Background: Citrobacter spp. are known opportunistic pathogens. Recent reports have indicated concerningly high rates of carbapenem resistance in long-term care hospitals. In this study, we investigated the characteristics of carbapenemase genotypes in carbapenem-resistant Citrobacter spp. (CR-Citrobacter spp.) isolated from clinical and surveillance specimens. Methods: CR-Citrobacter spp. isolates were collected from Seoul Clinical Laboratories in 2023. The isolates underwent multiplex polymerase chain reaction (PCR) analysis for the detection of six carbapenemase genotypes (KPC, GES, IMP, NDM, VIM, and OXA-48-like) using the PANA Real Typer CRE Kit (PANAGENE, Korea). Results: Among 329 CR-Citrobacter spp. isolates, 289 (87.9%) were from patients aged 60 years or older, with the majority isolated from long-term care hospitals (255, 77.5%). C. koseri was predominant in both the clinical and surveillance isolates at 84.7 % (72/85) and 67.6 % (165/244), respectively. KPC (76.5%) was the most common carbapenemase genotype detected in the clinical isolates, followed by OXA-48-like (11.8%) and NDM (8.2%). Double carbapenemase genotypes were detected in eight isolates (2.4%). Conclusion This study revealed a high prevalence of CR-Citrobacter spp., particularly C. koseri, in long-term care hospitals. The predominance of KPC-producing C. koseri highlights the need for enhanced surveillance and infection control in long-term care hospitals.

OBJECTIVES: It has been reported that caregivers of patients with chronic mental illness including schizophrenia are in higher risk for psychological and physical health problem. This study was performed to evaluate the depressive symptoms and associated factors in caregivers of patients with chronic mental illness. METHODS: The subjects were 77 unaffected caregivers (30 parents, 30 siblings, 10 offspring, and 7 spouses) of patients with chronic mental illness (62 schizophrenia, 4 schizoaffective disorder, 11 bipolar disorder) and 100 healthy controls. Depressed mood was assessed by Beck Depression Inventory (BDI) in all subjects. For their sick family members, clinical factors including psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS), duration of illness, number of admission were assessed. RESULTS: The mean BDI score of the caregivers was significantly higher than that of control subjects (11.2+/-11.6 and 8.0+/-7.5). Given that 23.4% of family group and 23.0% of control group are attributed to mild to moderate depressed state and 22.0% of family group and 8.0% of control group to above moderate depressed state, significant depressive symptom is more frequently observed in family group. The mean BDI score of parent group was higher than that of sibling group controlling for sex and age. In the parent group, BDI scores are positively correlated with age while the offspring and spouse group had negative correlation between BDI scores and age. Higher age, lower socioeconomic state, more severe positive symptom scores of patients were potential predictors for BDI scores of caregivers. CONCLUSION: This study showed that caregivers of patients with chronic mental illness have significant depressive symptoms. It may be suggested that depressive symptoms of caregivers are associated with aging, low socioeconomic state, and severe positive symptom rather than chronicity of their sick family members.
Aging ; Caregivers ; Depression ; Humans ; Parents ; Psychotic Disorders ; Schizophrenia ; Siblings ; Spouses