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Related Experiment Videos

Low-virulence Citrobacter species encode resistance to multiple antimicrobials.

C Pepperell1, J V Kus, M A Gardam

  • 1The Centre for Infection and Biomaterials Research, Hospital for Sick Children Research Institute. Departments of Surgery. Medicine, University of Toronto, Toronto, Ontario, Canada.

Antimicrobial Agents and Chemotherapy
|October 18, 2002
PubMed
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A Multicenter Case-control Study of the Effect of Acute Rejection and Cytomegalovirus Infection on Pneumocystis Pneumonia in Solid Organ Transplant Recipients.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America·2018

Multidrug-resistant Citrobacter species, including cefpodoxime-resistant strains, are common colonizers in transplant patients. These bacteria carry resistance genes, posing a potential threat for future antimicrobial resistance development.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Citrobacter species are gram-negative bacteria, typically commensals, but can cause nosocomial infections in immunocompromised individuals.
  • These bacteria often exhibit cephalosporin resistance due to beta-lactamase overexpression.
  • Multidrug-resistant Enterobacteriaceae (MDRE) are a growing concern, particularly in vulnerable patient populations.

Purpose of the Study:

  • To investigate the prevalence and characteristics of multidrug-resistant Citrobacter species in solid-organ transplant patients.
  • To identify the genetic mechanisms conferring antimicrobial resistance in these strains.
  • To assess the clinical significance of Citrobacter colonization in this patient cohort.

Main Methods:

  • Pulsed-field gel electrophoresis (PFGE) was used for strain typing.

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  • Genetic analysis, including PCR and DNA sequencing, was performed to identify resistance genes.
  • Phenotypic testing evaluated antimicrobial susceptibility profiles.
  • Clinical data was reviewed to determine infection rates.

    • Main Results:

    • Nearly half of MDRE-colonized transplant patients carried cefpodoxime-resistant Citrobacter strains (C. freundii, C. braakii, C. amalonaticus).
    • Extended-spectrum beta-lactamase (ESBL) genes (SHV-5, SHV-12) were identified in 26% of strains.
    • Resistance to aminoglycosides (28%), trimethoprim-sulfamethoxazole (31%), and fluoroquinolones (8%) was observed.
    • Class I integrons, encoding resistance to aminoglycosides and/or trimethoprim, were found, including novel instances in C. braakii and C. amalonaticus.

    Conclusions:

    • Multidrug-resistant Citrobacter species are prevalent colonizers in solid-organ transplant recipients.
    • These strains harbor significant antimicrobial resistance genes, including ESBLs and integrons.
    • Despite high colonization rates, clinical infections were infrequent, suggesting low virulence but potential for future resistance gene accumulation and evolution.