Authors :
Dr. Ashritha D N; Dr. Sr Romia Rodriguez
Volume/Issue :
Volume 10 - 2025, Issue 7 - July
Google Scholar :
https://tinyurl.com/nb9efud6
Scribd :
https://tinyurl.com/35hmx2hv
DOI :
https://doi.org/10.38124/ijisrt/25jul960
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Note : Google Scholar may take 30 to 40 days to display the article.
Abstract :
The increased occurrence of urinary tract infections (UTIs) among older male patients, particularly in those with
numerous comorbidities, has led to a greater awareness of these illnesses. The 76-year-old man patient in this case had a
complex UTI brought on by the multidrug-resistant bacterium Citrobacter koserii, who also had underlying disorders. This
case highlights the difficulties in diagnosing and treating UTIs in older men, especially those who have immunosuppressive
diseases and incontinence. Despite being thought of as having low virulence, C. koserii has shown signs of growing resistance
to antibiotics. Managing such infections requires prompt empirical treatment with broad-spectrum antibiotics such as
piperacillin/tazobactam, with culture-guided de-escalation guaranteeing the best results. For elderly patients with complex
UTIs brought on by multidrug-resistant organisms, early detection and focused antibiotic treatment are crucial. In order to
avoid therapeutic failure, this instance highlights the significance of individualized empirical therapy and careful follow-up.
Keywords :
Citrobacter Koserii, Urinary Tract Infection, Eldery Patient, Antibiotic Sensitivity, Piperacillin/Tazobactam.
References :
- Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. mayo de 2015; 13(5): 269-84.
- Doran TI. The role of Citrobacter in clinical disease of children. Clinical infectious diseases. 1999 Feb 1;28(2):384-94.
- Samonis G, Karageorgopoulos DE, Kofteridis DP, Matthaiou DK, Sidiropoulou V, Maraki S, Falagas ME. Citrobacter infections in a general hospital: characteristics and outcomes. European journal of clinical microbiology & infectious diseases. 2009 Jan;28(1):61-8.
- Barton LL, Walentik C. Citrobacter diversus urinary tract infection Am J Dis Child. 1982;136:467–8
- Whitby JL, Muir GG. Bacteriological studies of urinary tract infection Br J Urol. 1961;33:130–4
- Hernández ALD, Escalante SA, Escobar GAB. Identificación de Citrobacter koseri como nuevo patógeno en pacientes con rinitis crónica. Otorrinolaringología. 2014; 59(1): 1-10.
- Samonis G, Karageorgopoulos DE, Kofteridis DP, Matthaiou DK, Sidiropoulou V, Maraki S, et al. Citrobacter infections in a general hospital: characteristics and outcomes. Eur J Clin Microbiol Infect Dis. 6 de agosto de 2008; 28(1): 61.
- Zeng G, Zhu W, Lam W, Bayramgil A. Treatment of urinary tract infections in the old and fragile. World J Urol. noviembre de 2020; 38(11): 2709-20.
- Griebling TL. Urologic diseases in america project: trends in resource use for urinary tract infections in men. J Urol. abril de 2005; 173(4): 1288-94.
- EAU-Guidelines-on-Urological-Infections-2022.pdf
- Disponible en: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Urological-Infections-2022.pdf
- Nicolle LE. Urinary tract infections in the elderly. Clinics in geriatric medicine. 2009 Aug 1;25(3):423-36.
- Rowe TA, Juthani-Mehta M. Urinary tract infection in older adults. Aging health. 2013 Oct 1;9(5):519-28.
- Caljouw MAA, den Elzen WPJ, Cools HJM, Gussekloo J. Predictive factors of urinary tract infections among the oldest old in the general population. A population-based prospective follow-up study. BMC Med. 16 de mayo de 2011; 9: 57.
- GPC-infeccion-de-vias-urinarias.pdfDisponibleen: https://www.revistamedicaclcountry.com/app/default/files-module/local/documents/GPC-infeccion-de-vias-urinarias.pdf.
