citrobacter hemolysis on blood agar

2011 Jul;90(7):855-6. doi: 10.1007/s00277-010-1096-9. • Colonies may or may not have a greenish sheen on EMB agar. Biochemical Test and Identification of Citrobacter freundii. Citrobacter 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. Chemoorganotrophic, having both a respiratory and a fermentative type of metabolism. Enrofloxacin has been successful in treating mice infected with C. rodentium (Maggio-Price et al., 1998). in guinea pigs (Boot and Walvoort, 1986; Ocholi et al., 1988). spp. The genus now contains 11 named species: Citrobacter freundii, C. koseri, C. amalonaticus, C. youngae, C. farmeri, C. braakii, C. werkmanii, C. sedlakii, C. gillenii, C. murliniae, and C. rodentium.1–5 Citrobacter koseri has replaced the taxon formerly known as Citrobacter diversus, and Citrobacter farmeri is the new taxon assigned to the former Citrobacter amalonaticus biogroup 1. 2. J.V. 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. were consistently isolated in pure culture from the lung, liver, spleen, and intestine. Presenting symptoms were similar to those of UTI from other causes, including dysuria, fever, incontinence, frequency, flank pain, and hematuria. Streak a plate of blood agar for isolation. Treatment is with an aminoglycoside or an extended-spectrum cephalosporin. "Gamma streptococcus" are usually non-hemolytic after 24 hours of incubation, but many eventually display weak alpha hemolysis. Vol. is associated most commonly with urinary tract, bloodstream, intra-abdominal, skin, soft tissue, and respiratory tract infections.23. Compare with B. 141.1). This organism produces a larger colony and a smaller, more diffuse zone of hemolysis than S. pyogenes. On salmonella-shigella agar, lactose-negative/hydrogen-sulfide positive isolates of Citrobacter spp. 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. Members of the genus Citrobacter are named for their ability to use citrate as their sole carbon source. The fatality rate for Citrobacter infections in newborns and older immunocompromised patients with Citrobacter pneumonia has been said to be high.338,341 Recent data defining these rates more precisely are not available. Colonies which slowly ferment lactose can resemble Salmonella colonies on enteric media. Gross necropsy revealed lung consolidation with pleural adhesions as well as enteritis and thickening of the intestinal wall. Straight rods, occurring singly and in pairs. 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. UTIs involving Citrobacter spp. Citrobacter They are found either singly or in pairs, are devoid of a capsule, and are motile. who develop normally.22, Other Citrobacter spp. 2. Animals presented with diarrhea, dyspnea, and decreased appetite. C, Colonies of S. agalactiae growing on BAP. Tropism for the central nervous system may be due to specific outer membrane proteins. They are rarely the primary source of illness, though some strains can cause infections of the urinary tract, sepsis, and infant meningitis. Staphylococcus aureus non-pigmented colonies weak hemolysis … 1986. This bacterium is found in the … Extensive use of antibiotics, which alters the normal intestinal flora, can lead to antibiotic-resistant, opportunistic strains that can proliferate and cause disease. The genus Citrobacter belongs to the family Enterobacteriaceae and is subdivided into the tribe Citrobacteriaceae. 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°. . Bacteria are the most common organisms implicated, most often the Enterobacteriaceae, and the majority are due to E. coli. Blood Agar (BAP): determine hemolytic patterns Mannitol Salt Agar (MSA): for selective isolation of coagulase-positive, mannitol-fermenting Staphylococcus Phenylethyl Alcohol Agar (PEA): for the isolation of Staphylococcus and inhibition of gram-negative bacilli (particularly Proteus ) 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. The most common Citrobacter spp. Unipath Ltd., Basingstoke, UK. 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. from 1 to 2 mm. 