my son, 5.5yrs old had got a result of his routine urine culture as significant growth of citrobacter kesori, done after complaining for lower abdominal pain 1.5months back. Repeated it again after 4 weeks and found the same bug resistant to almost all oral antibiotics. sensitive to flouroquinolones and carbapenam, tazobactam.
he is not complaining about anything at present.
on examination his foreskin cannot be retracted fully
urine analysis is completely normal
discussed with pediatrician, advised suprapubic aspiration before starting antibiotics, cannot rely on culture as he is not circumcised
general surgeon, advised circumcision and iv antibiotics
urologist, attempted to retract and did it and told no need to do anything just repeat culture after 2 weeks hygiene
now i am confused what to do?
if citrobacter is not in urine then it must be in softtissues whether this needs treatment and if yes then which one?
thanks in advance
Citrobacter koseri is usually seen in newborn and in immunocompromised patients. It may be best to discuss the results with the doctor.There may be a possibility that the result may be a contaminant. If this is the case, then there shouldn’t be a need to treat. Does your child have any associated problems like obstruction in urine flow? In that case the infection may take longer to resolve. Suprapubic aspiration is a gold standard for obtaining urine specimens for culture and any growth of pathogenic bacteria in this specimen is considered significant. It is best that you discuss it with your doctor and take the decision. A complete history and clinical examination is important before deciding further course of treatment. Do keep me posted.
Best wishes and regards!
thanksl. after suprapubic aspiration culture turned out no growth, that was
a great news for me. the problem must be because of his prepuce narrowing.
if bug is around prepuce, is it a normal flora or still needs to treat local infestation.
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