Observations on Citrobacter species from a tertiary care health center with special reference to multi-drug resistance and presence of CTX-M gene.
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Date
2014-07
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Abstract
Background: Citrobacter is an important nosocomial pathogen and its multidrug
resistant (MDR) isolates are increasingly being reported across the globe.
They are known to produce extended spectrum beta lactamase (ESBL) and
harbor CTX-M gene. Objective: The aim was to isolate Citrobacter sp. from
clinical specimens, analyze their MDR status and look for the presence of CTX-M
gene. Materials and Methods: In this prospective study, Citrobacter isolates
positive for ESBL on screening, were confirmed by combined disc method
along with minimum inhibitory concentration (MIC) for cefotaxime. In selected
cefotaxime resistant isolates, multiplex polymerase chain reaction was done for
blaCTX-M gene. Results: Of 146 Citrobacter sp. isolated, most (73%) were from
admitted patients and hospital stay of >72 h and prior antibiotic intake were the
most common associated factors. Maximum isolates were from pus (41.1%).
Citrobacter freundii was the commonest species (49%) followed by Citrobacter
koseri (28%); 79 were ESBL producers. Seventy were cefotaxime resistant
as shown by MIC. blaCTX-M gene was detected in 15/40 of these isolates, all
belonged to CTX-M group 1. Conclusion: Overall incidence of Citrobacter in
our setup is low, but they were mostly MDR, and ESBL production was high,
which is a cause of concern. blaCTX-M gene detection is important because of its
rapid transmission to other bacterial species.
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Keywords
Extended spectrum beta lactamases, minimum inhibitory concentration, nosocomial infection
Citation
Mohan Sneha, Agarwal Jyotsna, Srivastava Richa, Singh Mastan. Observations on Citrobacter species from a tertiary care health center with special reference to multi-drug resistance and presence of CTX-M gene. Indian Journal of Pathology & Microbiology. 2014 Jul-sept 57 (3): 439-441.