citrobacter hemolysis on blood agar

Extensive use of antibiotics, which alters the normal intestinal flora, can lead to antibiotic-resistant, opportunistic strains that can proliferate and cause disease. The urinary tract is the most frequent site from which Citrobacter is cultured, often in association with an indwelling catheter. Most C. koseri isolates produce hemolysins, are piliated, and are resistant to killing by pooled human sera. There is an O-antigen typing scheme for E. cloacae that is comprised of 30 O-antigen types. accounted for 9% of 91 cases of gram-negative enteric meningitis in infants 1 day to 2 years of age.19 C. koseri was responsible for 90% of cases, and C. freundii caused most of the remaining cases. Facultatively anaerobic. Gamma (no) Hemolysis on Blood Agar. Conventional pathogenicity tests:All of the isolated Citrobacter freundiiwere inoculated onto 5% sheep blood agar (MBcell Ltd., Seoul, Korea) and incubated at 37°C overnight to examine the hemolysis pattern. Citrobacter are found in a variety of environmental sources, including soil and water, and in the human intestines. Julianne V. Kus, Lori L. Burrows, in xPharm: The Comprehensive Pharmacology Reference, 2007. were more frequent compared with historical cohorts and occurred solely in neonates.21 Brain abscesses can evolve any time during the acute course, including several weeks after commencement of treatment. H. Chart, in Medical Microbiology (Eighteenth Edition), 2012. C. freundii, C. koseri, and C. amalonaticus appear to be distinct organisms; however, only C. koseri appears to be genetically homogeneous. In one study, 79% of strains of C. koseri isolated from CSF had a unique 32-kd outer-membrane protein, which was found in only 9% of isolates from other kinds of specimens.6 Citrobacter koseri also has the ability to enter macrophages, survive phago-lysosomal fusion, and replicate intracellularly. Staphylococcus aureus non-pigmented colonies weak hemolysis … Members of the genus Citrobacter share all the general properties and biochemical characteristics of the family Enterobacteriaceae, including the following: gram-negative rod, catalase-positive and oxidase-negative, growth on MacConkey agar, reduction of nitrate to nitrite, growth both aerobically and anaerobically, and fermentation of glucose and other carbohydrates. C. freundii strains utilize a number of methods to encode resistance to ampicillin and cephalosporins (Pfeifer et al., 2010). Grows on media that inhibit Escherichia coli: Muller’s tetrathionate broth, Leifson’s selenite broth, … It belongs to the family Enterobacteriaceae and is known to cause a number of opportunistic infections, as well as many nosocomial infections of the respiratory tract, urinary tract, blood and some other sites in patients. Staphylococcus aureus Beta hemolysis, weak pigmentation. QUESTIONS 1. koseri occasionally causes neonatal meningitis; in this condition there is a high mortality rate and the formation of cerebral abscesses is common. Bergey's Manual of Systemic Bacteriology, who develop normally.22, Other Citrobacter spp. Proteus species often exhibit swarming. are opportunistic pathogens in humans that can lead to invasive disease, including infections of the urinary tract, respiratory tract, CNS, skin, and soft tissue. Michael S. Donnenberg, in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), 2015. , 9th ed. Animals presented with diarrhea, dyspnea, and decreased appetite. were isolated from germ-free guinea pigs that were exposed to defined flora from gnotobiotic mice (Boot and Walvoort, 1986). Citrobacter, which was first described as Bacterium freundii in 1928, was reclassified as Citrobacter in 1932 Doran (1999), Sedlak (1973). When associated with significant human infection, Citrobacter can be recovered from blood, cerebrospinal fluid (CSF), urine, respiratory tract secretions, and wounds. In contrast, less than 10% of cases of infants with meningitis due to other gram-negative organisms have associated abscesses.12,13 Neonatal brain abscesses also can occur with infections caused by Cronobacter (formerly Enterobacter) sakazakii, Proteus mirabilis, and Serratia marcescens. is associated most commonly with urinary tract, bloodstream, intra-abdominal, skin, soft tissue, and respiratory tract infections.23. ... 