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Klebsiella aerogenes, [2] previously known as Enterobacter aerogenes, is a Gram-negative, oxidase-negative, catalase-positive, citrate-positive, indole-negative, rod-shaped bacterium. [3] Capable of motility via peritrichous flagella, [ 4 ] it is approximately one to three microns in length.
Carbapenem-resistant Enterobacteriaceae (CRE) have been defined as carbapenem-nonsusceptible and extended-spectrum cephalosporin-resistant Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae complex, Klebsiella pneumoniae, or Klebsiella oxytoca. Some exclude ertapenem resistance from the definition. [5]
Klebsiella species are known to also infect a variety of other animals, both as normal flora and opportunistic pathogens. [4] Klebsiella organisms can lead to a wide range of disease states, notably pneumonia, urinary tract infections, sepsis, meningitis, diarrhea, peritonitis and soft tissue infections.
Typical genera include: [3] Citrobacter are peritrichous facultative anaerobic bacilli between 0.6–6 μm in length. [4] Citrobacter species inhabit intestinal flora without causing harm, but can lead to urinary tract infections, bacteremia, brain abscesses, pneumonia, intra abdominal sepsis, meningitis, and joint infections if they are given the opportunity. [4]
Coliform bacteria include genera that originate in feces (e.g. Escherichia, Enterobacter, Klebsiella, Citrobacter). The fecal coliform assay is intended to be an indicator of fecal contamination; more specifically of E. coli which is an indicator microorganism for other pathogens that may be present in feces.
TMP/SMX is commonly used due to its ability to achieve high concentrations in urinary tract tissues and urine. This antibiotic combination demonstrates notable efficacy in both the treatment and prophylaxis of recurrent urinary tract infections. [12] Common adverse effects include nausea, vomiting, rash,pruritus, and photosensitivity. [26]