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Thread: Citrobacter

  1. #1
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    Unhappy Citrobacter

    My urine culture has shown Citrobacter the last 8 times. Is there something that specifically causes this to grow? Is there something I can take or drink to prevent it? Could this have become my natural flora since I have a Neurogenic bladder? At what point should I start taking a medication? Is there a level of white blood cells to look for? Thanks

  2. #2
    Citrobacter is a bacteria that is a relatively rare cause of UTI for unhospitalized people. Were you hospitalized when you got your first infection with this? There are some very virulant strains of this in many ICUs, and we have seen most of these being totally drug resistant. It is a normal bacteria in your gut, but definately does not belong in your bladder or kidneys.

    Citrobacter is not considered to be an enteric pathogen because it is normal gut flora. When plated, Citrobacter colonies bare a strong resemblance to E. coli colonies. This group of bacteria is of small clinical interest. C. freundii is suspected to cause diarrhea and possibly extraintestinal infections. C. diversus has been linked to a few cases of meningitis in newborns.
    Over-use of antibiotics has produced a number of super-strains of Citrobacter which may be resistant to all antibiotics:

    The Gram-negative bacilli of the genera Escherichia, Klebsiella, Enterobacter, Serratia, Citrobacter, and Proteus (Table 26- 1) are members of the normal intestinal flora of humans and animals and may be isolated from a variety of environmental sources. With the exception of Proteus, they are sometimes collectively referred to as the coliform bacilli because of shared properties, particularly the ability of most species to ferment the sugar lactose.

    Many of these microorganisms used to be dismissed as harmless commensals. Today, they are known to be responsible for major health problems worldwide. A limited number of species, including E coli, K pneumoniae, Enterobacter aerogenes, Enterobacter cloacae, S marcescens, and P mirabilis, are responsible for most infections produced by this group of organisms. The increasing incidence of the coliforms, Proteus, and other Gram-negative organisms in diseases reflects in part a better understanding of their pathogenic potential but more importantly the changing ecology of bacterial disease. The widespread and often indiscriminate use of antibiotics has created drug-resistant Gram-negative bacilli that readily acquire multiple resistance through transmission of drug resistance plasmids (R factors). Also, development of new surgical procedures, health support technology, and therapeutic regimens has provided new portals of entry and compromised many host defenses.
    http://gsbs.utmb.edu/microbook/ch026.htm

    Have you been told the results of your sensitivity test for this colonization? Is it totally resistant? It would also be important to be checked for stones any time you have the same bacteria over and over as a cause of infections. Most often treatment would not be indicated unless you have a symptomatic UTI with fever, chills, malaise, flank pain, elevated white blood count, etc. etc.

    (KLD)

  3. #3
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    Cool

    Thanks for the info. No I haven't been told anything about my test but will now.
    Last edited by Jimi5; 05-06-2006 at 08:59 AM.

  4. #4
    VA hospitals don't have a lock on this. I work in a VA hospital, and nearly all of the cases of resistant Citrobacter we see are in patients transferred to us from nursing homes or other community and university hospitals.

    (KLD)

  5. #5
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    Cool

    Quote Originally Posted by SCI-Nurse
    VA hospitals don't have a lock on this. I work in a VA hospital, and nearly all of the cases of resistant Citrobacter we see are in patients transferred to us from nursing homes or other community and university hospitals.

    (KLD)
    I didn't mean anything like that. I'm very happy with my VA hospital stays. I wish the Iowa Veterans Home was as knowledgeable and good.

  6. #6
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    Question

    Looked at my file and I wasn't hospitalized right before or when I first got it.
    Is it something that grows on it's own or does changing my suprapubic catheter or having it pulled out a little at at night help it to grow?
    Should the same antibiotic be taken for the same bacteria?

  7. #7
    As I remember, you are living in an institutional setting. Most likely you got it from poor hand hygiene by a caregiver providing you bladder care, who may have passed it on from another patient.

