LAB WORK
TREATMENT OPTIONS
CLINICAL NOTES
- G(-) bacilli, most common species encountered are C. freundii and C. koseri
TREATMENT OPTIONS
- C. freundii is typically more resistant than C. koseri, but beta lactamase production (AmpC) is seen in both types
- For C. freundii, fluoroquinolones, cefepime, and carbapenems are the preferred agents to avoid inducing beta lactamase production, which can lead to treatment failure
- For C. koseri, in addition to the agents that can be used for C. freundii, 3rd generation cephalosporins, aztreonam, and Zosyn may also be effective
- Repeat cultures regularly to monitor for possibility of induced resistance
CLINICAL NOTES
- Typically a nosocomial pathogen
- Most commonly encountered in UTIs, but can lead to respiratory, wound, bone, heart, and CNS disease and bacteremia