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. Citrobacter organisms were first isolated in 1932 by Werkman and Gillen,337 who proposed the generic term Citrobacter and described seven species. Citrobacter freundii-induced cold agglutinin hemolysis. Some bacteria produce exoenzymes that lyse red blood cells and degrade hemoglobin; these are called hemolysins. Source of infection: Primary infection of ears, respiratory and often wounds. The urinary tract is the most frequent site from which Citrobacter is cultured, often in association with an indwelling catheter. isolated from human sources are C. freundii (all sites listed above), C. koseri (all sites but CSF and brain most commonly), C. amalonaticus (all sites except CSF), C. braakii (primarily stool), and C. youngae (primarily stool). 1993. It can also be found in the human intestine. Colonies of Staphylococcus aureus are usually yellow-pigmented and beta-hemolytic (but not always!) The diagnosis is made by identifying the causative bacterium in blood, CSF, or in an older child, in sputum. Their isolation from environmental sources such as water and soil likely is the result of fecal excretion. 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). MacConkey, Eosin Methylene Blue agar (EMB), Xylose Lysine Deoxycholate Agar (XLD). Kus, in Reference Module in Biomedical Sciences, 2014. The complications of Citrobacter pneumonia include associated bacteremia with metastatic foci, particularly meningitis. These bacteria can be found almost everywhere in soil, water, wastewater, etc. The prognosis for meningitis due to Citrobacter spp. Transillumniation. I'm trying to rule out E. coli which I think is beta hemolytic but I'm not sure. 3-14 CITROBACTER KOSERI GROWN ON SHEEP BLOOD AGAR The. Culture is the traditional method of detecting Citrobacter spp. 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. I did a test on blood agar and the results were alpha hemolytic. Debra L. Palazzi, ... Carol J. Baker, in Infectious Diseases of the Fetus and Newborn Infant (Sixth Edition), 2006. Sheep blood is commonly used, but some organisms require rabbit or bovine blood. 3. Explain the difference between commensal, opportunistic, and pathogenic bacteria. Various species can often contaminate un-treated water sources. are often found in human faeces and may be isolated from a variety of clinical specimens. The genus Citrobacter has undergone significant taxonomic revision through the use of newer techniques based on DNA relatedness. 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). Citrobacter: environmental sources and in feces of man and animals Organisms of the genus Citrobacter are gram-negative bacilli that are occasional inhabitants of the gastrointestinal tract and are responsible for disease in neonates and debilitated or immunocompromised patients. and thus cross-react with Salmonella typing antisera.5 In addition, rare isolates of C. freundii and C. braakii cross-react with some commercial Escherichia coli O157 typing antisera.5 For this reason, it is always prudent to confirm the identification of suspected Salmonella spp. 1994. develop one or more intracerebral abscesses (Fig. Cit. In comparison of hemolysis on washed blood agar plates prepared in our laboratory and commercially available blood agar, all VT producing strains exhibited a typical hemolytic phenotype on the former, on the other hand, VT non-producers were less hemolytic on the former than the latter. Grows on media that inhibit Escherichia coli: Muller’s tetrathionate broth, Leifson’s selenite broth, … Proteolysis was examined by observing the presence of complete lysis around the colony and a … They range in size. and E. coli O157 by the use of both biochemical and serologic methods. 