Citrobacter, how it is transmitted and what happens in case of infection

The anxiety returnsCitrobacter infection at the Borgo Trento Hospital in Verona. The tones, it must be said, are very different from those that characterized the microepidemic cause of four deaths in newborns (out of almost one hundred babies affected). Now there are three newborns who have tested positive for the test that reveals the presence of the bacterium. And fortunately they did not present any serious pathologies.

But what happens, in addition to inducing the blocking of admissions to neonatal intensive care as a precautionary measure by the hospital management, re-proposes the maximum attention which must lend itself to bacterial infections in general and in particular to Citrobacter koseri, one of the many “little brothers” of this family. Let us therefore try to understand the characteristics of these strains well, thanks to the information made available on the Istituto Superiore di Sanità website.

An omnipresent bacterium

Although it may seem strange to us when we read these lines, let's not forget that bacteria of the Citrobacter genus they also live in our body. Without causing particular disturbances. They are part of the so-called microbiota of the digestive system. This is enough to understand how much and how microbes of this type are able to survive and reproduce practically anywhere, perhaps remaining on our hands, remaining inside the water, reproducing in food.
Therefore, in the balance that occurs between human beings and the environment, coexistence with the different types of Citrobacter is practically obvious.

However, there are situations in which, both due to the bacterial load present and the objective weakness of the immune system in which the germs reproduce, they can cause infections. In this sense Citrobacter are true “masters” of opportunism. And they can determine very serious infections especially in the extreme ages of life, therefore in newborns, especially if premature, and in the elderly. Obviously, subjects are at greater risk of infection due to therapies such as those that affect the body's defense system or particularly serious pathologies that damage the immune system such as tumors (but not only) they are less able to defend themselves independently by these bacteria.

How Citrobacter is transmitted

Let's start with an assumption. Although the different types of bacteria (koseri is only one of those that can create serious infections in humans, but there are several “close relatives” with other names that are capable of causing these conditions) live practically everywhere, the majority fear is linked to infections that arise in hospital. And It is precisely in the wards that microepidemics can be created.

In this sense, ISS experts point out the need to observe strict hygiene rules, with the always valid rule of washing your hands several times, disinfecting them in hospital, and paying attention to contact with surfaces on which the bacterium could harbor. It should also be said that transmission can also occur with direct contact between people, during childbirth with the bacterium that can pass from mother to newborn while outside the hospital it is above all foods that create risks which obviously involuntarily transmit the bacterium. Most of these infections are acquired in hospital (nosocomial infections), however, given the spread of the bacterium, You can also get infected outside the hospital.

What happens in case of Citrobacter infection

Having specified that the response to bacterial infection changes from person to person and appears correlated to the immunological “robustness” of the individual, the germ can determine even very serious pictures affecting various organs and systems.
Sometimes the picture occurs on the skin and bones, with swelling, redness, pus formation also internally in case of osteomyelitis.
Then they can be there urinary infections with the classic symptoms of these pictures: presence of blood in the urine, pain and burning while urinating, urgency, real pain in the lower abdomen and lumbar area, fever.
Furthermore: in certain cases the clinical manifestation of Citrobacter is also localized to the respiratory system with general malaise, difficulty breathing, cough con sputum production.
Finally, it should not be forgotten that the germ can also circulate in the blood, invading different organs, which is what happens in the case of sepsis (there may also be very high fever, confusion, hypotension and even loss of consciousness), and above all it can cause in newborns (in these cases we still speak of Citrobacter Koseri) a very serious meningitis with the formation of abscesses within the brain.

How it is diagnosed and treated

First of all, we need to be sure that we are talking about Citrobacter. For this reason, based on the clinical manifestations of the infectious pathology, the available biological compounds are examined. Doctors can therefore perform a urine or blood test with subsequent urine and blood cultures, analyze the sputum emitted from the respiratory tract, and use a swab to check for the possible presence of bacteria of this type on the skin. These are the first analyses, which direct the picture.
Then further laboratory checks allow you to correctly create the “identity card” of the strain in question. This is important to further refine the diagnosis and to study the characteristics of a possible spread of the infection within a hospital.

Chapter therapies: we are talking about a bacterium, so the cure goes through a antibiotic treatment which must be done on the basis of the antibiogram. This test allows us to see in the laboratory which antibiotics or combinations of these drugs the specific germ will respond to. Let's not forget that Citrobacter are part of the Enterobacteriaceae family and are particularly accustomed to developing resistance to antibiotics. The doctor will be able to choose the most suitable treatment on a case-by-case basis.