Format

Send to

Choose Destination
Infect Dis (Lond). 2017 Jul;49(7):532-539. doi: 10.1080/23744235.2017.1297896. Epub 2017 Mar 9.

In vitro susceptibility and resistance phenotypes in contemporary Citrobacter isolates in a University Hospital in Crete, Greece.

Author information

1
a Department of Clinical Microbiology , University Hospital of Heraklion , Heraklion , Greece.
2
b Alfa Institute of Biomedical Sciences (AIBS) , Athens , Greece.
3
c Department of Internal Medicine-Infectious Diseases , Iaso General Hospital , Athens , Greece.
4
d Department of Internal Medicine , University of Crete School of Medicine , Heraklion , Greece.
5
e Department of Applied Mathematics and Physics , National Technical University of Athens , Athens , Greece.
6
f Department of Medicine , Tufts University School of Medicine , Boston , MA , USA.

Abstract

BACKGROUND:

Data on Citrobacter spp. susceptibility are scarce. We sought to study the evolution in the susceptibility of 385 Citrobacter spp. at the University Hospital of Heraklion, Crete, Greece during a six-year period (2010-2015).

METHODS:

Non-duplicate strains isolated from inpatients (intensive care unit, oncology, surgery, internal medicine, paediatrics) and outpatients were studied using Vitek 2. Phenotypic confirmatory tests were applied for detection of β-lactamases and aminoglycoside modifying enzymes.

RESULTS:

C. freundii (172, 44.7%) and C. koseri (166, 43.1%) were the most commonly isolated species. C. braakii (34), C. amalonaticus (6), C. youngae (6) and C. sedlakii (1) were the remaining isolates. Colistin and fosfomycin were the most active antibiotics (both 99.2%) followed by carbapenems (99%) aminoglycosides (96.6-98.4%), tigecycline (96.1%), cefepime (94.8%), ciprofloxacin (94.3%), tetracycline (92.7%), trimethoprim/sulphamethoxazole (91.4%), chloramphenicol (88.1%), piperacillin/tazobactam (86.5%) and 3rd generation cephalosporins (85.7%). C. freundii were more resistant than C. koseri. Antibiotic resistance did not increase during the study period for most antibiotics. Lower susceptibility to all antibiotics was observed among multi-drug resistant (MDR) strains. AmpC was the most common resistant mechanism (10.9%); carbapenemases (1.3%) and aminoglycoside modifying enzymes (2.9%) were also detected. All AmpC producers were resistant to cephalosporins but not to carbapenems. In all but one isolates aminoglycoside resistance was accompanied by acquired β-lactamases.

CONCLUSIONS:

Although Citrobacter species in general were susceptible, antibiotic susceptibility testing is required for the detection of resistant isolates.

KEYWORDS:

AAC(3); AAC(6); ESBL; KPC; MBL

PMID:
28276281
DOI:
10.1080/23744235.2017.1297896
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Taylor & Francis
Loading ...
Support Center