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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How is source of Citrobacter koseri infection identified?

A 37-week-old infant was delivered by cesarean section and discharged from a Connecticut hospital when he was 10 days old. Two days later he was lethargic and had a fever. When he was readmitted to the hospital, he had multiple brain abscesses caused by Citrobacter koseri. After a prolonged illness, the baby died. A second infant with a normal pregnancy and delivery died of C. koseri meningitis after a short illness. Nine infants in the hospital nursery had umbilical cord colonization by C. koseri. Environmental cultures were negative for hospital equipment tested. How do you identify the source of infection, and what is its normal habitat?
Thu, 24 Sep 2015
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Pathologist and Microbiologist 's  Response
hi by the above scenario looks like there was an outbreak of C. koseri in the hospital nursery. Now Citrobacter koseri belongs to Enterobacteriacea family whose members are normal inhabitants of our intestine. It can be isolated from various environmental sources like soil, sewage and as well as human feces. Since according to you environmental sources were negative for it, other possibility is improper hand hygeine practices in the hospital nursery by some staff. Hand hygeine is an essential step in health care to prevent transmission of micro-organisms. A breach in such practice can lead to an outbreak or a solitary hospital aquired infection case or many. In the case submitted by you source of infection probably are hands of healthcare staff or any other person attending these infants.
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