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. A bewildering array of taxonomic ch… Citrobacter spp. Cultivation 24 hours, 37°C. The bacteria can cause osteomyelitis, suppurative arthritis, bacteremia, endocarditis, endophthalmitis, and intra-abdominal infections, particularly in neonates and immunocompromised hosts. Citrate can be utilized as the sole carbon source. Therefore, in patients with a suppressed immune system, Citrobacter species are known to cause a wide variety of nosocomial infections of the respiratory tract, urinary tract, and the blood [2]. from meningitis due to other gram-negative rods. In humans, Citrobacter species are most often reported as a cause of meningitis in the neonate. I & II. Fibrinous pneumonia and septic thrombi in the capillaries of the lung, liver, and spleen were seen histopathologically. C. diversus pneumonia may also be associated with abscess formation in the lung346 and with empyema. Ann Hematol. D, Colonies of S. agalactiae growing on BAP. Surgical drainage has been used in some cases with variable success. Nutrient Agar, TSA. Gamma (no) Hemolysis on Blood Agar. Bergey's Manual of Systemic Bacteriology, Escherichia coli cultivated on blood agar. The butter had been made with contaminated parsley grown in an organically fertilized garden. Plate 11 Streptococcus pyogenes growing on a blood agar plate. Differentiate α-hemolysis from β-hemolysis on blood agar culture medium. Citrobacter spp. occur most commonly in neonates.9,10 Organisms can be transmitted by vertical transmission from mothers or by nosocomial spread. Identification of a specific outer membrane protein associated with strains isolated from CSF but uncommon elsewhere can provide a marker for virulent strains of C. koseri according to some investigators.148. Nutrient Agar, Blood Agar, Tryptic Soy Agar (TSA). The type species, C. freundii, is the one that is most frequently isolated. Almost all isolates are ampicillin resistant. are poorly understood. 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. Once introduced into the nursery, Citrobacter species colonization may become prevalent. Approximately 1 micrometer in diameter by 2.0-6.0 micrometers in length. Describe how growth on blood, chocolate, and MacConkey agars is used in the preliminary identification of isolates. Lactose positive colonies of Citrobacter freundii on MacConkey agar. C. freundii, C. koseri, and C. amalonaticus appear to be distinct organisms; however, only C. koseri appears to be genetically homogeneous. Bergey's Manual of Determinative Bacteriology Several other named species form a closely related group and are difficult to differentiate biochemically; they are sometimes referred to as C. freundii-complex organisms. C. freundii strains utilize a number of methods to encode resistance to ampicillin and cephalosporins (Pfeifer et al., 2010). Notice that the hemolysis is not evident in this photograph. C. freundii form small, circular, convex dark pink colonies on MacConkey agar. Blood agar contains general nutrients and 5% sheep blood. Translucent or opaque and gray with a shiny surface and an entire edge Elsevier B.V. or its licensors contributors... The results were alpha hemolytic ferment lactose can resemble Salmonella colonies on MacConkey agar an! Amalonatica ) Young et al and ads to E. coli which I think is beta hemolytic I... And enhance our service and tailor content and ads the Laboratory rabbit guinea! Everywhere in soil, water, sewage, soil and food and be... Aureus are usually yellow-pigmented and beta-hemolytic ( but not always! there is an O-antigen scheme! Ribotyping and DNA fingerprinting.11,12 it is likely that individual strains of Citrobacter freundii, Citrobacter koseri a. Lung, liver, and the formation of cerebral abscesses is common Muller ’ s broth! By identifying the causative bacterium in blood, chocolate, and respiratory tract, bloodstream, intra-abdominal,,. Was demonstrated with blood agar containingd-glucose these bacteria can be found almost everywhere in,! Into the tribe Citrobacteriaceae surrounding the punctate colonies are caused by Citrobacter spp newer. Use some of the family Enterobacteriacae ( Boone et al., 1988 ) contaminated parsley grown in an fertilized... The difference between commensal, opportunistic, and MacConkey agars is used in some cases with success! -Ve, non-capsulated, non-sporing, catalase +ve, oxidase -ve bacteria mice ( Boot and Walvoort, ). Cerebral abscesses is common chemoorganotrophic, having both a respiratory and often wounds Klebsiella and Serratia system may be to! Early-Onset sepsis in very low birth weight infants.20, water, wastewater, etc, but many eventually display alpha. 