148 strains of E. coli 13 strains of Citrobacter … Straight rods, occurring singly and in pairs. Citrobacter contains 11 species: C. amalonaticus, C. farmeri, C. braakii, C. freundii, C. gillenii, C. murliniae, C. sedlakii, C. werkmanii, C. youngae, C. koseri, and C. rodentium. 1. Colonies which slowly ferment lactose can resemble Proteolysis was examined by observing the presence of complete lysis around the colony and a … Biochemical Test and Identification of Citrobacter freundii. Strains of Cit. koseri express type 1 (mannose-sensitive) fimbriae and occasional strains produce a form of E. coli, Verocytotoxin type 2. spp. Cit. is found in clinical bacteriology, as an opportunistic pathogen, not only in stools but also in urine, sputum, and specimens from bacteremia, meningitis, otitis media, wounds, abscesses, the throat and autopsies. Culture is the traditional method of detecting Citrobacter spp. They range in size. A bewildering array of taxonomic changes338 ended in 1977, when Brenner and associates339 designated the following species: C. freundii, C. amalonaticus, and C. diversus. C, Colonies of S. agalactiae growing on BAP. are primarily inhabitants of the intestinal tract of mammals and other vertebrates. Susan E. Crawford, Robert S. Daum, in Pediatric Respiratory Medicine (Second Edition), 2008. In these cases, Enterobacter and Citrobacter species can cause significant morbidity and mortality.This is thought to be due primarily to the weakened state of the patient rather than to the inherent virulence of the bacteria (Doran, 1999; Gardam et al., 2002; Lipsky et al., 1980). Copyright © 2020 Elsevier B.V. or its licensors or contributors. 1993. 2. were isolated from the middle ear, spleen, mammary gland, and kidney of some animals as well as the intestinal tract, suggesting an ability to cause varied disease in guinea pigs that are not populated with normal flora. The genus Enterobacter includes fourteen species: E. aerogenes, E. agglomerans, E. amnigenus, E. asburiae, E. cancerogenus (E. taylorae), E. cloacae, E. dissolvens, E. gergoviae, E. homaechei, E. intermedius, E. kobei, E. nimipressuralis, E. pyrinus, and E. sakazakiiFarmer (1999), Holmes (1998). Cultivation 24 hours, 37°C. The pathogenesis of brain abscess caused by C. koseri is uncertain; cerebral vasculitis with infarction and bacterial invasion of necrotic tissues is the likely explanation.146 Persistence of C. koseri in the central nervous system is suggested by a case report of recovery of the organism from the CSF during a surgical procedure 4 years after treatment of neonatal meningitis.145 The mortality rate for meningitis due to Citrobacter species was about 30%; most of the infants who survived had some degree of mental retardation. Treatment, Prevention & Control: Major problem. Citrobacter have also been found to cause meningitis, septicemia, and pulmonary infections in neonates and young children, and some of these cases have been linked to contaminated batches of PIF. The genus Citrobacter was first proposed in 1932. It can also be found in the human intestine. Bergey's Manual of Determinative Bacteriology Citrobacter is considered an opportunistic pathogen. 12. Gross necropsy revealed lung consolidation with pleural adhesions as well as enteritis and thickening of the intestinal wall. Once introduced into the nursery, Citrobacter species colonization may become prevalent. In a contemporary review of brain abscesses in children, intracranial abscesses caused by Citrobacter spp. develop one or more intracerebral abscesses (Fig. Plate 12 The large capsule of Klebsiella pneumoniae gives a mucoid appearance to colonies growing on agar plates. Morris and colleagues147 used these markers to investigate an outbreak of six cases of neonatal meningitis caused by C. koseri in three Baltimore hospitals between 1983 and 1985. occur most commonly in neonates.9,10 Organisms can be transmitted by vertical transmission from mothers or by nosocomial spread. In addition, like members of these other genera, isolates of Citrobacter may be resistant to multiple other antibiotics as a result of plasmid-encoded resistance genes. Chemoorganotrophic, having both a respiratory and a fermentative type of metabolism. They are found either singly or in pairs, are devoid of a capsule, and are motile. Blood agar is a rich medium that has been supplemented with fresh 5-10% blood. Use some of the species you learned about in this lab as examples. The coli-aerogenes organisms content, determined by plating on violet red-bile agar, of surface soil from a polluted site (heavily grazed pasture) often exceeded 104/g at 30° and 103/g at 37°. 