Bacteremias due to Citrobacter diversus and Citrobacter freundii

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Abstract
• From 1974 to 1982, 38 patients developedCitrobacterbacteremia at two adult community-teaching hospitals in the Detroit Medical Center (incidence, 1.2 cases per 10,000 discharges).Citrobacteraccounted for 0.7% of all bacteremias during the study period. Of 31 cases reviewed,Citrobacterbacteremia frequently developed in elderly patients (65%) and was hospital acquired (77%). Initial sites of infection included the urinary tract (39%), gastrointestinal tract (27%), wound (10%), and unknown (13%). More bacteremias caused byCitrobacter diversustended to arise from the urinary tract, while patients withCitrobacter freundiibacteremia had significantly more gallbladder disease. Patients withCitrobacterbacteremia were more likely than patients withEscherichia colibacteremia to have had additional pathogens in the bloodstream, to develop bacteremia in the hospital, and to have undergone invasive procedures contributing to infection. Significant differences were not observed in demographic, host, or other epidemiologic or clinical factors examined. Of patients withCitrobacterbacteremia, 48% died. (Arch Intern Med1985;145:1808-1810)

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