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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For High Fever And Lethargy In A Child

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 diversus. After a prolonged illness, the baby died. A second infant with a normal pregnancy and delivery died of C. diversus meningitis after a short illness. Nine infants in the hospital nursery had umbilical cord colonization by C. diversus. Environmental cultures were negative for hospital equipment. a. What is the normal habitat of this gram-negative, facultatively anaerobic, non-endospore-forming, lactose-positive rod? b.Provide a plan for identifying the source of infection and preventing further infection.
Thu, 27 Sep 2018
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Pediatrician 's  Response
Hello,

I am sorry to learn about this tragic situation and hope I can share information to prevent this from occurring again.

Acquisition of Citrobacter diversus(and all gram-negative organisms) occurs through person-to-person transmission and nursery environmental sites like sinks, countertops, powdered infant formula, and respiratory therapy equipment.

Newborns with defects in skin integrity or mucosa or abnormalities of GI or GU tracts are at increased risk of gram-negative bacterial infections. Infection control programs ought to be run by pediatric infection control specialists.

An excellent method of preventing /controlling these infections is to practice good hand-washing technique.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Arnold Zedd, Pediatrician
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Suggest Treatment For High Fever And Lethargy In A Child

Hello, I am sorry to learn about this tragic situation and hope I can share information to prevent this from occurring again. Acquisition of Citrobacter diversus(and all gram-negative organisms) occurs through person-to-person transmission and nursery environmental sites like sinks, countertops, powdered infant formula, and respiratory therapy equipment. Newborns with defects in skin integrity or mucosa or abnormalities of GI or GU tracts are at increased risk of gram-negative bacterial infections. Infection control programs ought to be run by pediatric infection control specialists. An excellent method of preventing /controlling these infections is to practice good hand-washing technique. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Arnold Zedd, Pediatrician