- Guzmán N, García-Perdomo HA. Novedades en el diagnóstico y tratamiento de la infección de tracto urinario en adultos. 79: 14.
- Deveci A, Coban AY. Optimum management of Citrobacter koseri infection. Expert Review of Anti-infective Therapy. 1 de septiembre de 2014; 12(9): 1137-42.
- Tambyah PA, Maki DG. Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1497 catheterized patients. Archives of internal medicine. 2000 Mar 13;160(5):678-82.
- Samonis G, Karageorgopoulos DE, Kofteridis DP, Matthaiou DK, Sidiropoulou V, Maraki S, Falagas ME. Citrobacter infections in a general hospital: characteristics and outcomes. European journal of clinical microbiology & infectious diseases. 2009 Jan;28(1):61-8.
- Liu L, Zhang L, Zhou H, Yuan M, Hu D, Wang Y, Sun H, Xu J, Lan R. Antimicrobial resistance and molecular characterization of Citrobacter spp. causing extraintestinal infections. Frontiers in Cellular and Infection Microbiology. 2021 Aug 27;11:737636.
- Mohanty S, Singhal R, Sood S, Dhawan B, Kapil A, Das BK. Citrobacter infections in a tertiary care hospital in Northern India. Journal of Infection. 2007 Jan 1;54(1):58-64.
- Samonis G, Karageorgopoulos DE, Kofteridis DP, Matthaiou DK, Sidiropoulou V, Maraki S, Falagas ME. Citrobacter infections in a general hospital: characteristics and outcomes. European journal of clinical microbiology & infectious diseases. 2009 Jan;28(1):61-8.
- Clinical and molecular epidemiology of multidrug-resistant Citrobacter spp. infections in a French university hospital | SpringerLink
- Disponible en: https://link.springer.com/article/10.1007/s10096-007-0315-3.
- Lee R, Choi SM, Jo SJ, Lee J, Cho SY, Kim SH, Lee DG, Jeong HS. Clinical characteristics and antimicrobial susceptibility trends in Citrobacter bacteremia: an 11-year single-center experience. Infection & Chemotherapy. 2019 Mar 1;51(1):1-9.
- Sami H, Sultan A, Rizvi M, Khan F, Ahmad S, Shukla I, Khan HM. Citrobacter as a uropathogen, its prevalence and antibiotics susceptibility pattern. Chrismed journal of Health and Research. 2017 Jan 1;4(1):23-6.
- Fàbrega A, Madurga S, Giralt E, Vila J. Mechanism of action of and resistance to quinolones. Microb Biotechnol. enero de 2009; 2(1): 40-61.
- Rybak MJ, McGrath BJ. Combination antimicrobial therapy for bacterial infections: guidelines for the clinician. Drugs. 1996 Sep;52(3):390-405.
- Johnson JR, Russo TA. Acute pyelonephritis in adults. New England Journal of Medicine. 2018 Jan 4;378(1):48-59.
The increased occurrence of urinary tract infections (UTIs) among older male patients, particularly in those with
numerous comorbidities, has led to a greater awareness of these illnesses. The 76-year-old man patient in this case had a
complex UTI brought on by the multidrug-resistant bacterium Citrobacter koserii, who also had underlying disorders. This
case highlights the difficulties in diagnosing and treating UTIs in older men, especially those who have immunosuppressive
diseases and incontinence. Despite being thought of as having low virulence, C. koserii has shown signs of growing resistance
to antibiotics. Managing such infections requires prompt empirical treatment with broad-spectrum antibiotics such as
piperacillin/tazobactam, with culture-guided de-escalation guaranteeing the best results. For elderly patients with complex
UTIs brought on by multidrug-resistant organisms, early detection and focused antibiotic treatment are crucial. In order to
avoid therapeutic failure, this instance highlights the significance of individualized empirical therapy and careful follow-up.
Keywords :
Citrobacter Koserii, Urinary Tract Infection, Eldery Patient, Antibiotic Sensitivity, Piperacillin/Tazobactam.