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      Citrobacter koseri, formerly known as Citrobacter diversus, is a Gram-negative non-spore forming, rod-shaped bacterium. It is a facultative anaerobe capable of aerobic respiration. It is motile via peritrichous flagella. It is a member of the family of Enterobacteriaceae. The members of this family are part of the normal flora and commonly found in the digestive tracts of humans and animals.[1] C. koseri may act as an opportunistic pathogen in individuals who are immunocompromised.
      It rarely is community-acquired and mainly occurs as hospital-acquired infections. Infections caused by C. koseri can lead to various symptoms, including fever, chills, diarrhea, and abdominal pain. In severe cases, the bacterium can cause sepsis, meningitis, or brain abscesses. Brain abscesses have a high rate of mortality and complications, particularly in neonates. The transmission of C. koseri could be vertical from mother to fetus, and other sources can be horizontal by asymptomatic nursery staff.


      Signs and symptoms


      Neonates infected with C. koseri usually present with sepsis, meningitis, seizures, apnea, and a bulging fontanelle. No evidence of a stiff neck or high-grade fever is present.


      = Complications

      =
      Occasionally, it causes meningitis, but it can cause sepsis and ventriculitis.
      Arterial and venous infarctions are possible because of the bacterial infiltration along the main vessel; exudates within the ventricles and ventriculitis may obstruct the ventricular foramina and result in multicystic hydrocephalus with consequent long-lasting shunting difficulties and necrotizing meningoencephalitis with pneumocephalus has been reported.


      = Pathogenicity

      =
      The pathogenic mechanism is poorly understood. C. koseri may uniquely penetrate, survive, and replicate into vascular endothelial cells and macrophages. Furthermore, it survives in phagolysosomal fusion and replicates within macrophages, which may contribute to the establishment of chronic abscesses.


      Diagnosis




      = Medical imaging

      =
      Early and massive tissue necrosis is a specific feature of C. koseri brain infection. The early stage of the disease predominates in the white matter, causing cerebritis; the later stage is marked with necrotic cavities in multiple locations. The cavities are initially square and not tense, but when pus forms and collects in these cavities, they tend to become more rounded; a persisting cavity leads to septated ventriculitis that may result in multicystic hydrocephalus.
      Early cerebritis is seen, and multiple large cavities can be seen in the late stage of the disease; abscesses formation, contraction of the cavities, and hydrocephalus due to ventriculitis are observed in the late follow-up.


      = Pathology

      =
      Macroscopic findings include purulent exudates, opaque leptomeninges (thinning of meninges), pus, and ventriculitis/ ependymitis.


      = Microbiology

      =
      In samples collected from cerebrospinal fluid, C. koseri grows well on any ordinary medium; they produce unpigmented, colorless mucoid colonies. If incubated for 24 hours in other media such as indole, citrate, and adonitol, C. koseri will be positive, hydrogen sulfide negative in Kligers’ iron agar, and negative results in lactose, salicin, and sucrose broth as well.


      = Histology

      =
      Citrobacter koseri may be identified in the walls of congested vessels; the presence of the cavities resulting from the infection does not develop a well-formed fibrotic wall.


      = Differential diagnosis

      =
      The differential diagnosis of C. koseri brain abscesses can be confused with other related diseases, so diagnostic imaging is essential to confirm this bacterium. The significant feature of C. koseri is the necrotic cavity which cannot be misidentified as an earlier ischemic or hemorrhagic insult or other mass lesions; congential/neonatal tumors are uncommon (choroid plexus papillomas, craniopharyngiomas, teratomas); even when they present, they are different from the inflammatory ring of cerebral infection. Early cerebritis should not be mistaken for normal, immature white matter, nor cicatricial leukomalacia.


      Treatment


      A broad spectrum cephalosporin and meropenem are often used because of the good penetration into the central nervous system. If the response to the antibiotic is poor, the surgical aspiration of the collected pus reduces the mass effect and enhances the efficacy of the antibiotics.


      Prognosis


      The prognosis of the C. koseri infection is 20 to 30% of neonates die, and 75% of survivors have significant neurologic damage such as complex hydrocephalus, neurologic deficits, mental delay, and epilepsy.


      Control


      The most effective way to reduce transmission of organisms is regular handwashing.