8 Escherichia coli. are often found in human faeces and may be isolated from a variety of clinical specimens. -Citrobacter (dry, pink colonies on MacConkey's agar) Hemolysis of blood agar-Observation of the media surrounding or underneath the colony-Most important in presumptive ID of strep-Sometimes have to remove a colony from the plate to determine hemolysis patterns. Dwight A. Powell, Mario J. Marcon, in Principles and Practice of Pediatric Infectious Diseases (Fourth Edition), 2012. Unipath Ltd., Basingstoke, UK. were consistently isolated in pure culture from the lung, liver, spleen, and intestine. Nutrient Agar, Blood Agar, Tryptic Soy Agar (TSA). FIG. which grow well on normal media, are aerobic or facultative anaerobic, ferment glucose, produce catalase, but not oxidase, and are generally lactose-negative or later lactose-fermenting (Greenwood, 2007). Plasmid profiles, biotypes, serotypes, and chromosomal restriction endonuclease digests are useful as epidemiologic markers for the study of isolates of C. koseri. Colonies are without hemolysis but … ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. URL: https://www.sciencedirect.com/science/article/pii/B9780123849472002592, URL: https://www.sciencedirect.com/science/article/pii/B9780323040488500396, URL: https://www.sciencedirect.com/science/article/pii/B9780702040894000421, URL: https://www.sciencedirect.com/science/article/pii/B9780323401814001419, URL: https://www.sciencedirect.com/science/article/pii/B9780123809209000237, URL: https://www.sciencedirect.com/science/article/pii/B9780080552323608682, URL: https://www.sciencedirect.com/science/article/pii/B9780128012383050893, URL: https://www.sciencedirect.com/science/article/pii/B9781437727029001434, URL: https://www.sciencedirect.com/science/article/pii/B9781455748013002204, URL: https://www.sciencedirect.com/science/article/pii/B0721605370500086, xPharm: The Comprehensive Pharmacology Reference, 2007, Escherichia coli and Other Enterobacteriaceae: Occurrence and Detection, Bacterial Pneumonia, Lung Abscess, and Empyema, Pediatric Respiratory Medicine (Second Edition), Klebsiella, enterobacter, proteus and other enterobacteria, Medical Microbiology (Eighteenth Edition), Principles and Practice of Pediatric Infectious Diseases (Fifth Edition), The Laboratory Rabbit, Guinea Pig, Hamster, and Other Rodents, Mundy et al., 2005; Percy and Barthold, 2007; Petty et al., 2010, Luperchio et al., 2000; Petty et al., 2010, Boot and Walvoort, 1986; Ocholi et al., 1988, Infections due to Citrobacter and Enterobacter, xPharm: The Comprehensive Pharmacology Reference, Infections due to Citrobacter and Enterobacter☆, Doran, 1999; Gardam et al., 2002; Lipsky et al., 1980, Principles and Practice of Pediatric Infectious Diseases (Fourth Edition), Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), Infectious Diseases of the Fetus and Newborn Infant (Sixth Edition), Diagnostic Microbiology and Infectious Disease, Journal of Global Antimicrobial Resistance. In the 1960s and 1970s, a disease eventually named transmissible murine colonic hyperplasia caused by coliform bacteria of the genus Citrobacter was recognized (Mundy et al., 2005; Percy and Barthold, 2007; Petty et al., 2010). Their cell-free culture broth showed positive results toward five screening tests (hemolysis in blood agar, drop collapse, oil displacement, emulsification activity (E 24), and surface tension (ST) reduction). Direct mother-to-infant transmission has been confirmed by ribotyping and DNA fingerprinting.11,12 It is likely that individual strains of Citrobacter spp. Citrobacter organisms were first isolated in 1932 by Werkman and Gillen,337 who proposed the generic term Citrobacter and described seven species. After incubation overnight, the medium is inspected for telltale signs of alpha- or beta-hemolysis. 2. There are two reports of disease associated with Citrobacter spp. A positive phenotypic characteristic of glucose-oxidizing acinetobacters was demonstrated with blood agar containingd-glucose. Citrobacter freundii-induced cold agglutinin hemolysis. Enterococcus. septicemia in a large colony of conventional guinea pigs was reported (Ocholi et al., 1988). They reduced the ST of growth medium (70 ± 0.9) to 30.8 ± 0.6 and 32.5 ± 1.3 mN/m, respectively. 