. Only seven out of 13 outbreaks (54%) were definitively controlled. Conclusion This review highlights the clinical importance of endemic and epidemic Citrobacter spp. in healthcare settings. As an emerging, multidrug‑resistant nosocomial pathogen it requires heightened awareness and further dedicated surveillance efforts.

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Multi-drug Resistant Citrobacter freundii Isolates in a Burn Hospital in Northeast of Iran: A Single-Center Cross-sectional Study

Cited by 2 publications

References 18 publications

Seasonal distribution of human-to-human pathogens in airborne PM2.5 and their potential high-risk ARGs

Seasonal distribution of human-to-human pathogens in airborne PM2.5 and their potential high-risk ARGs

Epidemiology of Citrobacter spp. infections among hospitalized patients: a systematic review and meta-analysis

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