    Each time you have a UTI, you need a new culture and sensitivity test (C&S). The culture tells which bacteria is growing, but only the sensitivity will tell which antibiotic is correct to you. You cannot treat just based on what the bacteria is, and the sensitivity can change each time the test is done, since there can be different strains of the bacteria, or it may have developed resistance to the previous antibiotics used.

    (KLD)

  8. #8
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    Quote Originally Posted by SCI-Nurse
    As I remember, you are living in an institutional setting. Most likely you got it from poor hand hygiene by a caregiver providing you bladder care, who may have passed it on from another patient.

    Each time you have a UTI, you need a new culture and sensitivity test (C&S). The culture tells which bacteria is growing, but only the sensitivity will tell which antibiotic is correct to you. You cannot treat just based on what the bacteria is, and the sensitivity can change each time the test is done, since there can be different strains of the bacteria, or it may have developed resistance to the previous antibiotics used.

    (KLD)
    Thanks. That's what I thought

  9. #9
    Quote Originally Posted by SCI-Nurse View Post
    As I remember, you are living in an institutional setting. Most likely you got it from poor hand hygiene by a caregiver providing you bladder care, who may have passed it on from another patient.

    Each time you have a UTI, you need a new culture and sensitivity test (C&S). The culture tells which bacteria is growing, but only the sensitivity will tell which antibiotic is correct to you. You cannot treat just based on what the bacteria is, and the sensitivity can change each time the test is done, since there can be different strains of the bacteria, or it may have developed resistance to the previous antibiotics used.

    (KLD)
    Hello, so sorry to bring this ancient post back to life but I joined this forum because of your answer. I've been bedridden for the past almost 9 years. I'm not paralyzed but I cannot stand nor walk due to other issues. My daughter has been my caregiver. Today I found out that my urine tested positive for Citrobacter freundii complex. The doctor prescribed Bactrim based on the sensitvity test. He had actually never heard of this bacteria (hoping he was joking), which makes me not trust him a whole lot right now. But I live abroad so I'm rather limited on medical care unfortunately.

    I was basically curious how I got this in the first place.. that is until I read your post.

    I've read online a lot about how difficult it is to get rid of this bacteria. I've never had it before but now I am terrified. Do you have any advice? Thank you for your time.

    By the way, it said my Leucocytes are 58000 when I guess it should be less than 10000. The germ count of the bacteria is 1000 UFC/ml so no idea what this means since this is all French.

    I'm resistant to Penicillin which is ok because I'm allergic to it anyway.. the culture is also R to Cefoxitine .. and these are the drugs that are sensitive ...

    Sensitive:
    Ticarcilline - Ticarpen
    Cefixime - Oroken
    Ceftazidme - Fortum
    Ceftriaxone - Rocefine
    Ertapeneme - Ivantz
    Amikacine - Amiklin
    Gentamicine - Gentalline
    AC. Nalidixique - Negram, Pipram, Apurone, Urotrate
    Ciprofloxacine - Ciflox, Uniflox
    Ofloxacine - Oflocet
    Nitrofurantoine - Furadantine, Microdoine, Furadoine
    Cotrimoxazole - Bactrim, Eusaprim

    I'm wondering if I should actually try a natural remedy instead. Thanks again.
    Last edited by Dorie; 05-20-2017 at 11:03 AM.

  10. #10
    Quote Originally Posted by Dorie View Post
    Hello, so sorry to bring this ancient post back to life but I joined this forum because of your answer. I've been bedridden for the past almost 9 years.
    How do you manage your bladder? Are you continent? Have an indwelling catheter? Do intermittent catheterization?

    Do you have a fever or chills or flank pain or other symptoms of a UTI, or just this positive culture? A serum white count (WBC) of 58,000 usually indicates a serious infection someplace in your body. Do you have other sources of infection/inflammation such as bone infection, cancer, or pressure ulcers??

    (KLD)

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