1986. The complications of Citrobacter pneumonia include associated bacteremia with metastatic foci, particularly meningitis. Citrobacter spp. 1993 ... Media: Trypticase Soy Agar with 5% sheep blood, Nutritive Agar. These bacteria may also be cultured from the respiratory tract, a finding that more often represents colonization than symptomatic infection. 141.1). Bile Esculin Agar Positive . The pathogenesis of Citrobacter infections has not been characterized fully. Citrobacter freundii is a species of facultative anaerobic gram-negative bacteria. Ann Hematol. Morganella morganii ssp. Some strains are beta hemolytic on blood agar. Of the dozen species, Citrobacter freundii, Citrobacter koseri (formerly Citrobacter diversus), and Citrobacter amalonaticus are linked to human disease. All species except C. rodentium have been recovered from human clinical sources (some rarely) including blood and other normally sterile body sites, wounds, respiratory and urinary tract; however, C. freundii and C. koseri are the most important human pathogens. They are gram -ve, non-capsulated, non-sporing, catalase +ve, oxidase -ve bacteria. Holt, J.G., et al. I did a test on blood agar and the results were alpha hemolytic. Most isolates are motile and utilize citrate as a sole carbon source, but lack urease and lysine decarboxylase activity; production of hydrogen sulfide is variable, occurring with C. freundii and a few other species. They are differentiated by their ability to convert tryptophan to indole, ferment lactose, and use malonate.338 C. freundii produces hydrogen sulfide and hence can be confused with Salmonella, with which it was classified at one time. Some bacteria produce exoenzymes that lyse red blood cells and degrade hemoglobin; these are called hemolysins. In the pediatric population, infections due to Citrobacter spp. Although biochemical identification of the newer species can be accomplished through the use of conventional tests, most commercial identification systems do not include all species in their databases. This bacterium is found in the … The lysine decarboxylase reaction allows for separation of the hydrogen sulfide-producing isolates of Citrobacter spp. 1994. grow readily on ordinary media. Citrobacter spp. in guinea pigs (Boot and Walvoort, 1986; Ocholi et al., 1988). Historically, most infants were treated with a combination of penicillin or cephalosporin plus an aminoglycoside. Citrobacter species are 1.0 × 2.0–6.0 μm in size. C. freundii and C. koseri have mainly been isolated from urinary and respiratory tract infections. UTIs involving Citrobacter spp. Salmonella Vol. C. freundii accounted for 71% of cases, and C. koseri for the remainder. Composition of Blood Agar Blood agar, like most other nutritional media, has one or more protein sources, salt, and beef extract for vitamins and minerals. Gastroenteritis, osteomyelitis, pyogenic arthritis, pulmonary infections, and pneumatosis intestinalis have been described.13 In older children, adults, and immunocompromised hosts, Citrobacter spp. Stella Antonara, Monica I. Ardura, in Principles and Practice of Pediatric Infectious Diseases (Fifth Edition), 2018. Four types of hemolysis are produced in sheep blood agar by Streptococci namely; alpha hemolysis, beta hemolysis, gamma hemolysis, and alpha prime or wide zone alpha hemolysis. No early features distinguish meningitis due to Citrobacter spp. For example, in 1990, Citrobacter koseri replaced Citrobacter diversus.140 For the purposes of this chapter, C. koseri replaces C. diversus, even though the original article may refer to the latter name. From 1969 to 1989 in Dallas, TX, Citrobacter spp. circulating in the community periodically gain access to a hospital nursery from the hands of nursery personnel and visitors.13 One nursery outbreak of C. freundii was traced to contaminated infant formula.14 Outbreaks in nursery settings can last for months or years and appear to be best controlled by cohorting of patients and personnel. In about 25 % of infants with meningitis due to Citrobacter spp trying to out... Be isolated from urinary and respiratory tract, a finding that more often represents colonization than symptomatic infection coli E.... 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