Abstract
Fourteen neonates were diagnosed to have Citrobacter sepsis during 1986-89, representing 4.6% of all cases with bacteriologically proven sepsis. Most of these infants were low birth weight (mean 2046 gm, ± 750) and preterm (mean 34.8 weeks, ± 3.8). Mean age at onset of sepsis was five days. In 10 cases the hematological profile was suggestive of sepsis. Infants had clinical evidence of multisystem infection; 2 with septic arthritis and 3 meningitis. The case fatality rate was 61%. Resistance to antibiotics was frequent. Citrobacter species were also cultured from other sites : umbilical stumps, eye swabs, urine, skin pustules and umbilical catheter tips. The epidemiological features and virulence of this organism call for vigilance and strict control measures.
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References
Choudhuiy P, Srivastava G, Aggarwal DS et al. Bacteriological study of neonatal infections.Indian Pediatr 1975; 22: 459–463.
Khatua SP, Das AK, Chatterjee S et al. Neonatal septicemia.Indian Pediatr 1986; 53: 509–514.
Bhakoo ON. Neonatal bacterial infections at Chandigarh: A decade of experience.Indian J Pediatr 1980; 47 : 419–424.
Nellian AR, Choudhury P, Srinivasan S et al. A prospective study of bacterial infections in the newborn.Indian I Pediatr 1981; 48: 427–431.
Chetan R, Christo GG, Shivananda PG et al. Neonatal sepsis and meningitis in a rural hospital in South India.Kamataka Pediatr J 1987; 2: 15–18.
Gwynn CM, George RH. Neonatal Citrobacter meningitis.Arch Dis Child 1973; 48: 456–458.
Ribeiro CD, Davis P, Jones DM. Citrobacter Koseri meningitis in a special care baby unit.J Clin Pathol 1976; 29: 1094–1096.
Vogcl LC, Ferguson L, Gotoff SP. Citrobacter infections of the central nervous system in early infancy.J Pediatr 1978; 93: 86–88.
Graham DR, Band JD. Citrobacter diversus brain abscess and meningitis in nconatcs.JAMA 1981; 245: 1923–1925.
Parry MF, Hutchinson JH, Brown NA et al. Gram negative sepsis in nconates: a nursery outbreak due to hand carriage of Citrobaaer diversus.Pediatr 1980; 65 : 1105–1109.
Giacoia GP, West K. Sepsis with Citrobacter divcrsus in sick newborns.Am J Perinatal 1989; 6: 49–54.
Bhakoo ON, Agarwal KC, Narang A, Bhattacharjec S. Prognosis and treatment of neonatal scptieemia-a clinico bacteriological study of 100 cases.Indian Pediatr 1974; 11: 519–528.
Jain K, Prabhakar K, Ayyagiri A, Kumar L. Citrobacter meningitis: case report and a review.Indian Pediatr 1980; 17 : 380–382.
Chahar CK, Shekhawat V, Goyal K, Mathur HC. Citrobacter meningitis.J Indian Med Assoc 1983; 80: 143–144.
Rathi S, Jain K, Jain S. Neonatal Citrobacter meningitis.Indian Pediatr 1989; 26: 175–177.
Manroe BL, Weinberg AG, Rosenreld CR, Browne R. The neonatal blood count in health and disease: I. Reference values for neutrophilic cells.J Pediatr 1979; 95 : 89–98.
Scdlak J. Present knowledge and aspects of citrobacter.Curr Topic Micmbiol 1mmunol 1973; 62: 41–60.
Morris JG, Lin F-YC. Molecular epidemiology of neonatal meningitis due to Citrobacter diversus.J Infect Dis 1986; 154: 409–414.
Williams WW, Mariano J. Nosocomial meningitis due to Citrobacter diversus in nconates: new aspects of the epidemiology.J Infect Dis 1984; 150 : 229–235.
Morris JG, Tall BD, Kotloff KL, Sechter I. Carriage of Citrobacter diversus among young children in Baltimore.Ped Infect DisJ 1988; 7: 294–296.
Ramani A, Kundaje GN, Rao MS et al. Citrobacter as a frequent urinary pathogen in hospitalised patients.Indian J Med Res 1988; 88: 23–25.
Finn A, Talbot GH, Anday E el al. Vertical transmission of Citrobacter diversus from mother to infant.Pediatr Infect Dis J 1988; 7: 293–294.
Hodges GR, Dcgcncr CE, Barnes WG. Clinical significance of Citrobacter isolates.Am J Clin Path 1978; 70: 37–40.
Domingue GJ. The enteric bacilli: medically significant cnterobactcriaccac and vibrionccae. In: Rose NR, Barron AL (eds).Microbiology : Basic Principles and Clinical Applications. New York : MacMillan Publishing Company, 1983 : 155.
Holmes B, King A, Phillips I, Lapage SP. Sensitivity of Citrobacter freundii and Citrobacter koseri to cephalosporins and penicillins.J Clin Pathol 1974; 27: 729–735.
Dreichmann V, Band JD. Bacteremias due to Citrobacter diversus and Citrobacter freundii.Arch Int Med 1985; 145: 1808–1810.
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Christo, G.G., Mathai, J., Nalini, B. et al. Neonatal citrobacter sepsis : Clinical and epidemiological aspects. Indian J Pediatr 57, 781–784 (1990). https://doi.org/10.1007/BF02722277
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DOI: https://doi.org/10.1007/BF02722277