A 37-week-old infant was delivered by cesarean section and discharged from a Connecticut hospital when he was 10 days old. Two days later he was lethargic and had a fever. When he was admitted to the hospital, he had multiple brain abscesses caused by Citrobacter diversus. After a prolonged illness, the baby died. A second infant with a normal pregnancy and delivery died of C. diversus meningitis after a short illness. Nine infants in the hospital nursery had umbilical cord colonization by C. diversus. Environmental cultures were negative for hospital equipment. What is the normal habitat of this gram-negative, facultatively anaerobic, non-endospore- forming, lactose-positive rod? Provide a plan for identifying the source of infection and preventing further infection. Solution Part-a: The normal habitat of this gram-negative bacteria, Citrobacter diversus is mainly nutritive tissues of umbilical cord tissue on the infant after separation from the mother. The possible infection is in the infant developed due to unhygienic practices result in growth of this bacterial species in human intestine and meningis layers of brain (result in higher sepsis) to use nutritive lactose when drinking breast milk. This intestinal and meningis habitat can provide them a better change to generate higher anaerobic cellular respiration. Part-b: The main mode of infection is either through mother to infant or from those infants who have suffering from umbilical cord colonization by C. diversus. The mode of transmission is due to unhygienic practices by the nurses such as using \"nutritious hand creams\" for hand washing within the nursery finally touching newborn infant from the direct contact of infected infant\'s umbilicus. Therefore, it is crucial to use \"triple dye on umbilical stumps\" along with hygienic practices by the nurses in the nursery. It is crucial to use chlorhexidine hand washing preparations as a result; it is possible to prevent further infection..

1. A 37-week-old infant was delivered by cesarean section and discharged from a Connecticut
hospital when he was 10 days old. Two days later he was lethargic and had a fever. When he was
admitted to the hospital, he had multiple brain abscesses caused by Citrobacter diversus. After a
prolonged illness, the baby died. A second infant with a normal pregnancy and delivery died of
C. diversus meningitis after a short illness. Nine infants in the hospital nursery had umbilical
cord colonization by C. diversus. Environmental cultures were negative for hospital equipment.
What is the normal habitat of this gram-negative, facultatively anaerobic, non-endospore-
forming, lactose-positive rod? Provide a plan for identifying the source of infection and
preventing further infection.
Solution
Part-a: The normal habitat of this gram-negative bacteria, Citrobacter diversus is mainly nutritive
tissues of umbilical cord tissue on the infant after separation from the mother. The possible
infection is in the infant developed due to unhygienic practices result in growth of this bacterial
species in human intestine and meningis layers of brain (result in higher sepsis) to use nutritive
lactose when drinking breast milk. This intestinal and meningis habitat can provide them a better
change to generate higher anaerobic cellular respiration.
Part-b: The main mode of infection is either through mother to infant or from those infants who
have suffering from umbilical cord colonization by C. diversus. The mode of transmission is due
to unhygienic practices by the nurses such as using "nutritious hand creams" for hand washing
within the nursery finally touching newborn infant from the direct contact of infected infant's
umbilicus. Therefore, it is crucial to use "triple dye on umbilical stumps" along with hygienic
practices by the nurses in the nursery. It is crucial to use chlorhexidine hand washing
preparations as a result; it is possible to prevent further infection.