Citrobacter spp. bloodstream infection primarily affects the elderly either hospitalized or closely associated with health care – a population-based observational study with comparisons between C. koseri and the C. freundii complex
Sunnerhagen, Torgny LU
; Taie, Hiba
; Ohlsson, Johan
and Ljungquist, Oskar
LU
(2025)
In BMC Infectious Diseases
25.
p.1-9
- Abstract
- Objectives
Despite regularly being found in blood cultures, there are few studies of bloodstream infection (BSI) with Citrobacter. In this population-based study, the aim was to explore patient characteristics, outcome, and incidence in a publicly funded single payer setting.
Methods
Patients with growth of Citrobacter in blood culture were identified through the clinical microbiology laboratory in Lund, Sweden, for the year 2013–2023. This laboratory serves the whole Skåne region, with a population of 1.4 million. Medical records were retrospectively reviewed.
Results
554 episodes of Citrobacter BSI were identified, with septic shock seen in 25 (4%) episodes and with 38 (7%) episodes resulting in intensive... (More) - Objectives
Despite regularly being found in blood cultures, there are few studies of bloodstream infection (BSI) with Citrobacter. In this population-based study, the aim was to explore patient characteristics, outcome, and incidence in a publicly funded single payer setting.
Methods
Patients with growth of Citrobacter in blood culture were identified through the clinical microbiology laboratory in Lund, Sweden, for the year 2013–2023. This laboratory serves the whole Skåne region, with a population of 1.4 million. Medical records were retrospectively reviewed.
Results
554 episodes of Citrobacter BSI were identified, with septic shock seen in 25 (4%) episodes and with 38 (7%) episodes resulting in intensive care. The 90-day mortality was 18% and the median age of the patients was 77 years. Resistance to cephalosporins was below 10%, and carbapenem resistance was not found in any isolates. A majority of episodes were healthcare associated or nosocomial, and almost half of BSI cases originated from the urinary tract. The association with the urinary tract was stronger for C. koseri BSI than for C. freundii complex BSI, which was more often polymicrobial and associated with abdominal surgery.
Conclusion
Citrobacter BSI was primarily found in elderly patients, either hospitalized or in close contact with healthcare in other ways. C. koseri BSI was to a greater extent associated with urinary tract focus compared to patients with BSI due to C. freundii complex, which was associated with abdominal source of infection and polymicrobial BSI. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4bc3758f-12c4-4e9f-92ac-ca17f41f2bb4
- author
- Sunnerhagen, Torgny
LU
; Taie, Hiba
; Ohlsson, Johan
and Ljungquist, Oskar
LU
- organization
- publishing date
- 2025-10-20
- type
- Contribution to journal
- publication status
- published
- subject
- in
- BMC Infectious Diseases
- volume
- 25
- article number
- 1353
- pages
- 1 - 9
- publisher
- BioMed Central (BMC)
- ISSN
- 1471-2334
- DOI
- 10.1186/s12879-025-11972-6
- language
- English
- LU publication?
- yes
- id
- 4bc3758f-12c4-4e9f-92ac-ca17f41f2bb4
- alternative location
- https://rdcu.be/eLWQi
- https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-11972-6
- date added to LUP
- 2025-10-20 14:24:16
- date last changed
- 2025-10-21 07:31:13
@article{4bc3758f-12c4-4e9f-92ac-ca17f41f2bb4,
abstract = {{Objectives<br/>Despite regularly being found in blood cultures, there are few studies of bloodstream infection (BSI) with Citrobacter. In this population-based study, the aim was to explore patient characteristics, outcome, and incidence in a publicly funded single payer setting.<br/><br/>Methods<br/>Patients with growth of Citrobacter in blood culture were identified through the clinical microbiology laboratory in Lund, Sweden, for the year 2013–2023. This laboratory serves the whole Skåne region, with a population of 1.4 million. Medical records were retrospectively reviewed.<br/><br/>Results<br/>554 episodes of Citrobacter BSI were identified, with septic shock seen in 25 (4%) episodes and with 38 (7%) episodes resulting in intensive care. The 90-day mortality was 18% and the median age of the patients was 77 years. Resistance to cephalosporins was below 10%, and carbapenem resistance was not found in any isolates. A majority of episodes were healthcare associated or nosocomial, and almost half of BSI cases originated from the urinary tract. The association with the urinary tract was stronger for C. koseri BSI than for C. freundii complex BSI, which was more often polymicrobial and associated with abdominal surgery.<br/><br/>Conclusion<br/>Citrobacter BSI was primarily found in elderly patients, either hospitalized or in close contact with healthcare in other ways. C. koseri BSI was to a greater extent associated with urinary tract focus compared to patients with BSI due to C. freundii complex, which was associated with abdominal source of infection and polymicrobial BSI.}},
author = {{Sunnerhagen, Torgny and Taie, Hiba and Ohlsson, Johan and Ljungquist, Oskar}},
issn = {{1471-2334}},
language = {{eng}},
month = {{10}},
pages = {{1--9}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Infectious Diseases}},
title = {{Citrobacter spp. bloodstream infection primarily affects the elderly either hospitalized or closely associated with health care – a population-based observational study with comparisons between C. koseri and the C. freundii complex}},
url = {{https://lup.lub.lu.se/search/files/230849939/s12879-025-11972-6.pdf}},
doi = {{10.1186/s12879-025-11972-6}},
volume = {{25}},
year = {{2025}},
}