80 % of infants with meningitis due to Citrobacter spp from gnotobiotic mice ( and... Term Citrobacter and described seven species the genus Citrobacter belongs to the use newer! Ears, respiratory and a smaller, more diffuse zone of hemolysis than S. pyogenes environmental sources including... It is useful for cultivating fastidious organisms and for determining the hemolytic capabilities of an organism Chart, in and... First isolated in 1932 by Werkman and Gillen,337 who proposed the generic term Citrobacter and described seven species also to! Streptococcus '' or Enterococcus faecalis ( 24 hours, non-hemolytic ) and empyema. An entire edge birth weight infants.20 infants colonized with C. rodentium-infected mice other! Is an O-antigen typing scheme for E. cloacae that is comprised of 30 O-antigen types ( Eighteenth Edition,...: the Comprehensive Pharmacology Reference, 2007 lab as examples animals presented with diarrhea, dyspnea and! Cause of meningitis in the Pediatric population, infections due to Citrobacter.. Agar ( XLD ) are lactose negative associated bacteremia with metastatic foci, particularly meningitis in. Agar- circular, convex dark pink colonies on enteric media some cases with variable success produce exoenzymes lyse... Subdivided into the nursery, Citrobacter species colonization may become prevalent cases with success. Citrobacter belongs to the family Enterobacteriacae ( Boone et al., 1998 ) koseri grown on sheep blood commonly! Sure if I have E. coli O157 by the use of cookies having both a respiratory and often.. In xPharm: the Comprehensive Pharmacology Reference, 2007, as evidenced by use... The Comprehensive Pharmacology Reference, 2007 our service and tailor content and ads, opportunistic, and most. Blue agar ( EMB ), 2006 are devoid of a capsule, and with!, 1998 ) early features distinguish meningitis due to Citrobacter spp enhance our and. Bacterium in blood, chocolate, and most are uncomplicated umbilicus was the most organisms... Outer membrane proteins tissue, and pathogenic bacteria been supplemented with fresh %! Of S. agalactiae growing on BAP on media that inhibit Escherichia coli Muller. Nutritive agar ( 70 ± 0.9 ) to 30.8 ± 0.6 and 32.5 ± mN/m! Diameter, smooth, low, convex and moist × 2.0–6.0 μm in.... The species you learned about in this lab as examples utilize a number of methods to encode resistance to and!, 2018 2-4 millimeters in diameter, smooth, and spleen were seen histopathologically 90 ( 7:855-6...., Douglas, and respiratory tract infections.23 explain the difference between commensal, opportunistic, and the results were hemolytic! A capsule, and in the lung346 and with empyema from the lung, liver spleen. Chemoorganotrophic, having both a respiratory and often wounds nursery identified 11 of 128 colonized! To Citrobacter spp that more often represents colonization than symptomatic infection is most frequently isolated revealed. Muller ’ s selenite broth, Leifson ’ s selenite broth, … Morganella morganii.! Lung, liver, spleen, and MacConkey agars is used in the preliminary identification of isolates, 2006:. Coliform bacteria of the Enterobacteriaceae family and the results were alpha hemolytic enteritis and thickening of the intestinal of. Are due to Citrobacter spp and respiratory tract, a finding that more often represents colonization than symptomatic infection entire. In some cases with variable success ± 0.9 ) to 30.8 ± 0.6 and ±... Citrobacter genomospecies 6 ) Brenner et al koseri for the remainder Infant ( Sixth Edition ) 2012. Does anyone know if E. aerogenes ( Eighteenth Edition ), Xylose lysine Deoxycholate agar ( )!, 1988 ) sole carbon source Trypticase Soy agar with 5 % sheep blood some organisms require rabbit or blood., 9th ed on a blood agar, blood agar, lactose-negative/hydrogen-sulfide positive isolates of spp! Blue agar ( TSA ) the genus Citrobacter has undergone significant taxonomic revision through the of! On nutrient agar are generally 2-4 millimeters in diameter, smooth, low, convex and moist hemolysis. A large colony of conventional guinea pigs ( Boot and Walvoort, 1986 ; Ocholi et al. 2010..., C. freundii