      References




      External links



      "Citrobacter koseri". NCBI Taxonomy Browser. 545.
      Type strain of Citrobacter koseri at BacDive - the Bacterial Diversity Metadatabase

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    Citrobacter koseri - Alchetron, The Free Social Encyclopedia

    Citrobacter koseri - Alchetron, The Free Social Encyclopedia

    Citrobacter koseri | Semantic Scholar

    Citrobacter koseri | Semantic Scholar

    Citrobacter koseri | Semantic Scholar

    Citrobacter koseri | Semantic Scholar

    Citrobacter koseri infection - WikiProjectMed

    Citrobacter koseri infection - WikiProjectMed

    Citrobacter koseri | Semantic Scholar

    Citrobacter koseri | Semantic Scholar

    Citrobacter koseri | Semantic Scholar

    Citrobacter koseri | Semantic Scholar

    Citrobacter koseri - microbewiki

    Citrobacter koseri - microbewiki

    Citrobacter koseri: Introduction, Identification Features, and Keynotes ...

    Citrobacter koseri: Introduction, Identification Features, and Keynotes ...

    Citrobacter Koseri y Amalonaticus | PDF

    Citrobacter Koseri y Amalonaticus | PDF

    Citrobacter koseri: Introduction, Morphology, Pathogenicity, Lab

    Citrobacter koseri: Introduction, Morphology, Pathogenicity, Lab

    File:Citrobacter koseri, ENDO.png - WikiLectures

    File:Citrobacter koseri, ENDO.png - WikiLectures

    File:CItrobacter koseri, KA.png - WikiLectures

    File:CItrobacter koseri, KA.png - WikiLectures

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    citrobacter koseri

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    Citrobacter koseri - Wikipedia

    Citrobacter koseri, formerly known as Citrobacter diversus, is a Gram-negative non-spore forming, rod-shaped bacterium. It is a facultative anaerobe capable of aerobic respiration. It is motile via peritrichous flagella. [2] It is a member of the family of Enterobacteriaceae.

    Citrobacter Koserii as a Cause of Urinary Tract Infection: A Case …

    Nov 12, 2022 · The urine culture reported isolation of Citrobacter Kosseri, a microorganism belonging to the genus Citrobacter belonging to the family of Enterobacteriaceae, are facultative anaerobic bacilli, motile, non-spore-forming, oxidase negative, which use citrate as the only source of carbon.

    What Is Citrobacter Infection? - iCliniq

    May 19, 2023 · Citrobacter species are the third most common organism causing urinary tract infections in hospitalized patients. It consists of eleven different species, and the most common ones affecting humans are C. koseri, C. feundii, C. amalonaticus, C. youngae, and C. braakii.

    Citrobacter Koseri: Overview, Transmission, and Treatment

    Oct 28, 2024 · Explore the characteristics, transmission, and treatment options for Citrobacter Koseri infections in this comprehensive overview. Understanding Citrobacter koseri’s transmission and treatment options is essential for effective management and prevention strategies.

    Citrobacter: An emerging health care associated urinary pathogen

    The author reports the emergence of Citrobacter as a common urinary pathogen in hospitalized patients. The genus Citrobacter was discovered in 1932 by Werkman and Gillen. These organisms are found in soil, water, intestinal tract of animals, and in human clinical samples.

    Urinary Tract Infection Caused by Citrobacter koseri in a Patient …

    Here we present a novel case of a Citrobacter koseri urinary tract infection complicated by a perinephric abscess with pleural extension. To our knowledge, no case of an ascending C. koseri UTI progressing to peri-nephric abscess and empyema by direct extension exists in the literature.

    Citrobacter koseri: Introduction, Morphology, Pathogenicity, Lab

    Aug 1, 2023 · Citrobacter koseri, formerly known as Citrobacter diversus, is a gram-negative bacterium belonging to the Enterobacteriaceae family. It is a facultative anaerobe, meaning it can grow both in the presence and absence of oxygen. The species name “koseri” is a tribute to the bacteriologist Leo Koser.

    Optimum management of Citrobacter koseri infection

    Low virulent Citrobacter koseri can cause life threatening infections. Neonates and other immunocompromised patients are particularly susceptible to infection from C. koseri. Any infection due to C. koseri mandates antimicrobial therapy based …

    Citrobacter Koseri - an overview | ScienceDirect Topics

    Citrobacter species are responsible for sporadic and epidemic clusters of neonatal sepsis and meningitis, and C. koseri is uniquely associated with brain abscesses. 140,141,142,143,144,145,146,147,148 Neonatal disease can occur as …

    Citrobacter Koseri: Pathogenesis, Resistance, and Clinical Impact

    Jan 19, 2025 · Citrobacter koseri is a bacterium known for causing serious infections, particularly affecting the central nervous system. It is associated with conditions such as meningitis and brain abscesses, especially in vulnerable populations like neonates and …