Citrobacter bacteremia in a tertiary care hospital

From January 1998 to December 2001, 176 cases of Citrobacter bacteremia occurred of which repeat isolation was possible in 48 cases. Of 48 isolates, 79.1% were C. diversus and 20.9% C. freundii. Citrobacter bacteremia was polymicrobial in 46.1% cases, and maximum number of cases (54.1%) occurred in the age group less than 10 years. Portal of entry was unknown (42.3%), respiratory tract (20.9%), gastrointestinal tract (15.3%) and urinary tract 15.3%. C. freundii isolates were relatively more resistant than C. diversus against 10 tested antimicrobial agents, while 79.1% isolates were multiresistant. Sensitivity based on MIC was highest for ceftizoxime, ciprofloxacin and cefotaxime. Overall mortality of Citrobacter bacteremia was seen in 56% of cases. Therefore greater caution is required in selection of antibiotic therapy in order to avoid selection of strains and treatment failure.