Learn about Enterobacter cloacae infection diagnosis, including clinical documentation, medical coding, and healthcare best practices. This resource covers E. cloacae, Enterobacter cloacae complex, and associated symptoms for accurate identification and treatment. Find information relevant to healthcare professionals, including coding guidelines and clinical criteria for Enterobacter cloacae infection.
Also known as
Other specified bacterial infections
Covers infections caused by Enterobacter cloacae, not classified elsewhere.
Other aerobic gram-negative bacteria
Includes Enterobacter cloacae as a specified aerobic gram-negative bacterium.
Bacterial infections of unspecified site
May be used if the site of Enterobacter cloacae infection is unknown.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the Enterobacter cloacae infection confirmed?
Yes
Is there a specified site of infection?
No
Do not code Enterobacter cloacae. Code the presenting symptoms or clinical findings.
When to use each related code
| Description |
|---|
| Infection caused by the bacteria Enterobacter cloacae. |
| Infection caused by bacteria in the Enterobacter genus (not cloacae). |
| Unspecified gram-negative bacterial infection. |
Confusing localized Enterobacter infection with sepsis can lead to upcoding or downcoding, impacting reimbursement and quality metrics.
Missing documentation of infection site (e.g., urinary, respiratory) causes coding errors and affects severity reflection.
Incorrectly coding Enterobacter cloacae complex instead of specific species when identified impacts data accuracy and research.
Q: What are the most effective empiric antibiotic treatment options for suspected Enterobacter cloacae bloodstream infection in adults?
A: Empiric antibiotic treatment for suspected Enterobacter cloacae bloodstream infections in adults should consider the local antibiogram and the potential for resistance. Third-generation cephalosporins (e.g., ceftriaxone, cefotaxime) or carbapenems (e.g., imipenem, meropenem) are often initially chosen due to their broad-spectrum activity. However, increasing resistance to these agents warrants consideration of alternatives like piperacillin-tazobactam, fluoroquinolones (e.g., ciprofloxacin, levofloxacin) if susceptibilities are known, or aminoglycosides (e.g., gentamicin, tobramycin) in combination therapy. Definitive therapy should be based on culture and sensitivity results. Consider implementing rapid diagnostic testing to guide antibiotic selection and optimize patient outcomes. Explore how antimicrobial stewardship programs can help reduce the emergence of resistant strains.
Q: How do I differentiate Enterobacter cloacae complex infections from other gram-negative bacterial infections like E. coli or Klebsiella pneumoniae in clinical practice?
A: Differentiating Enterobacter cloacae complex infections from other gram-negative bacteria like E. coli or Klebsiella pneumoniae based solely on clinical presentation is challenging due to overlapping symptoms. Definitive identification relies on laboratory testing, including culture and biochemical identification methods like the VITEK system or MALDI-TOF mass spectrometry. While certain characteristics like motility and the production of ornithine decarboxylase can help distinguish E. cloacae, these are not always reliable. Consider utilizing advanced molecular diagnostics for rapid and accurate species identification. Learn more about the different phenotypic and genotypic methods used to identify Enterobacter species and their clinical significance.
Patient presents with signs and symptoms suggestive of Enterobacter cloacae infection. Clinical presentation includes [Specific symptoms e.g., fever, chills, urinary tract infection symptoms such as dysuria, frequency, urgency, pneumonia symptoms such as cough, shortness of breath, or bloodstream infection symptoms such as hypotension, tachycardia]. Differential diagnosis includes other gram-negative bacterial infections such as Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Diagnostic workup includes urine culture, blood culture, sputum culture, or wound culture, as appropriate based on the presenting symptoms. Laboratory findings indicate the presence of Enterobacter cloacae, confirmed by gram stain and culture sensitivity. Antibiotic susceptibility testing is pending to guide definitive antimicrobial therapy. Preliminary treatment initiated with [mention specific antibiotic e.g., piperacillin-tazobactam, cefepime, or meropenem] pending susceptibility results. Patient's medical history includes [relevant comorbidities e.g., diabetes, immunosuppression, recent hospitalization, or indwelling medical devices]. These factors may contribute to the development of Enterobacter cloacae infection. Patient will be monitored for response to therapy and potential complications such as sepsis, septic shock, or multi-organ failure. ICD-10 code [appropriate code e.g., B96.8, A49.89, J15.21] will be utilized for coding purposes. Treatment plan will be adjusted based on culture and sensitivity results and clinical response. Patient education provided regarding infection prevention measures and medication adherence. Follow-up scheduled to assess treatment efficacy and monitor for any adverse effects.