Antibiotic Resistance Patterns of Citrobacter Isolates from Elderly Patients with Urinary Tract Infections in Cote D’ivoire

Abstract

Aims : Citrobacter is a rarely acquired nosocomial pathogen. However, it is responsible for various clinical diseases and is associated with a wide range of infections that can lead to high mortality rates. The objective of this study was to evaluate the antibiotic resistance of Citrobacter strains responsible for urinary tract infections in elderly patients. From July 2023 to January 2024. Study Design : It is a retrospective study. Place and Duration of Study : Bacteriology and virology laboratory of Institut Pasteur, Abidjan, Côte d'Ivoire. Methodology : 47 strains of Citrobacter of human origin, collected at the Biological Resource Centre (CeReB) of the Pasteur Institute of Côte d'Ivoire, were isolated from various biological samples of elderly patients and identified by standard bacteriological and biochemical tests. Antibacterial susceptibility was determined by the antibiotic disc diffusion method. The production of extended-spectrum beta-lactamases was determined by the double synergy method. The chi-square test for homogeneity was applied to compare Citrobacter isolation rates according to biological sample type, hospital department, and patient sex. Results : Citrobacter strains were the most frequently isolated from urine at 59.57% (χ² = 18.28; p < 0.001). Citrobacter organisms showed high resistance to cephalosporins, specifically to cefixime (89.29%), cefotaxime, and ceftriaxone (60.71%). Among aminoglycosides, kanamycin was the most active molecule, with 10.71% resistance. However, resistance rates to fluoroquinolones exceeded 50%. Of the 47 strains, 17 (36.17%) produced extended-spectrum beta-lactamases. Conclusion : In light of these findings, bacterial resistance remains a major public health concern.