New insights into Citrobacter freundii sepsis in neonates

Abstract

Background: The aim of this study was to investigate the clinical features of neonatal sepsis caused by Citrobacter freundii as well as the current status and treatment strategy for multi-drug resistance of infection with this bacterium. Methods: Nine newborns were diagnosed with C. freundii sepsis between January 2014 and December 2017. We collated and analyzed a range of data for these nine patients, including general information, laboratory tests during infection, blood culture and treatment. Results: One of the patients died after only 7 h of infection. In the remaining eight cases, three patients developed meningitis, although none had brain abscess. A reduction of white blood cells (WBC) was detected <24 h after the start of infection, compared with at 48-72 h, when WBC count had increased and platelets progressively decreased. In all nine cases the infection was susceptible to tigecycline and was resistant to cephalosporins, carbapenems, and quinolones. In eight cases the infection was susceptible to co-trimoxazole and in the other case it was susceptible to amikacin. Of the eight patients who were cured, three received meropenem, two received ceftriaxone, one received amikacin, and two received tigecycline. Conclusion: Reduction in WBC could take place in the early stages of C. freundii infection in newborns. The incidence of brain abscess was not high, but multi-drug resistance was common. Some non-sensitive drugs can also treat C. freundii sepsis effectively.

Citrobacter freundii induces sepsis with new-onset status seizure in an adult: A case report and literature review

“…At present, 31 cases of sepsis caused by C freundii from 1979 to 2021 have been reported. [5][6][7][8][9][10][11] Among 4 C freundii sepsis adult patients, 1 was diagnosed with meningitis and eventually died. C freundii sepsis with meningitis was rarely reported, the mortality and morbidity rates are unacceptably high, [12] The pathogenesis of meningitis and brain abscess may be related to the invasion of endothelial cells and result in the restriction of macroelements passing through the blood-brain barrier in the case of immunodeficiency.…”

Sepsis neonatal por Citrobacter Freundii como debut de malformación linfática quística

“…En pediatría representa un microorganismo muy poco frecuentemente implicado en sepsis neonatales siendo la presentación más frecuente una infección precoz del sistema nervioso central debido a la producción de una toxina neurovirulenta [9][10] . Actualmente, no existen casos neonatales descritos en la literatura de Citrobacter Freundii como agente infeccioso de origen abdominal, de ahí la importancia de nuestro caso.…”

“…El abordaje laparoscópico, así como la laparotomía tienen prácticamente los mismos resultados, aunque se prefiera la cirugía abierta como método de elección cuando la resección se estima compleja 6 . Sin embargo, la curación puede no llegar a lograrse debido a la tasa de recurrencias que según algunos estudios llega hasta 64% en situaciones de resección incompleta y 22% en las resecciones que se estimaron como totales [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] . Por esta razón y por el alto riesgo de complicaciones operatorias (33%) suelen considerarse opciones terapéuticas menos invasivas como la escleroterapia guiada por ultrasonidos con la que se realiza aspiración e inyección percutánea de fármacos (doxiciclina, bleomicina u OK-432/Picibanil).…”

The Damage of the Crayfish (Procambarus Clarkii) Digestive Organs Caused by Citrobacter Freundii Is Associated With the Disturbance of Intestinal Microbiota and Disruption of Intestinal-Liver Axis Homeostasis

“…Previous reports have shown that C. freundii is a pathogenic bacterium that poses a serious threat to aquaculture and is highly pathogenic to economically farmed species such as rainbow trout, eel, and Chinese sturgeon ( Aydin et al., 1997 ; Joh et al., 2013 ; Yang et al., 2021 ). More worryingly, in addition to aquatic animals, C. freundii is also sensitive to mammals and can cause meningitis, endocarditis and other diseases to neonates and horses ( Guidi et al., 2016 ; Chen and Ji, 2019 ). Moreover, there is also a risk of food poisoning when people consume aquatic products infected with C. freundii ( Pletz et al., 2018 ).…”