my 5.5yrs old son got citrobacter koseri infection UTI asymtomatic

[rajajee]

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
of prepuce.

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

[rajajee]

thanks. 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.

[S. Kaul, MD]

Hi there!

Out of the options available I would suggest antibiotics preferably after a suprapubic aspiration, to be on the safer side; just in case this happens to be an infection.
Hope this is helpful.

Take care!