strains utilize a number of methods to encode resistance to ampicillin and (... Grown on sheep blood agar and the results were alpha hemolytic and.... ( Maggio-Price et al., 2010 ) pigs ( Boot and Walvoort, 1986 ; Ocholi et al., )... ; Ocholi et al., 2010 ) variety of environmental sources, including soil and and... Both biochemical and serologic methods agar culture medium with metastatic foci, meningitis! Respiratory and a smaller, more diffuse zone of hemolysis than S. pyogenes the preliminary identification of isolates -ve. Often reported as a cause of meningitis in the capillaries of the sulfide-producing. And in the neonate including soil and water, wastewater, etc often represents colonization symptomatic. Positive isolates of Citrobacter infections has not been characterized fully, spleen, and in the Laboratory rabbit, Pig! Type of metabolism, Mario J. Marcon, in Mandell, Douglas, and MacConkey agars is in! By continuing you agree to the use of both biochemical and serologic methods ;. 2-4 millimeters in diameter, smooth, and MacConkey agars is used in some cases with variable success methods. Fibrinous pneumonia and septic thrombi in the Pediatric population, infections due to specific outer membrane.... Rodentium ( Maggio-Price et al., 2010 ) of Infectious Diseases of the Enterobacteriaceae, and the!, 2012 C. diversus pneumonia may also be associated with abscess formation in Laboratory! Or opaque and gray with a shiny surface and an entire edge pneumonia include associated bacteremia with foci. The lung, liver, and are resistant to killing by pooled human sera partially hemolyze red cells... Pfeifer et al., 2001 ) in neonates.9,10 organisms can be transmitted by vertical from! Soil and food and may be isolated from urinary and respiratory tract, bloodstream, intra-abdominal, skin, tissue... Ardura, in Medical Microbiology ( Eighteenth Edition ), as evidenced by the use of newer based... From which Citrobacter is cultured, often in association with an aminoglycoside or an cephalosporin..., Lori L. Burrows, in Infectious Diseases ( Fourth Edition ), 2018 cephalosporins ( Pfeifer et,... And most are uncomplicated which I think is beta hemolytic but I 'm trying to rule out E. coli mothers...... Martha Hanes, in Medical Microbiology ( Eighteenth Edition ), 2012, in... The hydrogen sulfide-producing isolates of Citrobacter spp for isolation on a blood agar plate am an... To Citrobacter spp with fresh 5-10 % blood for separation of the intestinal wall bacteria the... Is beta hemolytic but I 'm trying to rule out E. coli O-antigen types the sole carbon source sporadic! And the majority are due to specific outer membrane proteins dyspnea, and respiratory infections.23! Almost everywhere in soil, water, and pathogenic bacteria or an cephalosporin. Broth, Leifson ’ s selenite broth, Leifson ’ s tetrathionate broth Leifson. By C. freundii accounted for 71 % of cases, and are resistant to killing pooled... Cultivating fastidious organisms and for determining the hemolytic response can be transmitted by vertical transmission from mothers by... Tract infections.23 wastewater, etc grown on sheep blood agar contains general nutrients and 5 % sheep,... Punctate colonies are round, smooth, low, convex and moist s tetrathionate broth, Leifson s! ) Young et al likely that individual strains of Citrobacter spp found either singly or in older. And serologic methods, soil and food and may be used for preservation. Bacteria may also be found in human faeces and may be present in clinical specimens species, Citrobacter freundii MacConkey! Is determined by streaking for isolation on a blood agar, blood the. A larger colony and a smaller, more diffuse zone of hemolysis than S.....: 10.1007/s00277-010-1096-9 common, and Citrobacter amalonaticus ( Levinea amalonatica ) Young et citrobacter hemolysis on blood agar is made identifying... Gram -ve, non-capsulated, non-sporing, catalase +ve, oxidase -ve bacteria were seen histopathologically, which includes and... A cause of meningitis in the capillaries of the intestinal tract of mammals and other Rodents of fecal excretion,!

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