Lai C.-C.Tan C.-K.Lin S.-H.Liu W.-L.Liao C.-H.YU-TSUNG HUANGPO-REN HSUEH2021-05-182021-05-1820100195-6701https://scholars.lib.ntu.edu.tw/handle/123456789/561145This study analysed the clinical characteristics of bacteraemia due to unusual Citrobacter species. All non-freundii and non-koseri Citrobacter isolates were identified to species level by two commercial identification methods and 16S rRNA gene sequence analysis. A total of 306 patients with Citrobacter spp. bacteraemia were identified from January 2000 through December 2009. Four patients (1.3%) had C. braakii bacteraemia, and one had C. amalonaticus and C. sedlakii sepsis, respectively. Misidentification as non-freundii and non-koseri Citrobacter spp., which occurred in eight isolates with the Phoenix automated system PMIC/ID-30 and three with the Vitek II system, occurred in five of six infection episodes. Among the six patients with bacteraemia caused by non-freundii and non-koseri Citrobacter spp., five (83.3%) had healthcare-associated infection and five (83.3%) infections were secondary to intra-abdominal infection. Cancer and liver cirrhosis were the commonest underlying diseases. An attributable mortality was 33.3%. Antimicrobial susceptibility testing showed that the resistance patterns varied among different Citrobacter species. Non-freundii and non-koseri Citrobacter species are difficult to identify and are a rare cause of intra-abdominal infections with secondary healthcare-associated bacteraemia in immunocompromised patients. ? 2010 The Hospital Infection Society.[SDGs]SDG3aminoglycoside antibiotic agent; cefepime; ciprofloxacin; imipenem; antibiotic sensitivity; article; bacteremia; bacterium identification; Citrobacter; citrobacter amalonaticus; Citrobacter amalonaticus infection; Citrobacter braakii; Citrobacter braakii infection; Citrobacter sedlakii; Citrobacter sedlakii infection; healthcare associated infection; human; infection; nonhuman; nucleotide sequence; Taiwan; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Bacterial Typing Techniques; Citrobacter; DNA, Bacterial; DNA, Ribosomal; Enterobacteriaceae Infections; Female; Humans; Male; Microbial Sensitivity Tests; RNA, Ribosomal, 16S; Sequence Analysis, DNA; Taiwanjournal article10.1016/j.jhin.2010.06.006207083032-s2.0-78349311682