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 speciesled
     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

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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.
  • Source: https://en.wikipedia.org/wiki/Providencia_stuartii

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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.  

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

Disclaimer

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