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Citrobacter diversus brain abscess: case reports and molecular epidemiology
M G Morgan1, C Stuart, A T Leanord
1Department of Medical Microbiology, University of Aberdeen.
Journal of Medical Microbiology
|April 1, 1992
Summary
Two infants in the UK developed Citrobacter diversus brain abscesses, a rare condition. Genetic analysis linked the cases, suggesting hospital environment contamination and highlighting the need for vigilance against this pathogen.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Neonatal Care
Background:
- Citrobacter diversus brain abscess is a rare but serious infection in infants.
- The UK had not reported cases since 1976, making these new occurrences significant.
- Understanding the source and strain characteristics is crucial for effective management and prevention.
Observation:
- Two infants in Aberdeen developed C. diversus brain abscesses within a five-month period.
- Restriction endonuclease analysis revealed the causative strains were identical in both patients.
- The isolates belonged to a specific biotype (d), distinct from other C. diversus strains.
Findings:
- Genetic analysis confirmed the isolates from both infant cases were identical.
- The C. diversus strains from the patients differed genetically from other clinical isolates.
- Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) was useful for differentiating C. diversus from C. amalonaticus but not for subtyping C. diversus strains.
Implications:
- The identical isolates suggest a potential long-term contamination of the hospital environment.
- Prompt diagnosis and aggressive treatment, including antibiotics and surgical drainage, are vital.
- While survival is possible, infants may experience residual neurological deficits, emphasizing the severity of the infection.