Providencia Species

Providencia species

Background:

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Enterobacteriaceae (Gram Negative Bacilli)
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>Citrobacter species:
     1] Citrobacter koseri
     2] Citrobacter freundii
>Enterobacter species:
     1] Enterobacter cloacae,
     2] Enterobacter aerogenes)
>Escherichia coli
>Klebsiella species:
     1] Klebsiella ozaenae
     2] Klebsiella pneumoniae
     3] Klebsiella rhinoscleromatis
>Morganella species
     1] (Morganella morganii)
>Proteus species:
     1] Proteus mirabilis
     2] Proteus vulgaris
>Providencia species:

     1] Providencia_rettgeri
     2] Providencia stuartii
>Salmonella species:
     1] Salmonella enteritidis
     2] Salmonella typhi
     3] Other
>Serratia marcescens
>Shigella species:
     1] Shigella dysenteriae (serogroup A)
     2] Shigella flexneri
     3] Shigella boydii
     4] Shigella sonnei
     5] Other

Providencia rettgeri:

Gram negative bacterium that is commonly found in both water and land environments.
Providencia rettgeri can cause a number of opportunistic infections in humans and can be found in the human gut. It has been known to cause urinary tract infections and traveller’s diarrhea.
Characteristics: 1) Motility: Positive 2) Gas from Glucose: Positive 3) H2S Production: Positive 4) Lactose Fermentation: Positive 5) Acid from Xylose: Negative 6) Acid from Mannitol: Positive
P. rettgeri is one of the 5 species found in the genus Providencia:
- Providencia stuartii,
- Providencia alcalifaciens,
- Providencia rustigianii,
- Providencia rettgeri
- Providencia heimbachae

Providencia stuartii:

Gram negative bacterium that is commonly found in soil, water, and sewage.
P. stuartii is the most common of the 5 species found in the genus Providencia capable of causing human infections.
Providencia stuartii is an opportunistic pathogen seen in patients with severe burns or long-term indwelling urinary catheters. Elderly individuals are at a greater risk for P. stuartii infections.
In humans, P. stuartii can be isolated from urine (most common), stool, and blood, as well as from sputum, skin, and wound cultures.
P. stuartii septicemia is primarily of urinary origin.

Therapy:

Important considerations: The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions. Generally, the most common agents/regimens are listed first. Listed dosages may need to be adjusted for renal dysfunction.

Ciprofloxacin 500-750 mg orally q12h or 400mg IV q12h
Levofloxacin 500mg – 750 mg IV/PO once daily
Piperacillin-tazobactam (Zosyn ®) 3.375 grams IV q6h
Meropenem 0.5 – 1 gram IV q8h
Amikacin 5 – 7.5 mg/kg/dose q8-12h (patient-specific pharmacokinetic dosing required)